Curriculum

Curriculum

Excellence - Our Tradition, Your Future


Our program's primary goal is to prepare you to provide top-quality, comprehensive patient care, both by treating illness and by supplying ongoing health maintenance for families. The curriculum's range and flexibility also allow you to pursue experience in areas of particular interest such as our Women's Health Track or our Sports Medicine track.

Thus, in addition to undertaking the program's required rotations and extensive concurrent training in behavioral science, working with families, community medicine and practice management, you will have ample time for your choice of elective activities.

 


Learning Objectives

 

Our program's learning objectives address your professional skills and personal development.

Professional Skills
To expand your skills as a physician, the curriculum will focus on sharpening your ability to do the following:

  • Assess patients' medical needs and independently treat those that are within the scope of your practice
  • Use specific diagnostic measures and problem-solving skills to analyze patient needs and prescribe therapy
  • Identify the emotional and social factors that influence patients' health
  • Consult with or refer to other specialists for problems that are beyond the scope of your practice and coordinate their advice with other resources to our patients' best advantage
  • Lead and coordinate a team of nurses, therapists, counselors, other physician specialists, and community agencies
  • Organize and maintain an efficient medical practice

 

Personal Development
To enhance your growth as an individual, a professional and a member of the community, the curriculum will present you with opportunities to do the following:

  • Develop good techniques for evaluating and implementing the findings of current medical literature
  • Teach and work cooperatively with other physicians and healthcare professionals
  • Gain insight into those factors that influence your behaviors and attitudes toward patients and colleagues and to objectively and comfortably handle challenging situations that arise with patients, families, or communities

 

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Forbes Family Medicine Center

 

Each year residents spend increasing time each week in the Family Medicine Center at Forbes. The center functions as a practicing physician's office where you will develop your own panel of patients and have the experience of working within a group practice that strongly promotes continuity of care. You will be part of a team that includes registered nurses, medical secretaries, clinical nurse specialists, and a patient educator/nurse practitioner, all of whom support your learning in the center. A patient-centered medical home is further supported by the electronic medical record (EMR).

The center's facilities include:

  • Clinical area with 14 patient exam rooms, some with special instruments and facilities for ENT exams and office procedures, such as colposcopy, cryosurgery, electrosurgery, and surgery
  • 2 rooms equipped for osteopathic manipulative therapy (OMT)
  • All rooms equipped with video monitoring and recording equipment
  • Family consultation room
  • Equipment for audiometry, tympanometry, spirometry, EKG, vision testing and similar evaluations
  • On-site lab for routine tests such as urinalysis, urine cultures, hemoglobin, serum glucose, pregnancy tests and microscopic exams
  • Residents' lounge
  • Library
  • Precepting areas
  • Medical records office
  • Waiting room
  • Patient education area
  • Faculty offices
  • Community activity room
  • Small exercise workout area

 

There is a full-time behavioral therapist on the faculty who is available to precept and consult.

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Clinical Rotations

 

The curriculum for each year of the Family Medicine Residency Program is as follows:

 

First Year
In the first year of the Family Medicine Residency Program, rotations are planned to reinforce and expand the knowledge and skills acquired in medical school and to introduce the care of families at the Forbes Family Medicine Center.

The focus of this first year is inpatient experience in these basic areas - adult medicine, pediatrics, obstetrics, surgery, and emergency medicine.

The first year curriculum is a longitudinal experience with graduating two half-days per week in the Family Medicine Center. The rotations are as follows:

Months Rotation
1 Core Rotation Coverage (June rotation at the end of 1st year)
1 Cardiology
1 Elective
1 Emergency Medicine
2 Family Medicine Inpatient Service
2 Night Float
2 Obstetrics
2 Pediatrics*
1 Surgery

 Total: 13 blocks

*On the Pediatrics rotation, residents see all newborns in the regular and special-care nursery, attend high-risk deliveries, evaluate pediatric patients in the emergency department and see patients in the pediatric faculty's offices. Full-time pediatric faculty teach residents on this service.

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Second Year
In the second year, the program emphasizes expanding your knowledge in pediatrics, internal medicine, and obstetrics while increasing your responsibility as a senior resident. During this year, you will begin to serve as a supervising physician and teacher for first-year residents and medical students, particularly on these three rotations. You will be provided with specific training in teaching to prepare you for this role.

Rotations are also scheduled in the intensive care unit and family medicine inpatient care. Additionally, there are 2 months of elective time.

The second-year curriculum is a longitudinal experience that includes three half-days per week in the Family Medicine Center. The rotations are as follows:

Months Rotation
2 Electives
1 Emergency Medicine
2 Family Medicine Inpatient Service
1 Family Medicine Outpatient / Geriatrics
1 ICU
1 Medical Selective
1 Night Float
1 Obstetrics/Gynecology
2 Pediatrics
1 Sports Medicine / Rheumatology

 Total:  13 blocks

Electives:

  • Allergy
  • Anesthesia
  • Community-Oriented Primary Care Project
  • Counseling
  • Endocrinology
  • Forbes Hospice
  • Gastroenterology
  • Hematology/Oncology
  • HIV / Primary Care
  • Infectious Disease
  • Neonatology
  • Nephrology
  • Occupational Medicine
  • Office Surgery
  • Pathology
  • Patient Education
  • Physical Medicine
  • Private Practice Initiative (PPI)
  • Radiology
  • Rheumatology
  • Sports Medicine
  • Teaching / Education
  • Women's Health

 

You may also design, in conjunction with your advisor, elective rotations to meet your individual needs and interests, either required rotations or medical electives.

*On the Family Medicine Inpatient Service, second- and third-year residents function as lead physician on the service to which resident and faculty patients are admitted. They supervise first-year residents. This service will expose residents to the full spectrum of family medicine patients - adults with medical/surgical conditions, children, newborns, postpartum patients and psychiatric consult patients. The resident rounds daily with a family medicine faculty member.

**Second-year residents may choose a focus for the obstetrics/gynecology rotation, as follows:

  • You may do obstetrics with a nurse midwife at a birthing center or with an obstetrician; or
  • You may focus on office gynecology.

 

***Geriatrics is taught as a 2-month block rotation along with monthly multidisciplinary teaching rounds at our nursing home. Residents follow a panel of nursing home patients throughout this year. Experience at our well-established hospice is also part of the rotation.

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Third Year
The program's third year gives you advanced clinical practice and more half-days per week in the Forbes Family Medicine Center.

In addition to the required medical and surgical subspecialty rotations, you will choose or design electives to expand your knowledge in previously introduced areas or integrate new ones of special interest.

The third-year curriculum includes five half-days per week in the Family Medicine Center and the following rotations:

Months Rotation
1 Dermatology
4 Electives
1 ENT/Ophthalmology/Urology
2 Family Medicine Inpatient Service
1 Family Medicine Outpatient
1 Geriatrics
1 Night Float
1 Orthopedics
1 Surgery Outpatient

 Total: 13 blocks

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Maternity Care / Women's Health Track

 

Competency
Usual tract
High interest track
Prenatal care / Newborn care
yes
yes
Intrapartum and Post partum care
yes
yes
#Continuity patients delivered
3-5
10
#Vaginal Deliveries
40
100
Gyne hours/gyne patient encounters
125 or 1 mo1
150 or 2 mo1
Extra OB/gyne month in 13 month grid
   1st and 2nd year?
no
yes
Vacuum extraction
no
yes2
ALSO course
yes
yes
ALSO Instructors Course
no
yes
OB ultrasound
no
yes
Cesarean section assists
As needed
30
Gyne OR time/
Observe at least one of each common (handbook)
--20 gyne surgery assists, including tubals, and D&Cs2
--learn office uterine ablations
Outside, high volume elective in 3rd year, maternity and neonatal
no
yes
Colposcopy, biopsy, ECC
no
yes
IUD
yes
yes
Nexplanon
As desired
yes
Women’s health outside experiences: PAAR, Agh Reproductive, Adagio, Planned Parenthood, observe at TMC, adolescent unit? (? During extra “gyne” month.)
As desired
yes
ASCCP colposcopy  course
no
yes
Women’s Health Congress CME
As desired
As desired
Prepare and give one conference on Women’s health as it relates to a non-ob/gyne medical or surgical topic.3
no
yes
Teach Intro to OB in continuing orientation
no
yes
Second resident on many / most deliveries4
no
yes

 

1. 1 month is 15 days/30 sessions gyne
2. If interested in going on to OB fellowship
3. for example: uro-gynecology, rheumatology hematology – oncology, breast surgery, sports medicine, preventive care, sexual medicine, behavioral medicine (eating disorder, DV, abuse, sexual dysfunction, PTSD), addiction, infertility
4. Consider run centering pregnancy/group prenatal visits so meet all pregnant?
 

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Sports Medicine Track

 

Musculoskeletal complaints are one of the top reasons why patients choose to see a physician. As such, learning the basics of musculoskeletal medicine is important, and required, to be taught in family medicine residencies. However, sports medicine at Forbes Family Medicine isn’t like any other residency.

Dr. Dougherty (Associate Program Director) is also the Associate Program Director for the Allegheny Health Network - Pittsburgh Primary Care Sports Medicine Fellowship, and a team physician for the Pittsburgh Pirates. Through his collaboration with the fellowship and Forbes Family Medicine, residents are exposed to a wide-range of sports medicine opportunities. We also now offer a Sports Medicine Track for residents who are interested in just learning advanced MSK care or are preparing for sports medicine fellowship.

The residency program performs pre-participation physicals for the Gateway School District (Monroeville, Pa.). We are also the team physicians for Greensburg Central Catholic High School (Greensburg, Pa.). Residents (in conjunction with Dr. Dougherty) are required to cover football and basketball games for GCC. Training room sessions are held, when needed, once weekly and sports medicine / track residents help with these evaluations. Sports-track residents, also have 2 additional rotations where they gain further experience and resume-building for fellowship applications.

Forbes Family Medicine is a unique place to practice family medicine. We are also a unique place to learn and experience sports medicine for both the traditional family medicine practitioner as well as the sports medicine interested resident.
 

Competency Traditional Track Sports Medicine Track
Sports/Rheumatology PGY2 PGY1
Sports Medicine II -- PGY2
Away Sports Medicine -- PGY2
MSK Radiology -- PGY3
Training Room Coverage PGY PGY1-PGY3
Game Coverage PGY2, PGY3 PGY1-PGY3
Didactic Presentations PGY2 PGY1-PGY3
Pittsburgh Pirate Coverage -- PGY3

 

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Didactic Learning Experiences

 

Family Medicine Conferences

Core curriculum conferences are presented for one hour, four days per week, with occasional additional times for progress rounds, grand rounds, practice management and journal club. These conferences provide an effective means for supplementing your knowledge of patient care and problem-solving. We have a well-organized conference curriculum that includes all the key areas of family medicine. Conferences are conducted by Forbes Hospital physicians, faculty, residents and contributing faculty from local institutions.

 

- See more at: http://www.ahn.org/education/graduate-medical-education/residencies/family-medicine-residency#sthash.Yyg3p6EL.dpuf

Family Medicine Conferences

Core curriculum conferences are presented on Tuesdays from 12 to 5 p.m., with occasional additional times for balint, grand rounds, and OMT workshops. These conferences provide an effective means for supplementing your knowledge of patient care and problem-solving. We have a well-organized conference curriculum that includes all the key areas of family medicine. Conferences are conducted by Forbes Hospital physicians, faculty, residents and contributing faculty from our organization.

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