Core Curriculum in Internal Medicine

Family Medicine residents are assigned to four months of Internal Medicine during the first year of training. These months are split between the Internal Medicine service and the inpatient Family Medicine service. This also includes experience in the Medical Intensive Care Unit. During the second year, residents have four months of internal medicine on the family medicine in patent service. In the second and third years, residents are required to take medicine subspecialities in cardiology and dermatology.

While on inpatient Internal Medicine, they are assigned to one of the three geographical teaching units. On teaching units, they are full members of the resident staff consisting of three first-year residents and two second-year residents. There is one full-time, board certified internist in charge of teaching on each unit. The Family Medicine team consists of three to four residents under the direction of faculty family physicians and attendings.

Core Curriculum in Pediatrics

Family Medicine residents are assigned to three months of Pediatrics in their first year; one month in their second year; and a third-year pediatric ambulatory month. The curriculum includes a one-month, full-time rotation in the Neonatal Intensive Care Unit/NBN at Detroit Riverview Hospital, emphasizing resuscitation and stabilization of newborns. Family medicine residents work closely with the pediatric residents under the direction of the chief of the Department of Pediatrics and the full-time faculty.

Core Curriculum in Obstetrics and Gynecology

Family Medicine residents spend two months on OB during their first year of training. The obstetrical service at SJH&MC is one of the largest in the state, averaging approximately 250-300 deliveries per month. A family centered LDRP unit provides a state-of-the-art setting.

The objective of training in obstetrics and gynecology is to teach residents the management of normal obstetrics and to identify potential problems. The importance of family centered obstetrics is stressed, with emphasis on prenatal education for parents, natural delivery and bonding. In the OB clinic residents are expected to evaluate and conduct normal prenatal care for expectant mothers, follow post-partum patients and assist in the management of high-risk patients.

The residents will follow patients they see in the Family Medical Center through their prenatal course, assist the mothers during birth, follow their postpartum course and care for the newborns. Four full-time family physicians in the department are available for OB supervision in the office and in the labor and delivery suite. Consultation with OB specialists is available when needed. Family Medicine residents also have the opportunity to care for high-risk obstetrical patients in the High-Risk Obstetrical Clinic under the direction of the chief obstetrical resident and full-time obstetrical staff.

During the second year, a block month is devoted to GYN under the direction of a precepting gynecologist. While on gynecology service, residents learn to perform a complete pelvic exam on office patients and on preoperative admissions. Residents assist on minor gynecological surgeries and procedures such as D&Cs, biopsies and colposcopies. Residents will also assist on some major gynecological surgeries. Family Medicine residents are actively involved with the management of emergency gynecological patients.

For residents who wish to make obstetrics and gynecology a significant part of their future practice, an additional three months of experience in this department is recommended and easily obtained through available electives.

Core Curriculum in Surgery

Two months of the Family Medicine curriculum are spent in general surgery. The first month is a preceptorship with a busy general surgery practice at River District Hospital. This affords the resident a full spectrum surgical experience, including pre-operative diagnosis and preparation, intra-operative skills and post-op management and follow-up. They are also exposed to an environment where family physicians are routinely involved in the surgical procedures for their patients.

The second surgical month is an ambulatory experience. Residents work with general and specialty surgeons in their offices performing minor surgical procedures. The experiences focus on those problems that the FM would encounter in their future practice and the procedures that they may perform.

During PGY III, residents have an optional procedure based elective experience that includes OR experience, endoscopy experience and casting work.

Core Curriculum in Behavioral Science/Psychiatry

Family Medicine residents spend one month in Psychiatry during the second year of training. The rotation is designed around the Psychiatric-Medical Unit and the Psychiatric Consultation Liaison Service at SJH&MC. Residents learn to diagnose and manage a variety of psychiatric problems under the guidance of staff psychiatrists and psychologists. The teaching focus is on differential diagnosis, treatment formulation and psycho-pharmacology. Behavioral science is an ongoing curriculum dealing with the psycho-social factors affecting the health of the individual and family. The methodology includes didactic lectures, videotaping and individual precepting with the behavioral scientist.

Electives Offered

The Family Medicine resident will have a total of five months of elective time in the second and third years. The resident has the option of either inpatient or outpatient electives. All electives are selected by the residents with prior approval of the program director and the participating physician on the elective.

Certain electives which are strongly recommended include:

• allergy
• cardiovascular disease
• community medicine
• emergency medicine
• endocrinology
• gastroenterology
• hematology
• industrial medicine
• infectious diseases
• medical ethics
• nephrology
• obstetrics and gynecology
• oncology
• oral surgery
• pathology
• pediatrics
• physical medicine
• plastic surgery
• psychiatry
• pulmonary diseases
• rheumatology
• podiatry
• rural preceptorships
• sports medicine

Core Schedule

PGY I

• 1 month orientation
• 2 months IM floor (SJH&MC)
• 1 month MICU floor (SJH&MC)
• 1 month FM floor (SJH&MC)
• 2 months IP Peds (SJH&MC)
• 1 month OB (SJH&MC)
• 1 month OB (DRH)
• 1 month NBN/NICU (DRH)
• 1 month rural FM (RDH)
• 1 month ER-Adult (SJH&MC)
  

PGY II

• 4 months FM floor (SJH&MC)
• 1 month GYN
• 1 month ER SJH&MC (Adult/Peds)
• 1 month Cardiology (SJH&MC)
• 1 month Orthopedics (SJH&MC)
• 1 month General Surgery (RDH)
• 1 month OP Surgery (SJH&MC)
• 1 month elective
• 1 month Psychiatry
  

PGY III

• 1 month Amb Peds (RDH)
• 1 month Community Medicine
• 1 month Occupational Med
• 1 month Ophth/ENT
• 1 month Urol/Practice Management
• 1 month Derm
• 1 month Family Medicine
• 1 month Orthopedics (RDH)
• 4 months Electives

Call

While serving on inpatient rotations, residents have call approximately every fourth night. While on outpatient rotations, they share in covering the FM inpatient service.

This translates into call for PGY I - PGY III as listed below:

• PGY I 1 call every five days (-70 calls)
• PGY II 1 call per week (-50 calls)
• PGY III 2 calls per month (24 calls)
  

For more information or an application you can write to the following address,
call (313) 343-3875, or email Kim Mahoney.

Medical Education Department
St. John Hospital and Medical Center
22101 Moross Road
Detroit, Michigan 48236