Night Float rotation is an inpatient rotation that pairs a PGY-2 or PGY-3 with a PGY-1 for management of the “Turley” and “Medicine” service lines. This is a 12 hour shift rotation with the focus of overnight monitoring and admission of patients needing hospitalization. The goal is to gain experience on how hospital patient care operations adjust from daytime, and to ensure safe patient care is provided during the entirety of the hospitalization. Residents are provided with dedicated individual call-rooms in addition to the resident work room. Oversight is provided by the attendings of both the “Turley” and “Medicine” service lines.

During this block, we rotate with a community pediatrician in a community health center. The practice is very busy, so we are exposed to a full spectrum of pediatric problems. We receive a lot of training with patient and parent education during well child visits and become very familiar with the vaccination schedule! One day per week is spent seeing sick children at the Turley Family Health Center. Another day is spent as part of the practice management/ health systems management curriculum to help you become more familiar with all the staff roles at the Turley Family Health Center.

Our in-patient pediatrics training is completed at Mease Countryside Hospital, a local affiliate hospital within the BayCare Health System. During this PGY-1 rotation, we work alongside the pediatric hospitalist and pediatric specialists. There is only one resident on this rotation at any given time, so it creates another excellent opportunity for individualized teaching and learning. There are no opposing pediatric residents rotating through this hospital. The structure is very similar to our adult medicine rotation, with a typical day consisting of pre-rounding alone, then presenting your patients to the attending. Afterwards, the remainder of the day is spent following up on the patients, their labs, imaging and consults; as well as completing admissions and discharges. One afternoon per week, the residents are excused from inpatient responsibilities so that they can attend to their continuity patients in clinic. The teaching is excellent; at the end of your block, you will feel very comfortable admitting and caring for a pediatric patient.

Women's health and maternity care are an integral part of family medicine!

During this PGY-1 rotation, the day begins by rounding on patients we delivered on the previous day. The remainder of the day is spent alongside the midwife or attending managing patients on the L&D, doing OB/GYN consults, seeing OB patients in triage, and delivering babies. We are fortunate to work with a panel of Certified Nurse Midwifes, FP/OB and OB hospitalist physicians to gain experience in: prenatal care for low-risk pregnancies, vaginal deliveries, first assist for Cesarean sections, basic OB ultrasound skills, repair of perineal lacerations, and ALSO provider certification.

If all is quiet on L&D, we go to Turley to see patients with the attending or midwife in clinic.

This is one of our more unique intern rotations as every day is different. We work primarily with our faculty behavioralist at Turley. We evaluate patients in clinic together and become more 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 and make house calls on terminally ill patients. Finally, we have several excellent lectures on common psychiatric problems and the medications used to treat them given jointly by our pharmacist and our behavioralist.

During this rotation, we spend two weeks on an inpatient surgical rotation. We provide first-assist on at least 25 major surgical cases. We are not expected to function as surgical residents; rather, our focus is on learning about the procedures for which we will be referring our patients, including an understanding of the indications, benefits and risks. We are also expected to learn to recognize the common conditions that require urgent surgical referral.

During this rotation, we work shifts (some day, some night) with our ER physicians. We have first contact with the patients, evaluate them, and order any appropriate labs and imaging. We then staff the patients with the ER physician, and, after evaluating the test results, determine whether they require hospitalization or can be treated and discharged home. There are plenty of opportunities for critical care; you will likely intubate a patient, do an arterial stick, and start a central line (all closely supervised, of course). This rotation tends to be fast-paced and fun.

During this rotation, we spend two weeks in the Newborn Nursery and NICU working with a pediatrician, neonatologist and neonatal nurse practitioners. Our mornings are initially spent pre-rounding and performing newborn physical exams. Next, we join our pediatrician on rounds. There is just one resident per attending on this rotation, so it's a great opportunity for personalized teaching and learning. After regular newborn nursery rounds, we proceed to the NICU and work alongside their team caring for babies with problems such as prematurity or sepsis. Our afternoons are largely spent in didactic sessions with the attending or in our continuity clinic or seeing sick children in clinic. Along with this daily routine, whenever a high-risk delivery or c-section occurs, we have direct hands-on involvement in the initial triage of the baby.

During this 2-week long rotation, we care for patients who require intensive care in the intensive care unit. It is common for our attendings to guide us through ultrasound-guided procedures like paracentesis or thoracenteses in our open ICU. As part of our Telemedicine Curriculum, you will have the opportunity to visit BayCare’s eICU where you may help manage critical patients and run codes overnight remotely from BayCare’s own Carillon Center. Because we work closely with our critical care attendings on our inpatient medicine service, this is a highly educational and enjoyable rotation.

The inpatient “Turley Service” is a daytime PGY-2 and PGY-3 rotation at Morton Plant Hospital. On this rotation a single PGY-2 or PGY-3 is paired with a USF/MPM Family Medicine attending and is responsible for the admission and management of hospitalized Turley Family Health Center patients. Our typical operation model consists of one-on-one morning rounds with the Turley attending with a focus on individualized teaching and bedside rounding. There is noon conference daily, and the afternoon consists of patient care, continuity clinic, and structured teaching exercises throughout the week. Residents maintain one afternoon continuity clinic per week while on the rotation. Senior residents cross cover the Medicine and Turley service lines for daytime long-call coverage. The resident will follow this one-week long rotation with a one-week “Transition of Care” rotation at Turley Family Health Center. This provides the opportunity to see patients after hospitalization to experience the continuity of care from the inpatient to the outpatient environment.

Night Float rotation is an inpatient rotation that pairs a PGY-2 or PGY-3 with a PGY-1 for management of the “Turley” and “Medicine” service lines. This is a 12 hour shift rotation with the focus of overnight monitoring and admission of patients needing hospitalization. The goal is to gain experience on how hospital patient care operations adjust from daytime, and to ensure safe patient care is provided during the entirety of the hospitalization. Residents are provided with dedicated individual call-rooms in addition to the resident work room. Oversight is provided by the attendings of both the “Turley” and “Medicine” service lines.

PGY2 - 4 weeks orthopedics; PGY3 - 2 weeks orthopedics, and 2 weeks sports medicine

In both second and third year, we rotate with several different orthopedics and sports medicine groups. Most of our time is spent in clinic, becoming comfortable diagnosing and treating the more common orthopedic problems and sports injuries as well as performing pre-participation sport physicals. Common joint injections and aspirations are also taught during both rotations. We are exposed to musculoskeletal ultrasound in the evaluation of sports medicine patients.  There are also numerous opportunities to work as a team physician under the supervision of our sports medicine faculty for many local high schools and at mass participation events. Residents can spend time with our sports medicine faculty at the University of South Florida as well. We also have weekly sports medicine clinics at the Turley Family Health Center where we practice ultrasound-guided joint injections under the guidance of our excellent sports medicine attendings and fellows. Additionally, we are able to spend time at a BayCare urgent care facility treating acute and chronic musculoskeletal concerns.

We spend four weeks in the second year on this rotation. We work with local Obstetricians and Gynecologists to learn the presentation and treatment of common gynecologic problems. We have further opportunities to manage these problems in our own patients at Turley. During these rotations, we also learn to perform various gynecologic procedures such as colposcopies, endometrial biopsies, and IUD insertions.

The PGY-2 cardiology rotation allows residents to become proficient in the diagnosis and management of a variety of cardiovascular disorders. Most of the rotation is spent working one-on-one with our community cardiologists, both in the outpatient clinic setting and in the hospital setting. The rotation also includes exposure to Morton Plant’s Heart Valve Clinic and also BayCare’s Heart Failure Clinic. Skills learned include advanced EKG interpretation, cardiac resuscitation, appropriate use of stress testing and cardiac catheterization, interpreting echocardiogram findings, and other methods of assessing cardiovascular health. Residents are also taught how to counsel patients about behavioral and lifestyle factors that impact cardiovascular risk, as well as social determinants of heart health.

During this rotation, we work with a community pediatrician and take an active role seeing patients on our own and creating assessments and plans. Several afternoons per week, we will see pediatric patients at our Turley clinic, helping to build our own panel of pediatric continuity patients.

This rotation is based at Mease Countryside Hospital ER due to their pediatric inpatient capabilities. We see pediatric patients on our own and order any appropriate labs or imaging. We staff each case with the board certified pediatric ER attending and determine whether the child requires admission or can be treated and discharged home. Like the adult ER experience, it tends to be a fast-paced and fun rotation with great hands-on learning.

During this four week rotation we work directly with local Dermatology and USF dermatology attendings as well as with our dermatology clinic at Turley. This is our opportunity to become very comfortable performing biopsies, cryotherapy, electrocautery, and desiccation.

During this rotation, we work with a local group consisting of interventional radiologists, neuroradiologists, and nuclear medicine physicians. This is a very enjoyable rotation as the group is fun and we have the opportunity to perform procedures ourselves. We spend at least one day learning about the indications for and the interpretation of the many nuclear medicine studies. And, of course, we read films!

During this 2-week long rotation, we care for patients who require intensive care in the intensive care unit. It is common for our attendings to guide us through ultrasound-guided procedures like paracentesis or thoracenteses in our open ICU. As part of our Telemedicine Curriculum, you will have the opportunity to visit BayCare’s eICU where you may help manage critical patients and run codes overnight remotely from BayCare’s own Carillon Center. Because we work closely with our critical care attendings on our inpatient medicine service, this is a highly educational and enjoyable rotation.

This is an outpatient rotation at the Turley Family Health Center that is paired with the Turley inpatient rotation during the PGY-2, PGY-3 years. This one-week long rotation is a blend of continuity, acute care, and hospital follow up visit types. The focus is experience in management of acute illness/injury in a clinic setting. The management/coordination of post hospitalization care to close care gaps and prevent re-admission. As well as the opportunity to maintain your own continuity patient panel.

This is another outpatient-based community rotation where we work with private practice neurologists and learn about the office work-up of common neurological problems such as vertigo, headaches, dizziness, and neuropathy. We also learn about the office management of chronic diseases like movement disorders and vasculopathy. Finally, we have the opportunity to see interesting hospital consults including strokes and seizures.

This primarily outpatient (inpatient possible) rotation with private physicians provides residents with an introduction to the renal disorders commonly evaluated by family physicians. Disorders may be primarily renal in origin or systemic diseases that have profound secondary effects on the kidney, such as diabetes, atherosclerosis, and vasculitis. Prevention of renal disease, another focus of the rotation, is paramount in decreasing the burden of chronic kidney disease. The socioeconomic aspect of chronic kidney disease on overall health care spending is important for the resident to understand as well.

Our time in ophthalmology is spent with a community physician both in the office and the operating room becoming comfortable with the fundoscopic exam and the management of the more common ophthalmologic problems such as glaucoma, cataracts, and eye injuries.

During this rotation we work with a community ENT physician, learning to become comfortable with the more common ENT problems and the indications for referral. We have the opportunity to observe procedures such as rhinolaryngoscopy.

During this rotation, we work with a group of community urologists in their offices. We are exposed to a wide range of urologic problems and become comfortable with the office management of common urological problems as well as indications for referral. We view procedures such as stone extractions and retrograde pyelograms. We also get exposure to renal, bladder and prostatic ultrasounds.

This rotation is designed to familiarize our residents with the community resources available to our patients in Pinellas County. Some of our options include working with the Homeless Empowerment Program (HEP), Pinellas Hope Medical Respite Program (under negotiation), completing school physicals, teaching medical students, and working with the BayCare Transition of Care Teams.

This rotation is spent with community endocrinologists. We become very comfortable with the management of diabetes with insulin, oral and injectable medications. We gain experience with the work-up of other endocrine disorders commonly encountered by family physicians.

The Geriatrics curriculum prepares graduates to provide high-quality, evidence-based, patient-centered care to older adults. Residents gain experience managing older adults across a variety of settings, including inpatient, ambulatory, acute rehab, nursing home, and home visits. In Geriatrics clinic, the attending and resident physician collaborate to provide care for geriatric patients with an emphasis on addressing the often complex physical, cognitive, and psychosocial needs of older adults. We also coordinate medical with social services for vulnerable elder patients through the Area Agency on Aging of Pinellas-Pasco.