Curriculum

A weekly schedule of formal teaching events will be posted. Your prompt attendance is required at educational meetings, unless a commitment of higher priority takes precedence. The relative priority can be changed by prerogative of the chief of the department to which you are assigned. The priorities are usually ordered as follows:

Attendance at Conferences: When residents are assigned to a specific service, they will be expected to invest themselves in that service and to attend related conferences, i.e., while on surgery service, residents are expected to attend Surgical Grand Rounds. All residents are required to attend the Family Medicine Didactics, Balint Group, Residents' Round Table, and Team Meetings. Punctuality at rounds and conferences is mandatory out of respect for the persons who organize and speak at these functions.

Each year the residency will send resident leadership to the National Conference of Family Medicine Residents & Students. The trip will be funded by the residency and time away will not be taken out of CME or vacation time.

While not a didactic lecture, the Residents' Round Table held every first and third Tuesday at 12:30 p.m. is one of the most important resident meetings. Round Table is an open forum for proposals, criticisms, and evaluations by residents, faculty, and clinic staff - and is where most ideas get their initial airing. This is the time that the entire program sits down together to communicate ideas, feelings, achievements and frustrations. On alternate Tuesdays, each of the Clinic teams, including nurse and faculty, meet individually to discuss team patient problems, charts, practice management issues, and family medicine topics. The second Tuesday of the month teams meet individually, and on the fourth Tuesday the three Swedish Family Medicine teams meet as a group (Group Teams). Residents learn group practice dynamics and leadership skills at these meetings.

The Swedish Family Medicine Clinic M&M conference is held on the first Friday of each month. This conference is intended to be an opportunity for residents and faculty to learn from Family Medicine Clinic patients (outcomes listed below). The conference is run by a Family Medicine faculty attending(s) who will review the cases for the previous month. Residents and faculty responsible for the patient will present cases; if the primary resident is not present, the resident or faculty most familiar with the case will present it. An informal discussion of each patient expands everyone's understanding of patient management. Pertinent papers directed at specific problems may be provided. All incidents involving M&M to patients are to be listed on the sheet posted in the faculty office or recorded through the QCP system.

Hospital admit for adverse patient outcome	Patient death
Return to clinic/ER for adverse patient outcome	Clinic-incurred incident
Unplanned surgical outcome	Patient dissatisfaction
Infectious complication	Drug reaction
Error: blood product	Continuity/preventive care deficiency
Error: medication	Delay in diagnosis
Error: test follow-up	Delay in consultation
Record documentation deficiency	Other, miscellaneous

Held each Wednesday, this conference features a case presentation of interesting family medicine scenarios. An actual case history is presented and residents and faculty generate a differential diagnosis, review EKGs, lab tests, imaging studies, and outline management options in a relaxed atmosphere. Cases cover internal medicine, pediatrics, and OB/GYN, and often specialists consulting on the case will attend the latter part of the conference for additional teaching and questions.

On Tuesdays at 1:40 p.m., the R-1's, with either Dr. Janet Hopkins or Dr. Jonathan Wulf, meet for an hour to talk about current and on-going personal and professional issues. Developing good communication skills is seen as an important goal. R-1 Groups vary in their preferences for how to best use this weekly meeting. A variety of possibilities exist. Since R-1 group is a formal part of the curriculum, regular attendance is required. R-1's are paired during their COH rotation to allow one person to leave and one to stay behind (if necessary).

R-2's and R-3's participate in a Tuesday meeting that is known as Balint Group. Balint was a British psychiatrist who developed the concept that physician self-awareness is an important aspect of medical training, development, and practice. Residents gather to discuss and share their perceptions of and feelings about their patients, especially those patients who tend to evoke strong positive or negative emotions. Case presentations are often used to illustrate the physician's role in the doctor-patient relationship. Ethical issues are frequently addressed. Drs. Janet Hopkins and Jonathan Wulf alternate serving as the group facilitator.