Curriculum Details

The St. John's Hospital Family Medicine Residency Program provides a diversity of patients, teaching faculty, and learning opportunities so residents will develop well-balanced clinical skills and knowledge.

First Year
The first year of residency emphasizes inpatient care. Residents are also introduced to ambulatory family medical care at the Phalen Village Clinic. All rotations in the first year are required. Several are described below.

• Adult Medicine Residents manage a busy inpatient medicine service for two nonconsecutive months. It is coordinated by a full-time residency faculty member board-certified in internal medicine and includes daily didactic teaching. On this service, residents provide care to all Phalen Village Clinic patients who are admitted to the hospital. In addition, the medicine team (a first-year, second-year, and third-year) cares for patients without a local physician who are evaluated in the St. John's Hospital emergency room and require admission. Residents manage patients in all areas of the hospital, including telemetry and ICU. Program faculty serve as preceptors for obstetric patients, pediatrics, and all inpatients after hours and on weekends. The first-year resident on this service does not round on weekends.

• Emergency Medicine For two consecutive months, residents evaluate and treat patients under the supervision of experienced emergency room physicians in the St. John's Hospital emergency department. The rotation consists of eight-hour shifts, and there is call only during the second month.

• Surgery This rotation is performed with a private group of five general surgeons. Residents provide pre- and post-operative care, surgical consultations, and assistance with surgeries.

• Pediatrics Residents spend one month on the teaching service at Children's Hospital in St. Paul, taking care of general pediatric inpatients as well as pediatric intensive care patients. The resident works on a team including pediatric and family medicine residents and medical students.

• NICU One month is spent in St. John's Hospital's NICU, working directly with neonatologists and neonatal nurse practitioners both in the level 2 nursery and attending deliveries and C-sections. Also during this month, the resident will see patients at one or two pediatric outpatient clinics. During the school year, one half day per week is spent in the training room of a local high school, assessing and treating student athletes.

• Obstetrics During two nonconsecutive months, residents cover the entire labor and delivery service, each delivering approximately 150 babies and assisting with C-sections. This is in addition to the many deliveries the resident performs throughout the year while on call. There is an obstetric lecture for residents and medical students once per week.

• Cardiology The resident works directly with an assigned cardiologist from a busy consultant group at St. John's Hospital. Often a medical student is part of this teaching team. This one-month rotation is repeated in the third year.

• ICU The resident works directly with an assigned pulmonologist from a busy consultant group at St. John's Hospital. Most patients are in the hospital's ICU.

For more detail on the first year rotations and schedules, see Ye Olde Intern Manual.

Second Year

• In the second year, residents learn to manage a wide spectrum of medical problems, including those characteristic of the traditional specialty disciplines. This occurs in both hospital and clinic settings, and includes an emphasis on office procedures, patient care, and office management. At Phalen Village Clinic, residents practice in teams to provide continuity of care. During the second year, residents are scheduled in the clinic four half-days per week, providing care to their own panel of patients, including significant numbers of high-risk OB patients. Preceptor to resident ratio in the clinic is 1:3.

• Second year rotations include adult inpatient medicine, behavioral medicine (hospice, child psychology, counseling), community health, family medicine, geriatrics, inpatient neurology, ophthalmology, orthopedics, orthopedic ER, otolaryngology, pediatrics, and podiatry. A month-long elective* is allowed in the second year.

Third Year

• The third year emphasizes attainment of advanced technical and conceptual medical skills. Three to five half-days are spent at the Phalen Village Clinic. Continuity of care, comprehensive family medicine, family dynamics, practice management, consultative medicine, and surgery services strengthen the curriculum.

• Third-year rotations include advanced surgery, chief, colo-rectal surgery, gynecology, internal medicine, outpatient neurology, pediatric emergency medicine, pulmonology (inpatient and outpatient), and urology. Three months of electives* allow the residents to gain additional knowledge and experience in many subspecialty fields as well as in procedures and in international medicine.

* Electives provide an opportunity for residents to tailor their education according to their interests or strengths. Recent electives include: adolescent medicine, advanced geriatrics, advanced obstetrics, advanced pediatrics, advanced emergency medicine, child abuse treatment, diabetes education, diabetes research, eating disorders treatment, endocrinology, gastroenterology, infectious disease, nephrology, pediatric cardiology, pharmacology, procedures, rheumatology, sports medicine, and international medicine (India). We have a well established clinical elective in Hawaii, where many of the patients are of native Hawaiian descent.

Elective rotations are available at other UM family medicine programs, and electives developed by residents are encouraged.