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.
Our program includes a multi-disciplinary rotation in Geriatrics, as well as longitudinal nursing home and home care experiences directed by our faculty. During the one month rotation, residents work with geriatricians who are board certified in both geriatrics and internal medicine or family medicine. Residents spend four half days a week seeing geriatric patients with the geriatric attending one-on-one in the Geriatric ambulatory clinic. Residents perform Geriatric Initial Assessments on patients and experience a multi-disciplinary team approach to assessing and managing patients. Participation in the Geriatrics rotation also includes teaching in the sub-acute unit in the state-of-the-art nursing and rehabilitation center, completed in 1996, rounding at a community nursing home and didactic teaching rounds by the faculty.
The longitudinal component includes monthly nursing home visits on longitudinal patients under the supervision of the geriatric attending. Additionally, residents learn to provide home care to one or two patients under the direction of our home visit program attending. During this rotation, residents are exposed to the core aspects of geriatrics with the goal of obtaining the ability to function independently doing home care, nursing home visits and geriatric assessments on their future patients.
The Orthopaedics rotation occurs in the office of a well-respected community Orthopaedist and partners. Residents see common musculoskeletal and sports medicine problems, learn office procedures and injections, and improve their musculoskeletal exam skills. The office has in-house X-Ray and residents improve their X-ray reading skills for bones and joints. Residents also round weekly in the hospital, and have the opportunity to scrub into surgeries. This experience is complemented by two weeks working in a military Orthopaedics setting, where care is provided for acute injuries and fractures.
Pediatric Emergency Medicine
Our program includes a one month rotation in the emergency room at Children’s National Medical Center in Washington, D.C. Residents spend 24 hours per week evaluating pediatric patients in the emergency room under the direct supervision of a pediatric emergency room attending. Residents experience a broad range of medical cases and are able to participate in numerous hands on procedures like suturing, casting, splinting, lumbar puncture and bladder catheterization.
Internal Medicine Elective
Residents are required to do one rotation in a Subspecialty of Internal Medicine during the PGY-3 year. This provides an important opportunity for residents to deepen their knowledge in Medicine. Residents may rotate at private offices or any number of local hospitals that could include Providence, MedStar Georgetown University Hospital, and The MedStar Washington Hospital Center. Recent rotations have included Nephrology, Rheumatology, Allergy and Immunology, Pulmonary, Endocrine, and Neurology. One of our most popular elective rotations is with Providence Nephrologist, Dr. Kamajit Sethi, who recently received a teaching award from our residents.
The Community Medicine rotation is carefully structured to provide residents with a unique experience in the healthcare of underserved residents in Washington D.C. through a combination of didactic seminars, hands on development of new programs at a Community Health Center, and clinical participation on a Care Management Team at the same Community Health Center.
Weekly didactic seminars with experts in the field of community medicine introduce the residents to the topics of Community Oriented Primary Care, Health Behavior Change, and Community Resources. Readings and learning assignments accompany each of these seminars optimizing the learning experience and providing the resident with a thorough knowledge base that can be readily applied in the clinical setting.
Residents work as part of a team providing patient care at a Community Health Center during their block rotation. The residents complete a Community Oriented Primary Care project as a team, addressing the healthcare needs of the patient community of the Community Health Center.
The combination of the block experience in Community Medicine along with the longitudinal Community Medicine experience described elsewhere (see “Longitudinal Curriculums”) provides residents with an exceptional overview of Community Medicine concepts and their practical application to benefit high risk patients in the District of Columbia.
The one month gynecology rotation is done in the third year at the busy Virginia Hospital Center GYN practice. The residents spend 3 half days per week being precepted one-on-one at this site. In addition, the residents spend one half day per week seeing gynecology patients and doing procedures at the Center For Life clinic at Providence Hospital under the supervision of Dr. Mejibi Mayor. It is estimated that approximately 30% of the patient encounters in the Family Medicine Center are for gynecologic complaints. Therefore a large amount of gynecologic teaching involves one-on-one precepting in the Family Medicine Center during the course of the three-year residency. Additionally, there are two Colposcopy Clinics held each month at the Family Medicine Center during this rotation. During this time, residents gain intense colposcopy experience being precepted one-on-one with a Family Medicine faculty member.
The elective months allow each resident to tailor their education according to their interests and long term career goals. Residents can choose to work with Providence Hospital and MedStar Georgetown physicians for additional training in subspecialty areas including radiology, nephrology, neonatology, cardiology, gynecology and gastroenterology, among many others. Residents also can use their elective time to strengthen skills in obstetrics, sports medicine, and procedural skills. Washington D.C. provides limitless possibilities for residents to explore additional interests including rotations with a well established HIV clinic, alternative medicine practices, health policy centers, and community health centers. With pre-approval, residents can utilize away rotations to seek experiences not available in the Washington D.C. area.