Curriculum
First Year
Your initial orientation focuses on the basic principles and philosophy of family medicine with more extensive training during the second and third years of your residency. As a first year resident, you are introduced to the Family Health center, seeing patients twice weekly on a half-day basis building your practice continuity. This experience, along with a range of inpatient block (four-week) rotations, is designed to help you begin practicing and building on the skills and training you received in medical school.
Second Year
As a second year resident, you take on a more active role in the direct care of your patients. Increased responsibility and a more intense work schedule require effective time management. You also spend more time in the Family Health Center. The medical surgical areas of family practice become an important part of our training as the number of your hospital and Health Center patients grows. Through your individual patient experiences and ambulatory rotations, our program will help you develop a greater understanding of family medicine.
Third Year
During the third year of your residency, you spend four half days in the Family Health Center each week with a practice mix of as many as 200 families. You select your elective rotations based on your special areas of interest. In addition, as you become well acquainted with your instructors and consultants, your teaching responsibilities increase. Your relationship with junior residents and medical students is a very important part of the learning experience throughout your training, but particularly in your third year.
Your initial orientation focuses on the basic principles and philosophy of family medicine with more extensive training during the second and third years of your residency. As a first year resident, you are introduced to the Family Health center, seeing patients twice weekly on a half-day basis building your practice continuity. This experience, along with a range of inpatient block (four-week) rotations, is designed to help you begin practicing and building on the skills and training you received in medical school.
Second Year
As a second year resident, you take on a more active role in the direct care of your patients. Increased responsibility and a more intense work schedule require effective time management. You also spend more time in the Family Health Center. The medical surgical areas of family practice become an important part of our training as the number of your hospital and Health Center patients grows. Through your individual patient experiences and ambulatory rotations, our program will help you develop a greater understanding of family medicine.
Third Year
During the third year of your residency, you spend four half days in the Family Health Center each week with a practice mix of as many as 200 families. You select your elective rotations based on your special areas of interest. In addition, as you become well acquainted with your instructors and consultants, your teaching responsibilities increase. Your relationship with junior residents and medical students is a very important part of the learning experience throughout your training, but particularly in your third year.
Three-Year Curriculum
(13 Four-Week Blocks Per Year)
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Third-Year Selective Choices Include:
- Dermatology
- Neurology
- Nephrology
- Sports Medicine
- Endocrinology
- Research
(Selectives will be treated as an in-house rotation and residents will see their patients in the FHC four half-days per week and attend all morning reports and lectures.)
Course of Training
Your schedule of clinical rotations is designed to meet ACGME and AOA requirements for internship and family medicine. Your residency training also includes regular conference presentations, grand rounds and seminars. Osteopathic principles and practices are emphasized throughout the residency for our osteopathic FP residents.
As a second and third-year resident, a more demanding schedule is expected as you become more involved in ambulatory patient care. Procedural skills and providing empathetic patient and family-oriented care are hallmarks of our program. Throughout your three years, your progress is closely monitored with regular feedback. The following clinical rotations and objectives are included in the training curriculum.
Internal Medicine
As a first-year resident, your primary responsibility is to learn the basic principles associated with internal medicine and to provide the medical attention your patients need. During the second year, you continue to manage your own patients, as well as those with more complicated illnesses, including intensive care and step-down unit cases. Throughout your three years, responsibilities increase in patient care and in the teaching and supervision of junior resident cases.
Obstetrics/Gynecology
Many family physicians have chosen to include obstetrics and gynecology in their practices. Since obstetrics remains a field of high risk, we have designed our program to meet these demands with intensive, rigorous training. Throughout residency training, you are responsible for a large number of patients, including routine and at-risk pregnancies. This clinical rotation allows you to perform vaginal deliveries and assist in cesarean sections. You learn to recognize which patients require assistance from an obstetrician and you are trained in a variety of other areas including nutrition, breast feeding, and preparation for parenting. Our requirements in this area are more rigorous than the usual family medicine residency.
Pediatrics
There is an emphasis on pediatrics in the Family Health Center. Throughout residency, you handle a variety of illnesses both on an inpatient and outpatient basis. You will attend conferences and participate in a variety of specialty clinics including Cardiology, Neurology, Gastroenterology, Pulmonology, and Endocrinology. These clinics are staffed with highly qualified pediatric sub–specialists from the University of Michigan - Ann Arbor.
Surgery
Throughout residency, you are trained in a variety of surgical procedures, many of which can be performed in your office on an outpatient basis. Since you are the first physician many of your patients will see, competency in this area is extremely important. You are expected to provide the initial diagnosis and often the initial care for emergency surgical problems. This surgery rotation provides a strong background in diagnosis, outpatient and emergency surgery. Emphasis is also placed on post-operative care.
Behavioral Science
Your behavioral science curriculum serves as an integral part of residency training. Health and illnesses are approached from a biopsychosocial perspective. The Family Health Center is the primary learning site for this training. The family medicine faculty is available to review recorded physician/ patient interactions with you to help improve your communication and technical skills. This is accomplished both with one-on-one precepting as well as scheduled videotaping. During the first year, you will gain experience in the psychological aspects of chronic illness while on your medicine rotation. As a second and third-year resident, you will also complete a two week behavioral science rotation. The doctor/patient relationship, family relationships and social issues affecting health are among the topics covered. Psychologists and psychology fellows are available to assist you.
Geriatrics
As part of the geriatric training, your studies include important topics such as Alzheimer's disease and other dementias, depression, cardiac and renal diseases, as well as various lectures on related health issues. You also conduct home visits with our Case Management Team. Your course of training includes inpatient and outpatient evaluation and management of elderly patients covering a wide array of illnesses. The ability to provide primary care and consultation for the older adult in acute, ambulatory and community long–term care situations is an important part of your training.
Neonatology
During your one-month rotation in the Neonatal Intensive Care Unit (NICU) at the University of Michigan Medical Center - Ann Arbor, you are trained to manage a variety of life-threatening situations. All patient care in the NICU is supervised by a neonatologist and the senior resident assigned to your team. Your individual responsibilities are very specific; performing case histories and physical examinations, as well as the daily management and transfer management of neonatal patients. This rotation is the only part of your residency training spent away from the Medical Center or Family Health Center campuses.
Psychiatry
In addition to your training in behavioral science, a specific rotation in psychiatry is offered with course training in major psychiatric diagnoses including depression, bipolar disorder, schizophrenia, personality disorders and applying these concepts in clinical situations. Eliciting the history, signs and symptoms often associated with substance abuse along with various therapeutic measures including pharmacologic, psychoanalytic and behavior modification is stressed. Performing various screening exams such as the Mast, Beck Depression Scale and general screening questions to determine risks for suicide are also part of the training.
Orthopedics
Disorders of the musculoskeletal system are common and family medicine physicians require special training in this area. You learn to diagnose and treat patients with common orthopedic disorders through a rotation that includes training in the orthopedist's office, clinics, emergency room and operating room. The second year provides training in reading radiographs and accurately describing all types of fractures along with the ability to stabilize fractures (casting, wrapping). You learn proper diagnosis and treatment of orthopedic problems such as congenital hip dislocation and Legg-Calve-Perthes disease along with common musculoskeletal disorders such as back pain and sports injuries.
Urology
Your course of training in urology includes diagnosis and treatment of common urological problems within the scope of a family physician. Good patient communication skills are vital as you learn to appropriately discuss various health issues, such as impotence and infertility The emphasis of this rotation is on common outpatient urological management. We feel this makes your urological consulting and referral more appropriate.
Ear, Nose and Throat
The ENT rotation includes the ability to accurately diagnose and initiate treatment for common ENT disorders including otitis media, vertigo, tinnitus, sinusitis, laryngitis and tonsillitis. Good patient communications skills are stressed as you learn to discuss various health concerns such as hearing aids, myringotomy tubes, treatment options for tonsillitis and various others. Along with basic office procedures such as laryngoscopy, you learn the ability to recognize when to refer first–line treatment failures to specialists for possible surgery.
Ophthalmology
Ophthalmology training includes diagnosis and treatment of outer eye problems such as strabismus, disorders of the eye lid, conjunctivitis, corneal abrasions, and trauma. Diseases of the inner eye including glaucoma, cataracts and retinal changes associated with common metabolic disorders, such as hypertension and diabetes, are part of the training. Procedures essential to providing quality ophthalmologic care include thorough funduscopic exams, proper use of a slit lamp, and removal of foreign objects from the eye.
Dermatology
Office dermatologic procedures such as bacterial and fungal cultures, skin biopsies and removal of moles and warts along with the diagnosis, treatment, and required healing time for most common primary skin disorders are part of your course training in dermatology. Ongoing lecture series as well as office rotation provides the basis for diagnosing and managing acne, eczema, psoriasis, and other common skin conditions.