Family Medicine

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Family Medicine Residency Curriculum

IU Methodist Family Medicine Residents benefit from comprehensive training in all aspects of family medicine. The program curriculum includes traditional four-week block rotations along with longitudinal rotations, electives and other personalized educational opportunities as well as a weekly seminar series.

First Year Curriculum

The first-year Family Medicine Residency curriculum is divided into thirteen four-week blocks. All first-year residents (or interns) take CORE 1 in July and then proceed through individualized schedules for the remainder of the year.

Orientation and CORE 1 provide an introduction to the clinical activities, knowledge and skills that interns need to successfully start residency. Interns spend one week in the outpatient setting and one week in the inpatient setting, working one-on-one with attending physicians and upper-level residents. The other two weeks consist of educational seminars, skill training and certification courses, including Cadaver Lab, Resident Retreat, Hospital Systems Training (Inpatient/Outpatient), GME Orientation, Compliance and Documentation, Using Interpreters, ALSO Certification, ACLS/BLS Certification, PALS Certification, NRP Certification and OSCEs.

CORE 2 is an outpatient-clinic focused rotation based at the Family Medicine Center. This rotation offers first-year residents the opportunity to enhance their chronic disease management, communication, counseling and procedural skills through interdisciplinary work with attendings, behavioral science faculty and on-site PharmDs. In addition, residents create patient education videos. During this PGY1 CORE 2 rotation, interns experience a variety of rotations including emergency medicine, family medicine inpatient services, general surgery inpatient, obstetrics, inpatient pediatrics, renal care and sports medicine.

First-year Family Medicine residents gain emergency medicine experience at IU Health Methodist Hospital, a Level 1 trauma center. Scheduled as an integral resident member of the emergency room, residents rotate through sections of the Emergency Department alongside Emergency Medicine residents. Family Medicine residents are required to staff patients with Emergency Medicine faculty prior to the patient’s discharge.

The three family medicine inpatient (FMI) rotations during the PGY 1 year are completed at IU Health Methodist Hospital, with more than 750 available beds, where the Family Medicine Residency has its own inpatient service. Many patients admitted to the service meet the Inter-Qual criteria for critical illness but are not necessarily admitted to the ICU. The FMI regularly admits and retains primary management of their non-ventilator critically ill patients in the PCU. There is close supervision on the inpatient rotation by upper-level family medicine residents.

On this rotation, the resident joins a general surgery inpatient team, which is led by a senior staff surgeon and includes one senior surgery resident and one PGY1 family medicine resident. The family medicine resident is a full and equal member of the team performing such duties as patient evaluation in the emergency room, diagnostic workup after admission, attendance during surgical operations, performance of indicated procedures, and active involvement in pre- and post-op care. This rotation is completed primarily at IU Health West Hospital.

Family medicine residents complete two obstetric (OB) rotations during the PGY 1 year. This rotation includes coverage in the obstetric area of IU Health Methodist Hospital, OB ultrasound experience in the Residency’s Family Medicine Center, and outpatient prenatal care experience at an Indianapolis Federally Qualified Health Center with one-on-one faculty teaching. This rotation is a night float rotation and is typically very busy. When the family medicine service is quiet, residents are expected to work with the midwives in the hospital that allows for consistent opportunities to obtain high volume experiences.

The two pediatrics inpatient rotations during the PGY 1 year are completed at Riley Hospital for Children at Indiana University Health, IU Health Methodist Hospital (newborn), and/or IU Health West. The Riley pediatric ward patient population consists of both private and service patients. A pediatric faculty member staffs inpatient pediatric wards for all service patients, rotating on a monthly basis. On Newborn, residents work with the pediatric faculty caring for all newborns that do not have a private pediatrician. Rounds are completed daily with a pediatric faculty member.

On the renal rotation, family medicine residents experience a combination of inpatient/ outpatient clinical training and work one-on-one with a nephrologist.

On this rotation, time is dedicated to joint examination, injury care, rehabilitation, injection technique and exercise prescriptions. Residents spend additional time with certified casting technicians. Musculoskeletal radiologists teach clinically oriented radiography. Physical therapists aid in the teaching of exercise prescriptions, therapeutic rehabilitation, and use of modalities in the treatment and recovery from injury.

Second Year Curriculum

During the second year of resident training, PGY2 residents experience a wide variety of rotations and electives.

Core rotations for second-year family medicine residents are designed to enhance residents’ outpatient clinical competencies as a continuation of the longitudinal CORE structure begun in intern year. Residents in second year COREs focus on developing their addictions medicine, practice management, and ENT knowledge and skills. Behavioral science, scholarship and community outreach activities are threaded throughout the three COREs, allowing residents to build on knowledge and skills developed in prior rotations and to immediately apply it in the outpatient clinic setting. Second year residents on COREs also have the opportunity to staff the majority of the Family Medicine Center specialty clinics, including the respiratory, pain management, procedure and ultrasound clinics.

Three family medicine inpatient rotations occur during the PGY2 year. The rotation description is the same as PGY1 rotations; but the PGY2 resident has an increased level of supervision of PGY1 residents and medical students.

The required geriatrics rotation includes didactics and clinical care, with home visits and nursing home visits made with supervising faculty. During this month, residents spend time with multiple providers of care for geriatric patients: rehabilitation providers, podiatrists, geriatricians, home hospice nurses, and more.

The gynecology (GYN) rotation averages 24 half days of GYN office experience with OB-GYN physician preceptors. These experiences occur in a Federally Qualified Health Center setting with ample opportunities for hands-on procedural experience. In preparation for these activities, the residency holds a colposcopy workshop every 18 months and an office gynecology workshop yearly to cover IUD insertion, endometrial biopsy, pelvic ultrasound, saline sonchysterogram, Implanon, Essure, Novasure, Adina, LEEP, ward catheter placement, and cervical cryotherapy.

Family medicine residents complete intensive care (ICU) rotations at Eskanazi Hospital, a Level 1 trauma center. While on call, residents are responsible for all necessary procedures, including intubation, ventilator management, central lines, arterial lines, thoracentesis and Swan-Ganz catheter placement. Residents care for two to five critically ill patients each day. Most patients remain in the ICU for several days, and the medical critical-care beds are consistently full.

One obstetrics (OB) rotation is included in the second year of residency. The rotation description is the same as the PGY1 rotation, but PGY2 residents have increased level of responsibility with supervision of PGY1 residents.

The pediatrics inpatient rotation during the PGY2 year is completed at Riley Hospital for Children at IU Health, where residents perform as upper levels alongside pediatrics residents, fellows and faculty.

Pediatrics outpatient is a concentrated rotation in an outpatient pediatrics clinic alongside pediatricians and family medicine preceptors, focusing on developmental screenings, well-child exams, acute care, asthma treatment and ADHD management.

In the second year of this graduate medical education training program, family medicine residents complete one block of electives. Residents may choose to repeat an experience in one of the required rotations, customize a rotation to accommodate his/her clinical interest and/or future or practice needs, or choose from existing electives, including addiction medicine, allergy and immunology, anesthesiology, cardiology, casting, colonscopy, colposcopy, complementary and alternative medicine, developmental pediatrics, endocrinology, ethics, gastroenterology, infectious disease, international medicine, maternal fetal medicine, neurology, palliative care, physical therapy, pulmonary medicine, radiology, research/scholarship, rheumatology, underserved medicine and wound care.

Third Year Curriculum

During third year of training, PGY3 residents complete several rotations and can participate in three blocks of electives.

The four third-year COREs for family medicine residents continue the longitudinal focus on outpatient clinical knowledge and skills. In the third year, residents focus on ophthalmology, urology and public health. The longitudinal public health curriculum is designed to engage residents with a broad array of public health issues facing the Indianapolis community and the United States, including health and healthcare disparity, the social and community contexts of healthcare, physician advocacy, epidemiology, global health, and health policy and economics. Practice management and leadership, behavioral science, and scholarship activities continue to be an integral part of all COREs in the third year.

This four-week rotation offers residents an intensive opportunity to work with board-certified dermatologists in an office setting. During this rotation, residents perform a variety of dermatologic procedures.

Family medicine residents continue their emergency medicine (EM) experiences at IU Health Methodist Hospital, a Level 1 trauma center. Residents are scheduled as an integral resident member of the emergency room and rotate through sections of the Emergency Department, as do the EM residents. Family medicine residents are required to staff patients with EM faculty prior to the patient’s discharge.

Two family medicine inpatient rotations occur during PGY3. Third-year family medicine residents have an increased level of supervision of PGY1 and PGY2 residents and medical students.

This rotation is predominantly office-based with a focus on outpatient evaluation and treatment of orthopedic-related pathology. Time is dedicated to joint examination, injury care, rehabilitation, injection technique and exercise prescription with additional time spent with certified casting technicians who are best suited to teach these skills. Physical therapists aid in the teaching of exercise prescription, therapeutic rehabilitation, and use of modalities in the treatment and recovery from injury.

This is a concentrated rotation in an outpatient pediatrics clinic, where residents work alongside pediatricians and family medicine preceptors at an FEDERALLY QUALIFIED HEALTH CENTER and at the Family Medicine Center, focusing on developmental screenings, well-child exams, acute care, asthma treatment and ADHD management.

In the third year of training, residents complete three blocks of electives. Residents may repeat an experience in one of the required rotations, customize a rotation to accommodate clinical interest and/or future practice needs, or choose from existing electives, which include addiction medicine, allergy and immunology, anesthesiology, cardiology, casting, colonscopy, colposcopy, complementary and alternative medicine, developmental pediatrics, endocrinology, ethics, gastroenterology, infectious disease, international medicine, maternal fetal medicine, neurology, palliative care, physical therapy, pulmonary medicine, radiology, research/scholarship, rheumatology, underserved medicine or wound care.

Longitudinal Behavioral Science Curriculum (all years)

The behavioral science curriculum spans all three of residency training and allows family medicine residents to work with the same patients and families during their residency. The curricular content of behavioral science as part of the Family Medicine Residency includes healthy behavioral, cognitive, emotional and relational functioning. This includes human behavior change, emotion regulation in families, family development and lifecycle transitions and preventative medicine as well as interpersonal and communication skills. For family physicians, this includes motivational interviewing, boundary setting with difficult patients and managing drug-seeking patients.

Residents learn how to manage mental and behavioral health problems, including relational problems and psychopharmacology for the individual patient, and also develop professionalism skills, which covers issues of diversity in practice, maintaining a patient-centered approach and compassion as well as managing fatigue and burnout.

Educational Seminar Series

The Family Medicine Residency Program provides an engaging educational seminar series (ESS) for faculty and residents at all levels of training. The ESS curriculum presents key, clinically relevant content from a broad range of family medicine core subjects, including adult medicine and chronic disease, behavioral science, coding/compliance, evidence-based medicine, geriatrics, gynecology, obstetrics, pediatrics, pharmacy, practice management and sports medicine.

Residents and faculty participate in the educational seminar series each Thursday afternoon. Each didactic consists of a short-session (12:30-2 pm) and a long session (2-5 pm).

In a four-week month, there is a short-session for grand rounds, journal club, wellness for residents, and chief/director meeting. The scholarship hour is resident-led grand rounds, journal club or morbidity and mortality sessions—the majority of which are built around interesting clinical cases experienced by the residents.

The final three hours address the core subjects. Seminars include case-based activities, small-group and panel discussions, Jeopardy-style review games, and hands-on activities in addition to traditional lectures. Longer workshops are also offered during ESS, with topics including minor office and dermatologic procedures, family violence, developmental pediatrics, common obstetric and pediatric procedures, and end-of-life care. The curriculum is built on an 18-month cycle, allowing residents the opportunity to engage with each topic twice during their training.