Family Medicine Residency - Whittier Curriculum
Rotations - First Year Curriculum
During the first year, residents split their time between LAC+USC Medical Center and PIH Health in Whittier. The rotations blend the large university county hospital experience with the private community hospital setting. Residents gain independence and individual confidence during the months at the county hospital. While on rotations within PIH Health, residents are better able to synthesize their newly gained knowledge under the more closely supervised environment. Throughout the year, interns maintain office hours one half-day session a week at the Family Practice Center and establish a primary care provider relationship with a panel of continuity patients.
Family Medicine Orientation (4 weeks)
During the first month of the intern year, residents participate in various didactic lectures covering basic principles of disease, physical diagnosis, administrative policies, and interviewing skills. Interns also gain an introduction to the Family Practice Inpatient Service rotation through highly supervised care of a limited number of hospitalized patients. First year residents are also introduced to patient care in the office setting and begin developing their office-based practices. New interns receive certification in Advanced Cardiac Life Support (ACLS), Neonatal resuscitation and Advanced Life Support for Obstetrics (ALSO).
Family Practice Inpatient Service (16 weeks)
Residents spend four months working in teams to admit and manage hospitalized patients while on the family medicine service. During the rotation, each team will admit and manage a wide variety of acutely ill pediatric and adult patients. Residents are directly responsible for patient care including regular hospital floor and intensive care unit patients. On call, residents also participate in stand-by OB deliveries, C-section assists, and surgical first assisting, thereby completing the full spectrum of Family Practice. Residents learn critical thinking with regards to the hospitalized patient and become proficient at various procedures, surgical assisting, and medical management. During the month-long rotation, residents take in house call under in-house senior resident supervision. Call schedule during the rotation is approximately every four days. The rotation involves daily-organized morning report with teaching by a panel of family medicine, internal medicine, critical care, surgery and pediatric attendings, as well as social services and hospital pharmacy fellows.
“Residents obtain superior training in caring for the hospitalized patient and are confident in the care of the acutely ill patient.”
-Alex Tran, Resident
Behavioral Science (4 weeks)
Emphasis is on improving doctor-patient interaction in the office and hospital settings. During the four-week rotation, residents will also receive didactic instruction and clinical exposure to psychiatric illness. While on service, the resident will work one on one with the Behavioral Medicine Coordinator. Residents gain valuable insight into patient, family, and physician attitudes and perceptions when treating acute and chronic diseases and dealing with end of life issues. Residents are in the family practice office setting three to four half days a week where they are given constructive feedback and training while seeing patients.
“Introduced to new and various aspects of medicine helpful throughout training.” “Residents obtain superior training in caring for the hospitalized patient and are confident in the care of the acutely ill patient.”
-Angela Cherlin, Resident
Women’s Health (4 weeks)
Residents follow along and manage private OB patients in PIH’s beautiful Ruth B. Shannon Maternity Care Center. During the rotation, first year residents become comfortable handling uncomplicated obstetric deliveries and first assist on C-section deliveries. With progressive experience, residents learn to identify and manage common complications in the pregnant patient. Weekly teaching rounds are conducted by Family Medicine and OB/GYN attendings. Call schedule during the rotation is approximately every five days. Residents also attend gynecological procedures and surgeries during the rotation.
Emergency Medicine (4 weeks)
The Emergency Medicine rotation is based at PIH’s R.C. Baker Regional Emergency Center. Patients are seen and evaluated under the close supervision of the Emergency Center attending. In addition to gaining valuable experience and confidence in managing patients with emergency and urgent care problems, residents have numerous opportunities for learning office and hospital-based procedures. Residents are assigned flexible weekday shift hours including some weekends.
“Great Experience working one on one with ER attendings. Plenty of procedures with good pace for learning adjusted to your level of comfort"
-Robert Boonyaputthikul, Resident
Pediatric Acute Care/Peds Clinics (4 weeks) Residents rotate through Pediatrics at LAC+USC, evaluating and treating acutely ill pediatric patients. They also spend time at various pediatric subspecialty clinics (Surgery, Cardiology, HIV, TB). Excellent didactic teaching is provided through attendance of pediatric grand rounds, problem rounds, and morbidity and mortality review. The month-long rotation provides weekends off and weekday short call until 10pm once weekly.
“Attendings are very helpful and they love to teach. We see pathology that normally we only see in textbooks. Great experiences!”
-George Wang, Resident
Pediatric Wards (4 weeks)
Residents rotate onto the very busy Pediatric Inpatient Service at LAC+USC Hospital. PIH Family Practice residents work side by side with pediatric residents and attendings while they are assigned to one of the four pediatric inpatient teams. A wide spectrum of complicated and uncomplicated pediatric illnesses are admitted and co-managed by the intern and senior pediatric resident. Additional responsibilities include daily presentations at attending rounds, and peds call every fourth night. On average, interns will admit one to five patients per call night.
“An Invaluable experience with diverse pathology. A definite “plus” to our training.”
-Eric Madrid, Resident
Newborn Nursery (4 weeks)
Residents spend four weeks in the Newborn Nursery. Newborn nursery provides endless opportunities to conduct newborn examinations and identify common exam findings as well as potential high risk infants. It includes short call until 9 pm.
“Hands-on experience with babies; Really good lectures, attending rounds and Midlevel’s are really helpful.”
-Daniel Camarillo, Resident
Rotations - Second/Third Year Curriculum
Geriatrics/Community Medicine (4 weeks)
With an ever-growing elderly population, the special needs and concerns of the geriatric patient are an important part of a family physician’s training. Residents gain valuable experience managing patients in the community’s skilled nursing facilities, assisted living centers, and the patient’s own home. The focus is on the diagnosis, intervention, and long-term care issues of the frail elderly. Combined with the rotation is a community medicine component that consists of an orientation and immersion into the process of evaluating whole communities in regard to their health issues. From County Health Department STD clinics to the Vector control Center for an overview of county efforts at stemming insect-born maladies, we provide an understanding for the resident as to what constitutes a well community. Included in the experience is exposure to occupational/industrial and preventive medicine. In addition, the residents coordinate and intervene for the care of at risk population including California Institute for Women (a prison program), the Rio Hondo Temporary Home and the CRC, (a collaborative effort at social/physical and emotional service for patients with limited access).
“A great rotation that not only has a variety of clinical experiences but great didactics as well.”
-Ben Birdsall, Resident
Practice Management (2 weeks)
Residents learn about the business and management aspects of an independent and group practice. Through didactic lectures scheduled throughout the year and week-long training conferences, residents are introduced to a vast array of topics, such as developing your resume, interview techniques, how to pick a practice, contracts, billing and coding, and financial planning.
The dermatology curriculum is both a longitudinal experience and a four-week block rotation done in the PGY-2 or PGY-3 years. In addition to weekly practical procedure clinics, residents have opportunities to participate in a dynamic curriculum, including a laser tattoo removal clinic for ex-gang members who are re-joining the workforce and a wound care specialty clinic. In addition, residents are given access to comprehensive CD-ROM based dermatology program that includes over 2,000 pictures of dermatologic diagnoses common to family medicine. At the completion of their training, residents will be well-practiced in diagnosis, treatment, and management of the full-scope of dermatologic conditions.
Palliative Care (4 weeks)
The Home Care/ Palliative Care Program is a longitudinal course of study involving patient care, multidisciplinary group meetings and academic study and discussion. Residents will become comfortable in improving the lives of patients by means of treating pain and other distressing symptoms and integrating the psychological and spiritual aspects of care. Residents and students will gain experience by working in home visits, nursing homes, clinic, and hospice.
Surgery (8 weeks)
Residents work one on one with private surgical attendings. The surgery rotation includes inpatient and office-based practice with the majority of time spent learning about the diagnosis of common surgical conditions and techniques of surgical assisting. Residents serve as first surgical assistants on the majority of operations performed during the month-long rotations. Days are traditionally long, but residents take no in-house surgery call.
Pediatrics PIH (8 weeks)
These 4 week rotations are split between in-patient and outpatient setting. Office-based pediatrics is under the supervision of a local pediatric attending. Residents see a large volume of well-child care and common ambulatory pediatric problems. Residents admit and round on hospitalized patients in the morning.
Women’s Health (12 weeks)
Both obstetric and gynecological issues and preventive health for women are focuses for this rotation. Residents see female patients with a variety of health concerns both acute and chronic during the Women’s Health Clinic time at the Family Practice Center. Common problems, such as prenatal evaluation, management of abnormal PAP smears, problems with menstruation, contraception, menopause, and breast disease, are just a few of the conditions seen. Residents gain additional experience in performing well-woman examinations and such office procedures as colposcopy, cryotherapy, endometrial biopsy, and IUD insertion. Call coverage for OB expands upon the residents’ obstetric skill. During the month long rotation, residents also assist on various gynecological surgeries. Excellent teaching and supervision is provided by and enthusiastic team of hospitalists.
International Medicine Qualifying residents may choose a 2-4 week elective in International health. Opportunities are also available for language and cultural immersion rotations. The program has a separate Tropical Medicine 3 year longitudinal program, with a focus on Sub-Sahara Africa. This program is open to pre-selected residents.
The PIH Family Medicine Residency has an extensive Didactic lecture training series. Didactic conferences take place Mon, Tues, Wed, and Fri. of each week (holidays excluded). Faculty are responsible for the bulk of the lectures, with visiting lecturers and other clinicians participating from all over the United States. The lecture series consists of didactic and hands-on workshops taught in a small group setting.
Residents regularly attend multidisciplinary conferences such as Geriatric Ground Rounds, Tumor Board, Pediatric Ground Rounds, Family Practice Grand Rounds, and Hospital CME programs. Residents also participate in the quarterly Family Medicine Department Meetings, and the quarterly General Medical Staff Meetings. At different times throughout their training, residents are responsible for giving lectures, and overseeing the Residency M and M rounds.
The didactic lecture series is designed on a 2-year cycle of core topics with added miscellaneous medical and professional lecture subjects, workshops, and scholarly activities interspersed within the core curriculum.
Didactic Conference Subject Areas Include:
- Tumor Board
- Palliative Care
- Human Behavior
- Support Group
- Community Medicine
- Pediatric Hospitalist Medicine
- Obstetrics and Gynecology
- General Surgery
- Surgical subspecialty
- Journal Club
- Scholarly Activity
- Practice Management