Family Medicine Inpatient
As a PGY-2 and 3 on the Family Medicine Service, you are in charge of a busy inpatient service. With support from your attending, PGY-1, and medical students, you are responsible for managing the wide variety of problems that a Family Physician cares for in the hospital. Typical responsibilities include evaluating new patients in the emergency department, working up admissions, continuing management of medical inpatients, managing laboring patients on labor and delivery, and their newborns. You learn and help direct “big-picture” management, assessment, and discharge planning, and have a large role in your residents’ and students’ education.
One senior resident described Dermatology as “my favorite rotation of second year.” The rotation’s focus on teaching and hands-on experience is what makes it valuable. Set at the Washington, D.C. Veterans Administration Hospital, attendings and residents in Dermatology provide supervision for patient care and procedures. Procedures taught include cryosurgery, curettage, KOH prep, and excisional, shave, and punch biopsies. Additionally, there is exposure to plastic surgery techniques and larger excisions.
The outpatient cardiology rotation is completed during the second year with Capital Cardiology Consultants at their Providence Hospital office. The cardiologists in the group are regularly recognized by the residents for their outstanding teaching. During the rotation, the resident sees patients independently, usually new consults, and then precepts directly with the attending cardiologist. Physical examination of the heart, especially auscultation and EKG reading, are emphasized. The residents also have the opportunity to participate in exercise treadmill testing, cardiac catheterizations and echocardiograms.
Residents gain additional training in Nephrology and Urology during this split rotation. In the Urology component of this rotation, residents rotate in the office of two local Urologists with strong interests in teaching. Residents learn about common Urologic complaints in both men and women, including: incontinence, impotence, BPH and prostate cancer. In the Nephrology portion of this rotation, residents learn about common renal disorders. Residents work with a Nephrologist that is widely recognized for her excellent teaching skills.
Residents have excellent exposure to inpatient and outpatient psychiatry during this one month rotation. The rotation combines time working with the inpatient psychiatry consult service at Georgetown University Medical Center and seeing patients at Fort Lincoln Family Medicine Center for outpatient consultations. Psychiatrists are on site at Fort Lincoln Family Medicine Center twice a week, allowing for ideal continuity of care for our patients with mental health issues. The presence of psychiatrists also allows residents to "curbside" consult regarding their patient management of mental healthcare. This creates a strong teaching environment in the area of mental health.
Residents gain additional specialty experience in orthopaedics and sports medicine in a rotation with time split between these two areas. Residents work in the orthopaedic clinic at Fort Belvoir, a military base in Virginia. This allows exposure to a physically active population with acute injuries, and can scrub into surgeries. In the sports medicine component of this rotation, residents rotate at the Georgetown University Sports Medicine Center. Here, residents develop an understanding of the principles of exercise physiology and learn how to include fitness counseling into health maintenance.
The Ophthalmology and Ear, Nose and Throat (ENT) rotations are done simultaneously during the second year of residency. Three half days per week are spent on Ophthalmology, three at ENT and the remainder of time is spent at the Family Medicine Center or didactics. For the ophthalmology experience, the residents rotate at the Capital Eye, a private practice at Providence Hospital. The residents have the opportunity to work with general ophthalmologists and subspecialists seeing patients in the areas of cataracts, retina, and glaucoma. In the beginning of the rotation, the teaching is focused on mastering ophthalmoscopy and becoming comfortable with the slit lamp. During the rotation, the residents progress to using the lenses for a detailed retina exam and learn to write and interpret ophthalmology reports.
The ENT portion of the rotation is done at Walter Reed Army Medical Center in Washington, D.C. This unique experience allows residents to see patients at a worldwide referral center under the supervision of nationally known experts. A wide variety of problems are seen including pediatric, adult and plastic surgery patients. While at Walter Reed, the residents become part of the ENT team seeing patients independently and then precepting directly with the ENT attending. Valuable skills learned during this rotation include nasolaryngoscopy and radiographic correlation of physical exam findings.
Our program includes two month long rotations in a Pediatrics subspecialty outpatient clinic of your choice, usually at Georgetown or Children’s National Medical Center. The residents spend five half days a week at the elective site and four half days at the Fort Lincoln Family Medicine Center. Many residents use this time to increase their exposure to pediatric specialties they believe will fine-tune their knowledge base in pediatrics. Some favorite subspecialities are Pediatrics Dermatology and Pediatrics Allergy.
Residents participate in a one month rotation in the Providence Hospital emergency department. The emergency department is divided into subacute and acute areas. This allows the resident to evaluate and manage a range of illnesses from minor to severe. Residents spend time in both areas of the emergency department and see patients independently under the supervision of the emergency room physicians. Residents learn a wide variety of procedures, as well as gain confidence in evaluating and treating a diverse group of patients and clinical presentations.