Family and Community Medicine: Residency Teaching Philosophy
Residency Centered Educational Home
The UC Davis Family Medicine curriculum emphasizes the resident as the center of the learning model which parallels the idea of the concept of the Patient Centered Medical Home.
PERSONAL PHYSICIAN DEVELOPMENT- each resident is an independent learner able to direct her/his own educational needs and goals. The curriculum is focused on allowing each resident to individualize their learning experience to meet their personal educational goals. This is done by maximizing elective time allowed in the 2nd and 3rd year of residency. There are also opportunities to develop longitudinal learning experiences. Past residents have used this unique learning experience to pursue their interest in adolescent medicine, dermatology and obstetrics. Rotations can also be enhanced based on individual learning interests such as a rural experience.
The Family Practice Center serves as the residents’ educational home. Learning experiences are incorporated into clinical experiences using one-on-one teaching environments. This includes specialty clinics for geriatrics, obesity, psychiatry, gynecology, and procedures where the residents are given the opportunity to have a concentrated experience to learn a skill which they can then incorporate in their continuity clinics.
PHYSICIAN DIRECTED TEAM MEDICAL PRACTICE - the resident leads their colleagues to collectively care for patients. Residents work in a variety of settings with a variety of team members. Our Family Practice Center includes support from a nutritionalist, diabetes educator and social worker. We have developed a team huddle prior to the beginning of each clinic which includes not only the medical support staff and physicians but also referral clerks and billing staff. Leadership opportunities are not limited to the hospital team but also include teaching medical students in the Family Practice Center.
WHOLE PERSON ORIENTATION - the resident is able to focus education on immediate and long term goals / career interests. Residents are active members of the learning process from their participation in the monthly curriculum committee meetings to creating electives or starting new interest groups. The residents are an invaluable part of the maintenance and development of the curriculum. The curriculum is constantly evolving to meet the needs of the resident learners and the changing environment of medicine. Innovations have included the Population and Community Medicine rotation and didactics which focus on population management using registries, continuous quality improvement and leadership training. In addition, there are monthly sessions on resident wellness and yearly workshops on resident well-being. Our residents have also created a family environment which often includes weekly dinner get-togethers, ultimate Frisbee and resident-led camping trips and events. We have celebrated many weddings and births together.
CARE IS COORDINATED/ ENHANCED ACCESS TO CARE - resident learning is facilitated within a larger framework of rotations and educational stages, and resident learning happens in multiple settings utilizing different technologies. Residents rotate through a variety of settings and have opportunities to learn teamwork with multiple health care professionals. Our residents work in both a university tertiary care setting and at a Veterans' hospital. Outpatient experiences include our Underserved Community Medicine rotation at a FQHC site, clinical experiences at Mather VA Hospital, large multi-specialty group practices, and private practices. Residents are also part of a care team which is composed of a faculty member, 3rd, 2nd and 1st year resident. The team works to not only take care of patients, but to take care of one another.
QUALITY AND SAFETY ARE HALLMARKS - residents learn evidence-based medicine and are part of quality improvement projects, get feedback on individual and practice performance measures. Residents lead and participate in monthly journal club as part of the didactic curriculum. As a department we have developed Faculty and Resident Evidence Discussions where evidence-based guidelines are discussed and compared with clinical data. Topics have included diagnosis of osteoporosis, use of aspirin in diabetes, and mammogram recommendations. Residents also participate in continuous quality projects on an individual, residency and department level that are centered around diabetes, obstetrical care and pediatrics as part of the Population and Community Medicine curriculum. The Practice Management curriculum includes quarterly feedback practice measures and time with billing specialists. Patient-centered medicine is a central theme of our learning environment. Our psychologist and family physicians work as a team to give feedback on patient encounters focusing on creating a patient-centered encounter and utilizing tools such as motivational interviewing. Residents are directly observed seeing patients in all three years of their residency training.
LEARNING ENVIRONMENT REFLECTS ADDED VALUE - resident education integrates concepts / principles across disciplines and learning environments to improve learning. The Department of Family & Community Medicine faculty have a diverse set of interests and skills, including research, geriatrics, health care policy, obstetrics and medical innovation. We also have two combined programs – Family Medicine/Ob and Family Medicine/Psychiatry – which enhances the learning environment in the department. This diversity has led to multiple opportunities for collaboration with other departments for unique learning programs such as Communities & Health Professionals Together and Global Health. The UC Davis Family & Community Medicine residency is also part of a larger learning community of medical students, other residencies, physicians and researchers. The university setting is dedicated to teaching and discovery with everyone striving together to improve patient care on both an individual and system-wide basis. The resources available include experts in a variety of fields as well as the Center for Reducing Health Care Disparities and the Center for Healthcare Policy and Research