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Curriculum

We do more than train physicians. We train healthcare leaders.

We have designed our curriculum to offer superior clinical training, with comprehensive, evidence-based education in all of the core Family Medicine rotations and strong longitudinal experiences in Community Medicine, Integrative Medicine, Leadership, and Research & Scholarly Activity. Our innovative curriculum and schedule maximizes learning on every rotation. Didactics are a strong component of the curriculum, and we utilize simulation, mobile technology (such as “Telederm”), and other innovative tools to continuously learn, teach, and provide the best care.

Rotation Schedule

Capstone 3A: Scholarly Activity & QI/PI 2 weeks
Capstone 3B: Health Systems Managementand Leadership 2 weeks
Family Medicine Practice Continuity Clinic 3-5 half days per week
Petaluma Health Center 3-4 half days per month
Adult Inpatient Medicine Chief 8 weeks
Pediatrics (Outpatient) & Newborns 4 weeks
Women’s Health (Gynecology) 4 weeks
Maternity Care Shifts (on outpatient rotations) 1-2 shifts per month
Medical Subspecialties 3 weeks
Surgical Subspecialties 2 weeks
Pain Management & Addiction 2 weeks
Intensive Care Unit 2 weeks
Emergency Medicine 2 weeks
Surgery 2 weeks
Dermatology & Procedures 2 weeks
Community Medicine 2 weeks
Integrative & Lifestyle Medicine 2 weeks
LTC/SNF Rounds 1 half day per month
Scholarly Activity 2 weeks
Electives 8 weeks (4 away)
Electives (including up to 4 weeks away/Global Health elective) 8 Weeks
Vacation + CME 4 weeks

Curriculum

Adult Inpatient Medicine

  • Team of two PGY-1s, one PGY-2, one PGY-3, and 1-2 medical students, supervised by family medicine and hospitalist attendings
  • 24/7 access to specialists help develop competency and skill while providing the highest quality, equitable care to all of our patients regardless of insurance type
  • Care for medically complex patients drawn from a large catchment area, including uninsured, housing insecure, and underserved
  • Opportunity for many procedures, including formal training in Point Of Care Ultrasound (POCUS) for inpatient medicine
  • Morning rounds, formal didactics during and off rotation, and simulation training

Pediatrics

Residents receive repetition and robust volume in pediatrics by rotating through pediatric outpatient clinics, inpatient pediatric care, newborn rounding, and dedicated pediatric time in the Emergency Department. Residents train with family medicine faculty, pediatricians, and Emergency Room physicians at our Santa Rosa, Walnut Creek and Antioch facilities. The curriculum consists of:

  • 8 weeks in the first year of combined inpatient/outpatient shifts – round on inpatient in the morning (including pediatric and teenage patients, newborns, lactation, circumcision if desired) then outpatient pediatrics in the afternoon, to maximize learning and patient numbers.
  • 4 weeks of inpatient pediatrics, newborn resuscitation and ED at the Kaiser Medical Center in Walnut Creek as a member of the inpatient pediatric service.
  • 6 weeks of combined additional outpatient pediatrics in the second and third years, including urgent care.
  • Residents have the option of doing a maternal/child or urgent care “track” in the 3rd year, whereby they spend additional time either on labor and delivery and caring for newborns at deliveries or spend time doing additional pediatric and adult urgent care.
  • Caring for pediatric patients from birth to adolescence in the resident continuity clinic, where residents average >25% pediatric visits per clinic and have 10-25% pediatric patients on their patient panels.
  • There will also be opportunities to provide teen education at teen parent groups, teen mentorship at Ceres Community Project, and to conduct pre-participation physicals at high schools around Sonoma County.

Gynecology

We believe gynecology IS family medicine, and family medicine IS gynecology. Our Family Medicine and Ob-GYN faculty have teamed up to make this rotation full of learning experiences. Your mentors will consist of both family medicine physicians and obstetrician gynecologists and your clinics will be in both the Adult and Family Medicine and Obstetrics and Gynecology departments.

You will have two Gynecology blocks in your first year. The first will be 3 weeks long, followed by a 1-week vacation in the first half of the year. Your second block will be in the final 6 months of your first year, and will be 4 weeks long, including a 2-week vacation. You will have a 2-week GYN block in your second year, and the opportunity for GYN elective time.

Our goal is to expose you to the broad breadth of gynecology health issues that you will encounter as a family doctor. Each topic is also within the scope of what you will also be seeing in your continuity clinics too. During this rotation, you can expect a 1:1 clinical experience with the attending in each of the following clinics:

  • General Gynecology Clinic
  • Procedure Clinic
  • SAB and TAB Procedure Clinic
  • Colposcopy Clinic

We will teach you to pay attention to gender expansive language and introduce you to workflows that ensure equity and inclusion of our nonbinary/transgender patients

General Gynecology Clinic: The unique set of patients scheduled each day will provide the backdrop for you to grasp a solid fund of gynecology knowledge. Here you will address issues ranging from vaginitis, to abnormal uterine bleeding, hormonal issues, STIs, contraception, breast problems, and cancer screening. If the menstrual cycle and the actions of the sex hormones have intimidated you in the past, don’t fear! You will become much more comfortable and fluent in this area.

Procedure Clinic: Consider this your “long-acting contraception” clinic. Here you will have ample opportunity to refine your speculum skills and find every cervix with ease! You will learn the risks/benefits of all forms of long-acting contraception and will gain the skills to counsel patients and independently perform these procedures in your future practice. You will also perform endometrial biopsies in this clinic.

SAB and TAB Procedure Clinic (opportunity to opt out): Here you will be exposed to the management of early pregnancy loss and elective terminations. You will practice dating early pregnancies and learn about medical and procedural management, including the risks and benefits of each. If you decide that doing TABs is not for you, come speak to one of us and we will come up with an alternative educational experience.

Colposcopy Clinic: We have a brand new beautiful colposcope! Here you will gain the skill of colposcopy and an in-depth understanding of cervical cancer screening, including the management of abnormal pap smears.

Obstetrics

Residents work 1:1 with nurse midwives, family doctors, and obstetricians as they learn skills and become increasingly competent and independent in obstetrics, both in our own family medicine center, our obstetrics and gynecology clinic, and on Labor and Delivery. Upon graduation, all residents will be well-prepared to provide low-risk obstetrics including prenatal care and postpartum care. For residents desiring additional obstetrics training or preparing to go to OB fellowship after residency, electives in high-risk obstetrics are available.

  • 16 weeks combined in the first and second years on Labor and Delivery caring for and delivering patients admitted for labor under the supervision of family medicine faculty, obstetricians, and certified nurse midwives. High volume department averages >150 deliveries per month
  • Additional L&D shifts scheduled across the third year to maintain skills, along with workflows to encourage residents getting continuity deliveries
  • Attention to gender expansive language and workflows to ensure equity and inclusion of our nonbinary/transgender patients
  • Caring for prenatal patients in the residents’ own continuity clinics in the family medicine center

Behavioral Medicine

Residents at our program get a comprehensive longitudinal experience in patient care as well as space for personal development and self-reflection, in large part facilitated by our faculty behaviorist and psychiatrist who are enthusiastically dedicated to resident learning and wellness. The behavioral medicine residency curriculum is incorporated into all aspects of outpatient and inpatient care, beginning with a longitudinal curriculum woven into every rotation of the first year.

  • Longitudinal curriculum throughout the three years including integrated presence of our faculty psychiatrist and psychologist in the family medicine center
  • Formal didactics throughout the three years including opportunities for 1:1 learning about relevant psychiatric conditions/concerns on inpatient medicine, obstetrics, musculoskeletal, and other rotations.  Also included are hands on patient evaluations throughout the three years to develop skills in motivational interviewing, diagnosis and treatment.
  • Dedicated chronic pain and addiction medicine rotation with time in the Chemical Dependency Recovery Program (CDRP) and the opportunity to learn about buprenorphine prescribing. Residents learn, in a compassionate and holistic way, the evaluation and treatment of patients with chemical dependency.
  • Training in mind-body techniques such as motivational interviewing, HeartMath, mindfulness, and other evidence-based modalities for mental health and wellness as well as Personal and Professional Development (P&PD) and Balint support groups.

Community Medicine

Our program engages residents in community health from day one, primarily through longitudinal curricular experiences with our affiliated partner, Petaluma Health Center, a federally qualified health center (FQHC) which includes a high performing wellness and prevention-minded community health center, a homeless clinic, school-based clinics, and other safety net programs. All residents see patients at PHC regularly throughout their entire three years, precepted by our Community Medicine Fellow. Our curriculum encompasses population health, public health, leadership, and advocacy for justice in healthcare and other social determinants of health. Graduates will have the knowledge and skills to lead sustainable community change.

  • 3-week block in the second year and 2-week block in the third year.
  • Residents explore the concept of “The Community as a Unit of Health”, both in addressing our most vulnerable community members as well as exploring the population-based and structural supports that help maximize the total health of all members of a diverse community.
  • Experiences during community medicine rotations include (but not limited to):
  • Didactic curriculum in community medicine, population health, public health, structural competency, health equity, and advocacy for justice in healthcare

Musculoskeletal and Sports Medicine

Caring for musculoskeletal injuries and conditions is one of the most important skills a Family Physician will develop. Residents will learn how to manage these injuries through the eyes of specialists in Sports Medicine, Orthopedic Surgery, Physical Medicine and Rehabilitation and Podiatry.

  • 4 weeks in the first year and 4 weeks in the second year, with repetition and further skill development seeing patients in continuity clinic.
  • Didactics, workshops, and opportunities for training room, team sport, and mass event coverage. Residents will learn to care for uncomplicated fractures, learn to recognize when a consult is necessary, master physical examinations, and aspirate/inject joints and soft tissues.
  • Formal and informal training in musculoskeletal ultrasound with opportunities for more advanced training in point of care ultrasound (POCUS).

Simulation and POCUS Training

Each class participates in a state-of-the art simulation lab with our high-fidelity mannequins and trainers. We teach hands-on skills for common procedures and emergency situations, including lumbar puncture, obstetrical emergencies, laceration repair, intubation, point of care ultrasound, and joint injections. Throughout the three years of training, our residents have scheduled resident specific OSCEs utilizing our skilled cast of standardized patients; these cases focus on common diagnoses and clinical management, interpersonal communication skills, and ethical conundrums. Sessions conclude with a video review and facilitated debriefing to get supported coaching on clinical management and team-building skills.

The residency has three point of care ultrasound devices to use in both the hospital and clinic setting. In addition, you will have access to ultrasound carts for use on your other core rotations including (but not limited to) obstetrics and gynecology, the intensive care unit, and the emergency department. Point of care ultrasound training occurs across a wide range of clinical settings and will cover heart, lung, abdomen, vascular, obstetrics, musculoskeletal, bedside procedures, and others. Multiple hands-on training sessions are also built into the curriculum. Finally, there is simulation software available to provide virtual training.

Family Medicine Practice

Continuity clinic is the cornerstone of all Family Medicine residency programs. We are committed to providing high quality personalized care for a diverse population of patients in all phases of life. (All) Our residents and faculty practice full-scope outpatient family medicine in our Family Medicine Center, including gynecologic, dermatologic, and musculoskeletal procedures, pediatrics from newborn to adolescence, and prenatal care.

  • Residents are assigned their own panel of patients (starting with 100 patients and growing to a maximum of about 400-500 patients by graduation) to maximize patient-physician bonding and continuity of care.
  • Each resident team has a dedicated medical assistant to ensure patient continuity. Residents will spend an increasing number of half days per week in the FMC as they progress from first year (average 1-3 half days per week) to third year (average 3-5 half days per week).
  • R3s will have the unique opportunity to transition from resident learner to clinical teacher and leader through our Ambulatory Care Chief Curriculum. This curriculum includes leadership training in practice management and team facilitation, and guidance in developing a quality or performance improvement project.

Emergency Medicine

Our Emergency Department services a diverse patient population, which includes pediatric to geriatric cases and patients of all insurance statuses. Residents are the only learners in the Emergency Department, providing an optimal learning environment. Residents have a dedicated Emergency Medicine rotation, but also care for patients in the ED while on other inpatient and subspecialty services. The Simulation Lab is utilized for specific scenarios and complements the rotational experience.

Surgery

Residents will have rotations in both General Surgery as well the surgical subspecialties. Residents are assigned to a surgical attending for a 1:1 teaching experience, always acting as first assist in the operating room. Our goal in the OR is for residents to learn surgical skills. Residents also focus on preoperative and post-operative management and care.

Capstone

We have designed an innovative set of immersive learning experiences for 4 weeks during each year of residency to catalyze each class’s learning as they move from one level of training to the next.

  • R1: Clinic Immersion and Community Medicine: The first-year curriculum immerses interns in our Family Medicine Center and community partners FQHC Petaluma Health Center and Ceres Community Project. Begin and end your R1 year with a focus on clinical skill building and community medicine, spending time in the garden and kitchen at Ceres Community Project.
  • R2: Advanced Clinical Skills and Global Medicine: Expand your skills with leadership training and advocacy work, including an optional class trip to Guatemala with our Community Medicine Faculty to work beside lay health workers in a rural underserved community (pending safety of global travel). Engage in advanced clinical training to set you up for success as you transition to second and third year senior resident duties inside and outside the hospital.
  • R3: Leadership and Professional Development: Third years will broaden their expertise as teachers and practice leaders with an ambulatory care chief curriculum that will prepare you to be a superb clinician-leader in any community setting around the world. Residents will have funded support and guidance in both global health opportunities and research projects.

Scholarly Activity and Research

Kaiser Permanente has the second-largest patient database in the country (second only to the VA Medical system) and a regional Kaiser Permanente Division of Research; these are incredible resources that help us conduct patient-centered, clinically relevant, community-minded research. We are also thrilled to have a full-time research project manager on-site to support all faculty and residents in scholarly activity. All residents will complete a collaborative scholarly activity project and a QI/PI project during residency and will get faculty support and advising for this requirement. Residents and faculty will pitch their research and QI/PI projects each year at an annual “Research Shark Tank” event; faculty-resident teams will then work together to develop their projects, which may include retrospective data analysis, curriculum design, or writing for publication. Second and third-year residents will then collaborate with our Quality Team and FMC leaders to develop and implement a patient-centered practice improvement project. We financially support our residents presenting at conferences.

Integrative Medicine

We are privileged to formally affiliate with the UAzIMR, the University of Arizona Integrative Medicine for Residents curriculum. This is a three-year longitudinal curriculum designed to be interwoven into the 36 months of clinical rotations. UAzIMR is committed to developing physicians who model the healthy lifestyle they learn about, have a positive sense of well-being, and are relationship-centered in their approach to medical care. This philosophy is incorporated into the curriculum, reflective exercises, and collaboration with faculty and peers. All residents have access to the online curriculum when they start residency, and dedicated time and formal didactics for a portion of the curriculum. Those who are interested may use elective time to complete the whole 200-hour curriculum and receive a certificate of completion upon graduation.

Physical Health and Wellness

Our program values wellness and a healthy work/life balance. We believe that doctors who take care of themselves take better care of their patients. With a humane schedule (no overnight shifts in the first year and no 24-hour call at all!), strict adherence to ACGME Resident Work Hours requirements, and supportive faculty, we ensure that our residents “thrive.” Our faculty model healthy, balanced lifestyles.

Formal residency wellness practice includes:

  • Resident Balint Group: Balint is a small-group method of discussing and reflecting on the doctor-patient relationship. The purpose of the Balint Group Session is to build empathy for the patient and to explore creatively the unique bond between doctor and patient.
  • Personal & Professional Development (P&PD) Groups: Regularly scheduled with protected time, weekly Personal and Professional Development (P&PD) sessions are facilitated by a skilled behaviorist to foster support and community during this dramatic time of growth and experience.
  • Our Integrative Medicine Curriculum includes time for self-reflection, personal health goal setting, and respect for the body, mind, and spiritual aspects of the resident experience.
  • Residents will participate in HeartMath training and mind-body techniques such as guided visualization, meditation, and yoga. A heart and meaning in medicine group is also held monthly.

Electives

Residents have a total of 12 weeks of elective time (4 weeks in the second year, 8 weeks the third year) to pursue training and experiences in areas of special interest. During the third year, 4 of the 8 weeks of elective time may be spent away with no required on-campus clinical duties. Residents can create their own elective experiences, or they may elect to participate in our formalized elective rotations, including (but not limited to):

  • Advanced Obstetrics
  • Lactation
  • Gynecology
  • Point of Care Ultrasound
  • Integrative Medicine & Lifestyle Medicine
  • Sports Medicine
  • Global Health
  • Health Policy
  • LGBTQ Care
  • Community Medicine
  • Geriatrics and Palliative Care

Residents have access to all Global Health rotations through Kaiser Permanente California. Our partnerships with nonprofit global health organizations help foster global citizenship amongst our physicians. Residents make critical connections between global social and healthcare issues and their local communities. Residents explore the health effects of poverty, migration, climate change, emerging infectious disease, and access to healthcare. These experiences add depth and breadth to the clinical capacity of our physicians, and in the process, improve the care they provide to our local and global communities. Additional funding is available to offset the costs of travel through the Reginal GME Department.

Geriatrics

Sonoma County is a wonderful place to retire, hence many seniors reside here. Residents will participate in both a longitudinal and focused curriculum geared toward providing high-quality care across the geriatric timeline. Residents are assigned to an extended care facility where they learn the art of managing patients in a non-hospital setting. This includes geriatrics, home care, hospice care, and other community-related experiences. Didactic seminars, geriatric assessment scales, and ethical decision making are all part of the overall experience. Throughout residency, we teach geriatric clinical skills through a Family Medicine lens. At least six home visits are made to complete the scope of caring for the elderly as a family physician.

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