Tracks/Areas of Concentration

Addiction Medicine

Learning Objectives

• To develop a greater breadth and depth of medical knowledge and clinical skills in addiction medicine.
• To experience addiction medicine across a variety of inpatient and outpatient clinical settings in an integrated care model.
• Gain additional experience and develop competency with Medication Assisted Therapy (MAT) inductions and maintenance.
• Develop academic scholarship skills in addiction medicine.

Expectations for the AOC Achievement

• Curricular expectations
  • Complete a total of six weeks of elective time in a variety of settings
• Required electives
  • Complete the two week Suboxone elective, which includes working with outpatient and inpatient MAT programs
  • Complete the two week addiction medicine elective, which includes working with outpatient MAT programs, experiencing group sessions, and managing co-occurring mood disorders
• Additional electives
  • Complete two weeks of elective time in a clinical setting or area of addiction medicine that interests you
    • Examples include acute detoxification settings such as Helio Health; rural outpatient MAT programs such as CASA; inpatient assessment rotations such as Toxicology at Strong Memorial Hospital; etc.
• Participate in MAT inductions
  • By participating in the AOC, priority will be given to you for inpatient induction consultations and bridge consults based on your rotation schedule
    • Residents in AOC currently on Team AB / Team C, outpatient electives will have priority for inpatient consults
    • If possible, induction consultations will be scheduled with an AOC resident in clinic for MAT follow-up and maintenance
• Attend eight or more HFM Controlled Substance meetings during the course of the residency program
• CME Expectations
  • AOC residents are expected to attend at least one regional or national CME conference during the residency program that focuses on addiction medicine, or one general FM national conference with workshops specific to addiction medicine
• Scholarly Work
  • AOC residents are expected to either produce a paper or article for consideration of publication, or, present a poster, lecture, or workshop at a regional or national meeting
  • Present two cases at HFM Controlled Substance meetings.

Determination of AOC Achievement

Achievement of an AOC in addiction medicine will not be determined until the third year of residency. A committee will convene to determine if the resident has achieved an area of concentration. Initially, this committee will consist of the Director/Co-Director of Addiction Medicine, the Residency Director, and the Residency Program Coordinator.

Medical Education

To develop hands-on teaching and other related skills important to the practice of medical education, and to equip the resident to provide high-yield educational experiences to students and residents over the course of their career. By graduation, participants will:

• Demonstrate evidence of both quantity and quality of educational work by creating an Educator's Portfolio.
• Identify strengths, areas of improvement, and long-term career goals through an Educator's Personal Statement.
• Develop group facilitation skills by leading at least two educational sessions for either medical students, residents, or both, in collaboration with a faculty member.
• Develop lesson planning skills by creating the content of at least one of the two aforementioned educational sessions, with faculty supervision.
• Develop clinical teaching skills by precepting medical students in clinic and doing direct observation of junior resident peers in clinic using the PCOF, and providing verbal and written feedback to them and their supervisors.
• Interpret medical education literature through participation in a journal club or SOFM format.
• Contribute to medical education at the University of Rochester Family Medicine Residency or the University of Rochester School of Medicine and Dentistry through curriculum development, program evaluation, or other educational project, and submit the work for presentation either locally, regionally, or nationally.

Political Advocacy & Leadership Track (PALT)

The goal of the Political Advocacy and Leadership Track (PALT) is to give residents the skills to improve our health care system and the health of our patients through political advocacy and leadership.

The PALT track meets monthly for most of the year. Meeting alternate between outside speakers and workshops designed to give residents practical skills for political advocacy.

Previous speakers have included:

• Kristen Gillibrand, U.S. Senator
• Joe Morelle, U.S. Congressman
• Michael Mendoza, M.D., MPH, Monroe County Health Commissioner
• Peter Robinson, Chief Operating Officer, University of Rochester Medical Center
• Chris Bell, Executive Director, Monroe County Medical Society

Topics have included:

• COVID pandemic and the role of the family physician promoting public health
• Black Lives Matter and racial disparities
• Addressing poverty in Rochester
• Reproductive rights
• Climate change and it's health impacts
• Nutrition and food deserts in Rochester
• Opioid Crisis

Workshops have included a variety of advocacy skills:

• How to lobby elected officials
• Writing effective letters to the editor
• Brief public speaking and TV appearances
• Composing resolutions for NYSAFP and AAFP Congress of Delegates promoting voter registration

Members of PALT are encouraged to get involved in the New York State Academic of Family Physicians, the American Academy of Family Physicians and other FM organizations, as well as our local Monroe County Medical Society. Previous residents have become members of Commissions, Boards of Directors and Congress of Delegates for these organizations. Residents are strongly encouraged to attend the yearly Family Medicine Advocacy Conference in Washington each May, where they have the opportunity to meet their federal legislators.

Interested residents can make PALT their Focused Area of Interest (FAI) or Area of Concentration (AOC).

Geriatric

The Geriatric Area of Concentration is supported by a Geriatric certified Family Physician on our faculty. Requirements include:

• Documentation of satisfactory completion of four weeks of approved geriatric medicine elective
• Documentation of satisfactory completion of all scholarly work requirements, including copies of presentation materials used (posters, slides, etc.)
• Copies of progress notes from additional geriatric home visits
• Documentation of attendance at an approved geriatric medicine CME conference.

Global Health Track

Established in 2003, this track prepares highly motivated and accomplished residents to care for under served populations anywhere in the world. Up to six interested residents per class are selected to enter the global health track. Each Fall and Spring trip usually has 4-6 residents traveling to work at the site. While further detail of this site can be found on the global health page, we would like to highlight a few important features of this track:

• Didactic training occurs in the U.S. to prepare residents for working in international sites
• GHT residents make up to 3 trips during their residency to work in an under served setting in Honduras, which is the primary overseas site
• Travel expenses and insurance are covered by the Program for times spent overseas
• Department faculty travels to Honduras with the residents
• Training is also available to residents who want to participate in an international experience but do not wish to commit to the full GHT program.

Maternal & Child Health Track

One of the long standing strengths of our program, maternal and child health, has remained an important focus with extensive obstetrical training for those residents who are particularly interested in including OB in their future practices. Some of the highlights of this track include:

• Obstetrics and Gynecology training occurs at Highland Hospital, a community hospital where residents generally accumulate experience with 40-60 deliveries in their required two blocks on service in the first year
• Those who wish to pursue additional OB training have the opportunity to do another 2-3 blocks and can amass up to 100 or more deliveries, with opportunities to first assist Caesarean sections, as well as perform vacuum-extraction deliveries
• OB track residents will take second call on the Labor and Delivery service, providing an opportunity to be involved in all complicated deliveries and gain more experience with ultrasound, Maternal-Fetal Medicine and newborn care
• Certified Nurse-Midwives are a constant presence on the labor deck and add to the diversity of the maternity care experience managing routine and high-risk patients.

Research Area of Concentration

Learning Objectives include:

• To gain knowledge about the basics of research subject safety and  research study design
• To gain experience in writing research study protocols and conducting a clinical research project
• To develop academic scholarship skills in data analysis, writing up and presenting research findings
• To gain networking experience in attending and presenting at national conferences
• To gain exposure to different types of clinical research projects that can be done within the scope of family medicine.

Integrative Medicine

To develop foundational knowledge in core, evidence-based integrative medicine topics to equip residents with the skills needed to deliver high quality integrative medicine in the acute clinical setting and in the prevention and management of chronic disease.

By graduation, AOC participants will:

• Acquire knowledge of and practice in the application of integrative medicine in the clinical setting.
• Identify an area of focus within Integrative Medicine and increase evidence-based knowledge and management skills in that area.
• Create long-term career goals through capstone statement on how one will implement IM in his/her future practice.
• Develop clinical teaching skills by educating peers and faculty on how to implement IM into their clinical practice.
• Develop connections and understand community resources for integrative medicine.

Expectations for AOC Completion/Curricular Activities:

• Complete "Integrative Medicine for Residency (IMR)" online modules (200 hours total) and pass the final exam by graduation (LO1)
  • Lead at least two module reviews during journal club (LO4)
  • Prepare handouts or resources (smart phrases, notes, etc.) to help other residents and faculty with information (LO4)
• Residents will choose a single "area of focus" within IM, as approved by Dr. Kaizuka, in which they create a portfolio of the latest research and clinical management guidelines to be applied to the resident's clinical practice (LO2).
  • Portfolio can include:
    • Presentations or teaching (see #5)
    • IMR journal club module reviews
    • Developed smart phrases, etc.
  • Topics for and "area of focus" can include, but are not limited to:
    • Sleep Medicine
    • Spirituality and Health Care
    • Stress and Mind Body
    • A particular chronic illness of choice and management
      • Integrative Rheumatology
      • Topics in Obesity
      • Integrative Gastroenterology
      • Integrative Microbiome
      • Integrative Oncology
      • Integrative Hypertension
      • Integrative Endocrinology
      • Diabetes Care
    • Chronic Pain Management
    • OB/GYN
    • Environmental Medicine
    • Mental Health
      • Approach to Anxiety and Depression
    • Whole Systems Medicine
    • Vitamins, Minerals, and Supplements
• Demonstrate effective application of IM knowledge in the clinical setting as evidenced by review of five self-chosen clinical notes (LO1)
• Develop a capstone statement of 1-2 pages that addresses future professional goals within the context of Integrative Medicine (LO3)
• Educate peers and faculty by leading at least two educational sessions, with content created by the AOC resident but in consultation/collaboration with associated faculty (LO4).
  • Options to present include:
    • Thursday Teaching
      • Mystery Case
      • Didactic Teaching
    • Grand Rounds
• Attend one Integrative Medicine conference event either locally, regionally, or nationally. (LO5) Options include, but are not limited to one of the following:
  • Academy of Integrative Health and Medicine (AIHM)
  • Complementary and Alternative Medicine (CAM)
  • Annual Integrative Medicine Conference (UMMSOM)
  • Nutrition and Health Conference by University of Arizona
  • Functional Medicine Conference
• Complete at least two weeks of electives in Integrative Medicine
  • This will help provide resources back to the residency program and also further resident's practical experience with other IM professionals in the community. (LO6)

Determination of AOC Achievement

• Resident will meet with Dr. Kaizuka on a quarterly basis to track progress on the above activities and objectives.
• Provide a copy of a capstone statement
• Provide a copy of the portfolio on chosen "area of focus" which includes:
  • Pertinent presentations/educational session summaries that relate to area of focus.
  • Resident developed clinical tools (such as smart phrases, informational handouts, etc.)
  • Pertinent IMR journal club module reviews
• Provide copies of at least five de-identified clinical notes demonstrating implementation of IM principles in clinical practice.
• Provide a copy of completed IM online modules and a proof of passing the final exam.
• Provide proof/dates of IMR conferences attended and copies of other presentations (not already included in the "area of focus" portfolio)
• Provide dates of IMR Journal Club attendance and copies of modules presented (not already included in the "area of focus" portfolio)

Determination of AOC completion is made by Dr. Kaizuka and Dr. Schultz by May 1st of the third year of residency.

Sports Medicine

The Sports Medicine Area of Concentration offers an opportunity for interested residents to expand their interest and exposure to the field, beyond what is offered through the Sports Medicine rotation in the 3rd year. Residents pursuing this area of concentration will have increased opportunities to:

• Develop academic scholarship skills in sports medicine
• Develop advanced examination skills of the musculoskeletal system
• Gain additional experience and develop proficiency in the following areas:
• Creating orthotics for injury management
• Performing sports pre-participation physical exams
• Assisting as team physician for various high school and college athletic programs
• Diagnosing and managing sports medicine and orthopedic injuries
• Caring for medical problems in the athlete
• Performing orthopedic procedures, including: joint and soft tissue injection/aspiration, fracture management and reduction, casting and splinting, joint relocations, etc.
• MSK ultrasound teaching/learning.

Osteopathic Manipulative Treatment

• To further advance osteopathic manipulation skills throughout residency for both DO and MD residents with access to a Family Medicine Osteopathic Preceptor(s).
• To encourage scholarly work in the field of osteopathy.
• To develop resident's teaching skills of osteopathic techniques.
• To incorporate the core osteopathics principles into daily practice as family physicians.

Expectations of Participants Include:

• OMT Clinical Care Experience
• Conference Attendance
• Scholarly Work
• Teaching Core Principles to other learners