The following curriculum innovations support our commitment to graduating residents who are competent to lead change and deliver effective, personal, high-quality care.

Central to family medicine is care of the family unit. Childbirth and parenting is the core dimension of many families. Our residency combines nursery, pediatrics and obstetrics in a required experience over the first two years using family physicians as supervisors and role models. This intensive experience with young families provides grounding for residents in family dynamics and the clinical knowledge necessary to strengthen family relationships, regardless of the practice style they may choose for a career.

This six-month curriculum is the cornerstone of the third year. Implemented in 2007, it integrates many diverse curricula, from group visits to pediatrics to dermatology, into a longitudinal experience. It is designed to give residents the core experiences necessary to deliver patient centered, personal medical home care. Residents learn to teach and model a whole person orientation to care, foster relationship building through continuity, develop skills to facilitate and work within interdisciplinary teams, demonstrate integration of specialist, office and community resources into effective care planning and attend to quality improvement and safety of care.

Over the course of the second and third years, residents develop a Comprehensive Longitudinal Interdisciplinary Care Knowledge and Skills (CLICKS) project. Working with a faculty mentor, residents identify a “primary” patient and family with whom to interact more intensively. Residents collect detailed information about the patient’s family history, and how the patient is interacting with the family, health care system and community. With this knowledge, residents develop and carry out a care management plan generated collaboratively with the patient, family, interdisciplinary care team, and the resident. Residents are required to produce scholarly products, which includes the care plan, poster presentation at end of the second year and an oral presentation to peers and faculty at the end of the third year; it is strongly encouraged to use this project as the basis for Clinical Jazz presentations and Grand Rounds.

Both Family Health Centers use Centricity – the leading full-featured EMR and is “paperless.” Much of the residency’s scholarly activity is aimed at developing the EMR as a tool for practicing evidence based medicine. This includes incorporation of guidelines and decision support into clinical encounter forms, monitoring care management and populations, clinical improvement using practice based data and reducing errors of communication among practitioners.

Care of patients is delivered in office settings in the context of larger institutions and the community. To be effective practitioners, graduates will need not only clinical knowledge but also skills to advocate for their patients within organizations and to lead innovation and change.

• Personality and perceptions
• Communication styles
• Leadership and competence
• Conflict resolution
• Negotiation
• Team working

This innovation involves the integration of behavioral health and primary care. The Family Health Centers serve as internship sites for six psychology and family therapy interns. Program therapists supervise the interns, providing comprehensive care to patients and families. Residents and therapists often see patients together, applying a systems model to go beyond traditional mental health diagnoses and address critical issues of generalist practice, including:

• The doctor/patient relationship
• Psychosomatic problems
• Compliance issues
• Coping with chronic illness
• Psychodynamic concerns
• Problems of living
• End-of-life care