PGY 3 Rotations
This rotation is for two weeks in each year of residency training. The overall goals of this curriculum include:
PGY 1 Goals
- Demonstrate competence at interviewing and interacting with patients in a respectful and effective manner.
- Be able to identify and describe some different approaches to effective behavior change and demonstrate their applicability to the practice of family medicine; and
- Demonstrate competence in evaluating and treating adult depression and substance abuse
PGY 2 Goals
- Be able to evaluate common psychiatric disorders in children, with an understanding of possible differential diagnosis and different possible treatment approaches.
- Apply principles of behavior change to the assessment and treatment of child and adolescent patients; and
- Develop an appreciation of the medical and mental health needs of individuals with developmental disabilities.
PGY 3 Goals
- Be able to evaluate common psychiatric disorders in adults, with an understanding of possible differential diagnosis and possible treatment approaches.
- Be able to differentiate between when to treat psychiatric disorders as a primary care physician vs. when and where to refer for further evaluation and /or treatment; and
- Demonstrate appreciation for and recognition of how one’s own feeling, attitudes, background, and biases can influence the evaluation and treatment of patients, and how to manage such an influence effectively.
Currently required for 4 wks in the second year the goals for this curriculum include:
- Understanding the basic concepts of common cardiac conditions and diseases
- Obtaining adequate cardiac history, and performing appropriate physical exams in a comforting and non-judgmental manner.
- Be able to make initial, appropriate evaluation and recognize conditions requiring referral to a Cardiologist
- Formulate a solid treatment plan based on best evidence available and using care and concern when performing a cardiac evaluation.
Currently required for 2wks in the third year the goals for this curriculum include:
- Recall of the United States leading health indicators, the factors that indicate the health status of a community and the objectives for improving the health of a community
- Define the established procedure for the referral of patients to available community services.
- Develop a personal plan to integrate preventive health into his/her practice.
- Incorporate preventive health initiatives as a standard of their medical practice.
- Differentiate cultural differences of the primary minority groups in Utica, NY
- Be able to recall cultural differences of the community’s diverse population and to apply culturally appropriate care to their patients.
- Actively participate in school-based health and demonstrate the competency to care for school aged-children and young adults.
- Actively participate in the Parent Partners in Health Education project and demonstrate the competency to care for people with disabilities.
Critical Care Medicine (ICU)
Conducted at St. Elizabeth Medical Center’s ICU department and currently required for 4wks in the second year the goals of this curriculum include:
- Admitting and managing patients who require critical care in the ICU at STEMC;
- Be familiar with the common critical care issues encountered in a community hospital such as STEMC
The resident will discuss their elective rotations for the program year with their faculty advisor who can assist in determining educational needs and how best to develop interests and plan electives accordingly.
Residents will spend 6 to 8 wks in St. Elizabeth Medical Center’s Emergency Department (an accredited Trauma Center) experiencing both day and night shifts in the ER with the following goals:
- Be competent in providing appropriate emergency care at the Emergency Department under the supervision of the Emergency medicine staff
- Learn the coordination of emergency care through effective triage, rapid mobilization of team care and appropriate use of consultants
- Achieve the basic and advanced trauma and life support skills under supervision
This curriculum covers inpatient and outpatient geriatric care as well as the Home Visit program in a combination of a block rotation in PGY 2 and a longitudinal experience throughout the second and third year where residents will follow up with at least 2 geriatric patients at the Presbyterian Home less than 5 miles from the Medical Center. This goals of this curriculum include:
- Gain fundamental skills of outpatient, inpatient, and nursing home assessment and management of geriatric patients defined as those age 75 and over, or age 65-74 with chronic diseases
- Learn the functions of the multiple professional disciplines involved in caring for the frail elderly, and be able to communicate and work with them in a positive manner that facilitates good patient care.
- Gain an understanding of the community organizations that can help the frail elderly remain at home.
- Learn the role and the importance of the support system in managing the frail elderly, and learn how to assist that system in helping to maximize the quality of life of frail elders.
This rotation is a combination of both inpatient at Faxton- St. Luke’s Healthcare and outpatient experience at St. Elizabeth Women’s Health Center across the street from the main campus. Goals of this experience include:
- Competence in diagnosing and managing common gynecology cases
- Gain experience in office based gynecology and in gynecological procedures and treatments.
- Know the indications for consultation or referral to a gynecologist.
Internal Medicine (Medicine Days/Family Practice Service/Night Float)
You will have a total of 30 wks of an inpatient experience throughout your Residency training. These will take place on both the Internal Medicine Service and the Family Practice Residency Service where you will be able to follow your Family Medicine patient admissions across the continuum of care.
- Gain inpatient care experience
- Be able to provide in-patient care for the unassigned patients admitted through the Emergency department (those without a Primary Care Provider)
- To provide continuity of care for all patients from the Family Medicine Center and In-patient care for all patients from the Faculty practice sites
- Demonstrate competency in managing the top ten most common in-patient, clinical problems among adults at STEMC
- Be able to teach and supervise a medical student and/or junior residents
Maternal Health (OB)
One month in the first year will be spent at Crouse Hospital in Syracuse, where you will have an intensive OB experience. On average, residents return from this rotation with 20 vaginal deliveries already completed. The remainder of your outpatient OB experience will take place at St. Elizabeth Women’s Health Center and inpatient continuity deliveries will be performed at Faxton-St. Luke’s Healthcare less than 2 miles from the Medical Center. The goals for this experience include:
- Proficiency in the diagnosis and management of common obstetrical problems in the inpatient setting.
- Recognizing those cases that should be expeditiously transferred to adequate treatment facilities as the patient approaches delivery, should that patient be in one of the high risk delivery categories.
- Provide quality and continuous prenatal care to the patients of the St. Elizabeth Women’s Health Center.
- Become proficient in the skills required to perform vaginal deliveries and assist in caesarian section deliveries.
This rotation is gained in an outpatient setting with a Board Certified Neurologist for 2 wks in the third year of training. The goals of this experience include:
- Learn the pathophysiology, etiology, clinical features, physical exam findings, diagnostic work-up, treatment and management of common neurological diseases, disorders and syndromes.
- Understand the indications and role of neurological consultation and the concept of shared care for certain neurological conditions.
- Recognize the importance of preventative medicine, especially risk factor identification and healthy lifestyle modification in neurological disease.
- Support the patient through consultation, assessment, treatment, rehabilitation and long-term care with emphasis on treatment options, risks and benefits.
A 2 wk outpatient rotation in the third year of training with the following goals:
- Competently recognize ocular emergencies arising from endogenous or exogenous causes;
- Demonstrate the coordination of care between the ophthalmologist and the family doctor for chronic and acute eye conditions; and
- Demonstrate knowledge of current technologies in ophthalmologic care of patients
A 2wk outpatient rotation in the third year of training with the following goals:
- Gain familiarity with the pathophysiology, differential diagnosis and management of common primary care ENT complaints
- Review and reinforce basic anatomic, microbiologic, and pharmacologic concepts salient to diagnosis and management in this setting
For a total of 6wks throughout residency training, you will experience predominantly out-patient treatment but also including exposure to in-patient care of orthopedic patients with the following goals:
- Understand the pathophysiology, etiology, clinical features, physical exam findings, diagnostic workup, treatment and management of common orthopedic diseases and injuries.
- Know the indications for orthopedic consultation or referral.
- Understand the importance of patient risk factor assessment and education leading to lifestyle modification in the overall treatment and prevention of orthopedic disease.
You will gain exposure to Pediatric care in each year of residency training. You will rotate both in private physician offices and participate in inpatient pediatric rounds with the following goals:
- Demonstrate an overall understanding of childhood medical, mental health and social issues, as well as their management;
- Demonstrate a level of professionalism, manifested through a commitment to carrying out their given responsibilities, adherence to ethical principles and sensitivity to a culturally and economically diverse patient population.
For 2wks in the first year of training you will rotate with Board Certified Neonatologists in the Neonatal Nursery at Faxton-St. Luke’s Healthcare with the following goals:
- Understand clinical guidelines for the provision of newborn care.
- Recognize the breadth of normal newborn transitional physiology and the deviation into illness.
- Diagnose and initiate treatment of common medical, surgical and psychosocial issues of the well and sick newborn infant.
- Work as the member of a team of Obstetrical and Pediatric Primary Care Providers, Nurse Practitioners, Nurses, Lactation Consultants, Social Services and discharge planning colleagues in providing care for the newborn infant and family.
- Seek consultation and/or referral from a regional Perinatal Center
The Family Physician must be prepared to practice in an environment that is changing and evolving. This requires that he/she have a broad knowledge base of the practice of medicine as well as the skills necessary to be financially secure. The principals of practice management are applied in a progressive fashion over the three years of residency.
- Complete an introduction of the key departments within the Family Medicine Center and develop an understanding of their functions
- Introduced to the key components of quality studies and the importance of quality in the practice of medicine
- Introduced to the basic components of billing and coding
- Introduced to the fine points of effective dictation
- Develop an understanding of the importance of preventive guidelines in primary care
- Develop the pertinent skills to identify and access relevant primary care guidelines
- Develop skills needed to integrate research and quality in their practice.
- Develop an understanding for the importance of continuous improvement of the care delivered in their patient practice.
- Design and formulate a study to assess quality of care in their practice
- Present the information in a meaningful manner to an audience
- Identify barriers to adherence with guidelines and devise methods to overcome these barriers
- Develop a career plan
- Apply the principals of effective E&M Coding
- Learn the importance of understanding the basic principals of financing a practice for long term financial success
- Learn the components and principles of managing a practice
A formal rotation for 2 wks in the third year of residency as well as weekly didactics in PGY 1, the goals for this curriculum include:
- Demonstrate accurate and appropriate ordering of diagnostic testing.
- Demonstrate accurate examination of basic and common radiological tests. Based on this exam he/she will formulate a report that differentiates disease processes. This is expected to be completed by the end of the first year.
- Application of good medical practice when selecting diagnostic imaging tests, employing knowledge of contraindications and current guidelines for various disease processes.
- Advocate for the patient, analyzing social situations, test design and insurance prerequisites.
For 2wks during your training you will be exposed to rheumatology in the outpatient setting with the following goals:
- Be competent in diagnosing and managing common Rheumatic diseases
- Gain experience in office-based rheumatology and in Rheumatologic procedures and treatments
- Know the indications for consultation or referral to a Rheumatologist
For 2wks in the second year of training you will experience Sports Medicine with the following goals:
- Learn how to evaluate and manage athletes with outpatient sports related injuries in the acute and post-injury time period.
- Develop confidence and comfort in advising athletes, trainers and coaches on medical situations as they affect sports events and the athletes themselves.
For a total of 8 wks you will receive both inpatient and outpatient surgery experience with the following goals:
- The resident will be able to identify and evaluate emergent and non-emergent surgical conditions in the primary care setting, with timely and appropriate surgical referral
- The resident will acquire the clinical knowledge and skills in order to assist the surgeon in the assessment and management of patients in the pre-operative and post-operative periods
- The resident will develop competent psychomotor skills necessary for assisting major surgery in the operating room under strict aseptic condition
- The residents will learn how to perform outpatient surgical procedures, such as repair of lacerations, biopsy of superficial lesions, and management of simple wounds and burns
For 2 wks in the first year of training you will receive both inpatient and outpatient urology experience with the following goals:
- Understand the basic concepts of common urologic conditions and diseases
- Obtain adequate urological history, and perform appropriate physical exams in a comforting and non-judgmental manner
- Be able to make initial, appropriate evaluation and recognize conditions requiring referral to a urologic specialist
- Formulate a solid treatment plan based on best evidence available and use care and concern when performing urological procedures.