This is one of our more unique intern rotations as every day is different. We work primarily with our faculty behavioralist at Turley. We see patients together, and in the process become comfortable with the psychiatric office visit and the documentation of the psychiatric evaluation. We are also exposed to the many community resources available to our patients in terms of counseling, rehab programs, and classes. We also spend time with a Hospice physician making house calls on terminally ill patients. Finally, we have several excellent lectures on common psychiatric problems and the medications used to treat them done jointly by our pharmacist and our behavioralist.
Successful chronic disease management is a cornerstone of family medicine, but is easier said than done! To better equip our residents for this often challenging task and to better serve our highest risk patients, we developed an interprofessional collaboration model we call the chronic care management team.
We began the project with patients with diabetes with a HgbA1c ≥9. Each patient comes in for an initial extended visit. They see a Family Medicine resident and a Pharmacy resident simultaneously who work on optimizing medication management under the guidance of both a FM and Pharmacy preceptor. Next the patient sees our dietician for nutrition education. Lastly, they see our social worker, who identifies any barriers to care and provides them with a summary sheet of take-home points and has them teach back lessons they learned. She calls them 3 days later to check on their progress and make sure they followed through with recommended changes. Additionally, she tracks their visits and A1c levels over time so patients are not lost to follow-up. So far, we have lowered the average A1c in this challenging group from 11.6 to 9.2!
We have since expanded the clinic to include patients with uncontrolled hypertension and are exploring adding patients with COPD next.
The Geriatrics curriculum is a longitudinal experience across a variety of settings aimed at preparing graduates to provide high-quality, evidence-based, patient-centered health care to older adults. Residents manage the care of hospitalized geriatric patients on the Medicine and Turley inpatient services. They learn care of the ambulatory elderly patient in their supervised continuity clinic at Turley Family Health Center. They also gain experience in nursing home/rehab care and home visits. Third year residents spend 4 weeks on the Geriatrics rotation working directly with a community-based geriatrician and with core faculty at Turley co-managing their geriatric patients. Experiential learning is supplemented throughout the course of residency training by noon conferences, didactic sessions with faculty and symposia dedicated to geriatrics-specific topics. In 2018, Turley Family Health Center received a grant from the U.S. Health Resources and Services Administration (HRSA) to further develop its existing geriatrics curriculum through a partnership with the USF Geriatric Workforce Enhancement Project (GWEP). In GWEP clinic, the attending physician, Family Medicine resident physician and pharmacy resident collaborate to provide care for geriatric patients with a particular emphasis on addressing the often complex physical, cognitive and psychosocial needs of older adults.
The Management of Health Systems Curriculum (more traditionally called the Practice Management Curriculum) is comprised of a required 2 week rotation plus longitudinal elements and optional additional weeks on a customized Practice Management Rotation. The goal of this curriculum is to equip the graduating residents with the knowledge, skills and confidence to effectively manage the business and patient service components of a medical practice, be it outpatient, inpatient or as a champion of quality service metrics and EMR integration. Management of one’s own office or other practice setting requires expertise beyond pure medical skill and knowledge. It is critical to gain an understanding of team leadership, hiring, coaching and firing team members, contract negotiation (with potential employers, partners or insurers), quality improvement methodology, practice quality and financial metrics, business plan development, practice valuation, asset protection, retirement and other financial planning (including the basics of time-value of money calculations) and physician-group politics.
These topics are covered via lectures, day-to-day modeling by faculty, daily experience using both CPT and ICD codes, other longitudinal resident activities and through a rotation that covers core elements and yet leaves significant room to explore areas of specific interest to individual residents—based in part on the resident’s anticipated practice setting. This curriculum is led by a core group of three faculty with extensive experience in each of these topics and include (1) the Program Director, (2) a physician experienced in private practice and large medical group practice, and (3) a physician with prior experience as president of a mid-sized physician group and as department chair and hospital chief-of-staff.
With the changing role of physicians in today’s healthcare environment residency programs have a responsibility and obligation to teach far beyond the fundamentals of direct patient care. We must teach, role model and encourage a culture in which community responsibility and physician leadership are cultivated. In addition, we have implemented a curriculum to provide residents with the foundation and tools necessary to become the well-rounded and responsible healthcare professionals of tomorrow.
The overarching goal of the Leadership for Life Curriculum is to establish a supportive and fun culture where hard work is rewarded and professionalism developed and celebrated.
Towards these goals several residency activities and events are scheduled throughout the residency experience. These include New Resident Team Building Day, Residency Support Groups, Intern Out Day, Halfway Home Day, Almost Done Day, and Life Balance Events.
New Resident Team Building Day is a full day of social and physical interaction activities designed to acquaint the new intern class with each other and with faculty. It’s a day during a busy orientation process to get outdoors, put things in perspective and to have some fun.
Residency Support Groups occur monthly in the first year of residency and less frequently in the PGY2 and PGY3 years. These group meetings are designed to allow residents an ongoing forum for team building, problem solving and skills training.
Intern Out Day occurs mid year in the PGY1 year. This scheduled full-day away from all residency responsibilities addresses the question, “Who are we and how do we work best together?” The focus is on team building, cohesion development and stress management. It is also the celebration of completing over half of the most difficult year of postgraduate medical education.
Halfway Done Day addresses the question, “Who am I as a healthcare professional and how do I balance the various roles in my life?” and occurs in the first half of the PGY2 year. The focus is on individual growth and development with recognition of the individual attributes that contribute to the collective “whole” of the healthcare profession. The day also serves to celebrate the individual’s completion of half of their postgraduate medical education while simultaneously addressing skills and attitudes relating to how to balance the competing issues of family, finance, physical, spiritual, personal and professional well-being. Almost Done Day is planned for the last quarter of the PGY3 year. This activity addresses the question, “What is my potential and how can I use my gifts and talents to fulfill my potential and contribute to my profession and my community?” This is an exercise in leadership development and is meant to stimulate and motivate soon-to-be graduates to face the future with determination and purpose.
Life Balance Events occur during each year and are an opportunity to learn and practice the areas of life balance adapted from work by Dr. Thomas Stevenin. Each resident year group is given a budget to plan and implement an activity for all residents and faculty focusing on one of the elements of a balanced life: Health and Physical Condition, Home and Family, Life's Work or Profession, Financial, Mental and Personal Growth, and Self-fulfillment or Spirituality.
The goal of our telemedicine curriculum is to provide our residents with a basic understanding of this growing healthcare field, and also to have our residents participate in hands-on telehealth learning opportunities in a variety of settings.
Our health system, BayCare, has a number of expanding telehealth programs our residents participate in including: telemedicine acute and chronic care visits, eICU, eSNF, telehealth wound care, mobile health monitoring, and other innovative methods of healthcare delivery.
As innovation in care delivery and technology continue to transform healthcare, we must ensure that our current and future physicians have all of the available tools and resources they need to provide the best possible care for their patients.
Welcome to University of South Florida / Morton Plant Mease Wilderness Medicine Track. Wilderness medicine is defined as the practice of medicine in austere, resource constrained, and possibly remote environments. The skills taught by our Track promote knowledge and understanding: in wilderness medicine, pre-hospital care, disaster medicine, international and travel medicine, and tactical medicine. This track is offered to PGY-2 and PGY-3 Family Medicine residents and runs longitudinally over both years. Interns may participate if their schedule allows.
Your educational experience will start with didactic lectures. However, wilderness medicine cannot be taught in the classroom alone. We will spend most of our time outdoors building on core topics learned.
There are five longitudinal components that all residents will complete:
The 4 didactic modules cover: mountain medicine, desert medicine, tropical medicine, and dive and marine medicine. These modules will give the resident the required knowledge and technical skills to competently practice wilderness medicine. Each module is taught through week long seminars conducted by USF /MPM Family Medicine Faculty. Each of these modules will have required reading from Auerbach’s, Wilderness Medicine, additional texts, and key articles from the medical literature. These modules will all have associated field, experiential education, and research requirements. Through the experiential aspect of the track all Residents will gain hands on clinical experience. This will develop and hone their technical and leadership skills.
The USF/MPM Family Medicine Residency program is the first and only Family Medicine Residency in Florida to conduct Advanced Wilderness Life Support (AWLS) training. Training is provided by 3 core faculty certified as Lead Instructors and various subject matter experts. All residents in the track will complete AWLS certification. However, this opportunity is open to all residents and faculty.