Family Medicine Residency Core Rotations for Residents

All residents will have clinical experience and rotations in a model Patient Centered Medical Home at the Center for Family Medicine located in the Eisenhower George and Julia Argyros Health Center in La Quinta, and on the inpatient services at Eisenhower Medical Center. In addition, the residents will have inpatient rotations in obstetrics, neonatal medicine and pediatrics at hospitals with a high volume of patients in those disciplines. The rotation schedule is established on a four-week block model for 13 blocks throughout each year.

Office-based and community-based experiences will complete the breadth of exposure for the resident to develop the requisite skills of the well-trained family physician.

  • Adult Medicine will include:
    • Internal Medicine wards (3 blocks)
    • ICU/CCU (2 blocks)
    • Family Medicine Inpatient Service (2 blocks)
    • Hospitalist Medicine (2 blocks)
      Additional experience in Adult Medicine is provided in:
    • Cardiology (two, 3-week blocks)
    • Geriatrics, including a 4-week intensive block rotation and a longitudinal continuity nursing home component covering the latter 24 months of the residency training period
  • Care of Neonates, Infants, Children and Adolescents experience will be addressed through:
    • Pediatrics Inpatient service at Loma Linda University Medical Center (2 blocks)
    • Newborn Nursery at Loma Linda University Medical Center (1 block)
    • Pediatrics Outpatient at various community sites (1 block)
  • Maternity Care will include:
    • Obstetrics Inpatient care (2 blocks), scheduled at California Hospital Medical Center in Los Angeles and Robert E. Bush Naval Hospital at Twenty-Nine Palms
  • Gynecology will include the following experiences:
    • Office Gynecology (2 weeks in the PGY1 year)
    • Office Gynecology and common inpatient procedures (3 weeks in the PGY2 year)
  • Care of the Surgical Patient will be addressed through:
    • General Surgery Inpatient (1 block)
    • General Surgery Outpatient (1 block)
    • Surgical Subspecialty experience in Ophthalmology (2 weeks), ENT/Otolaryngology (2 weeks), and Urology (2 weeks)
  • Musculoskeletal and Sports Medicine experience is provided in block rotations and longitudinal experiences:
    • Office Orthopedics and common inpatient surgeries, including an introduction to common sports-related injuries (1 block in the PGY-2 year)
    • Musculoskeletal Medicine, including Physical Medicine and Rehabilitation, Rheumatology and Osteoporosis (1 block in the PGY3 year)
    • Longitudinal Sports Medicine experiences will occur in all three years to include community-based /pre-participation /sports physicals, sports medicine coverage at local sporting events (eg., high school and college sports, the Humana Challenge Golf Tournament, BNP Paribas Tennis Tournament)
  • Emergency Care (2 blocks)
  • Human Behavior and Mental Health will be addressed through block, longitudinal and continuity clinic experiences. These will include:
    • Center for Family Medicine based clinical and tutorial experience during block rotations (Center for Family Medicine Orientation, Human Behavior) and during Center for Family Medicine continuity clinics
    • Hospital-based experience in Geropsychiatry at Eisenhower Hospital, addiction medicine at the Betty Ford Center, and care of abused children at the Barbara Sinatra Children’s Center at Eisenhower
  • Care of the Skin is structured through an office-based block rotation (2 weeks) with a private dermatologist and during the planned Procedures Clinics in the Center for Family Medicine.
  • Continuity of Care will be based in the model Center for Family Medicine located in the Eisenhower George and Julia Argyros Health Center in La Quinta.

Elective Rotations for Residents to Enhance the Competencies

  • Sufficient opportunity is available for residents to elect rotations in a variety of other disciplines including Women’s Health, Complementary and Alternative Medicine, Sports Medicine, Dermatology, Radiology, Pain Management, Palliative Care and HIV Medicine.
  • For interested residents, several tracks will be available for their elective time to focus in an area of special interest. Tracks under development include Global Medicine, Sports Medicine, Pain Management/Palliative Care/Addiction Medicine.
  • All residents have the opportunity for a research elective in the third year of training for individual study. Topics that are available for residents to choose from include, for example, preparation for submission of posters, other research/scholarly activities and additional experience in Information Technology and Practice Management.
  • All residents will be required to participate in research or other scholarly activity within the 36 months of training. Residents will always be in an environment that allows access and consultation in all areas of general and subspecialty care.
  • Residents will work on teams that have physicians, students, pharmacists, social workers, and case managers.
  • Residents will have one day off each week (averaged over four weeks), have limitations on work hours and patient volume that complies with ACGME regulations, and be given time to attend the curricular educational offerings.
  • Individual scholarship with appropriate mentoring will be strongly encouraged.

Learning Opportunities:

  • Direct clinical care in the inpatient, outpatient and Center for Family Medicine continuity care settings
  • Clinical care conferences, inpatient rounds, patient and family-centered conferences, including medical decision-making and end-of-life discussions
  • Performing and teaching procedures
  • Didactics and structured conferences: Medical Grand Rounds, other teaching conferences, Journal Club, monthly Practice Management
  • Self-directed readings, assigned learning modules specific to rotations
  • In-Training Exam preparation and ABFM Board preparation

Assessment Methods:

  • Resident assessment at the end of each rotation (New Innovations); individual and aggregate data from outside attendings
  • Review of resident procedure logs
  • Resident performance from the initial and 18-month clinical assessment
  • Resident performance on annual In-Training Examination reviewed by overall program and by PGY class
  • Resident performance on required presentations and scholarly project
  • Ongoing informal program assessment during monthly Resident-Faculty Meetings and monthly end-of- rotation Transition Meetings
  • Annual Program Review, including residents, core Family Medicine faculty and rotation attending input
  • Graduate performance on the ABFM Certification Examination (when applicable)
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