Teaching-Health-Center

Curriculum

Family MedicineThe Family Medicine Residency Program is a postgraduate training program following graduation from a College of Osteopathic Medicine, approved by the Commission on Osteopathic College Accreditation (COCA). The length of the residency program is three years.

The program provides residents with advanced and concentrated training in Family Practice and Osteopathic Manipulative Medicine and will prepare them for the examination provided by the American College of Osteopathic Family Physicians (ACOFP). This training program has been designed in compliance with the AOA Basic Standards for Family Practice and the ACOFP.

Upon successful achievement of the program, the physician will be prepared to provide comprehensive osteopathic primary care to diverse populations in multiple clinical settings. The program offers the resident with well-structured training in both cognitive and procedural domains, which will provide primary responsibility for patient care in the inpatient and outpatient settings. This training will offer extensive didactic and clinical experiences. Utilization of osteopathic principles and practices relating to family medicine will be incorporated into the training program.

The Osteopathic Medicine Department will choose a pertinent topic each month to instruct the Osteopathic Workshop series. The workshops will consist of an informal discussion of the topic followed by a practical portion during which participants will practice the examination skills and the techniques that will be demonstrated. Teaching faculty will be immediately available for supervision, consultation, and support of the resident in patient management issues. Residents will be supervised with progressive varying levels of oversight, depending on their educational level, skills and level of expertise.

As per institutional policy, and in accordance with the AOA regulations, resident’s duty hours will be closely monitored and will not exceed an 80-hour week average in order to establish the best environment for residents to maximize their educational experience while still maintaining continuity of patient care. All call schedules will be distributed to guarantee that residents never work more than every third night and have at least one or two days in seven days (averaged over a four-week period) free of regular responsibilities. The teaching health center will provide adequate in-house sleeping quarters, food services, library availability and inter-professional support services to establish an optimal environment for the resident productivity and wellbeing.

During the first year of residency training, residents are expected to develop:

  • Complete history and physical examination based on the complaint.
  • Be able to formulate a differential diagnosis based on the complaint.
  • Be able to recognize a patient experiencing acute distress.
  • Be able to recognize a patient experiencing a psychiatric condition.
  • Develop proficiency in vaginal deliveries.
  • Show progress in developing proficiency in health promotion and disease prevention.

During the second year of residency training, residents should:

  • Be able to develop a complete differential diagnosis.
  • Be able to work with a critically ill patient and institute first line of treatment modalities.
  • Develop criteria to decide which patients should be managed at an ambulatory setting and those who would benefit the most from hospitalization.
  • Be able to perform office procedures common in the practice of Family Medicine.
  • Be able to supervise lower level of residents and develop teaching skills.
  • Show progress in developing proficiency in health promotion and disease prevention.
  • Show progress in developing proficiency in the care of the patient with chronic illness.
  • Show progress in developing proficiency in the care of the patient with psychiatric illness

During the third year of residency training, residents should be able to:

  • Formulate a complete differential diagnosis based on history and physical exam.
  • Formulate an assessment to establish treatment modalities (decision making)
  • Be able to work with the acute and chronically ill patient.
  • Be able to work with the patient having acute and chronic psychiatric illness.
  • Recognize when it is appropriate to consult or refer to a specialist or sub-specialist.
  • Demonstrate proficiency in the evaluation of the surgical patient for medical clearance.
  • Develop administrative skills that facilitate an optimal care to the patients.
  • Develop skills and strategies for adequate Community Care.
  • Be able to supervise lower level of residents, medical students and develop teaching strategies guided by the Faculty.

At the end of the training program, the trainee will be expected to:

  • Progress toward unsupervised, independent care at the time of graduation.
  • Develop the skills necessary for career-long professional learning sufficient to maintain certification in the specialty.
  • Possess the knowledge sufficient to pass the AOBFP certification exam.
  • Diagnose and manage common medical problems, both acute and chronic.
  • Demonstrate the ability to define and expand the differential diagnoses list.
  • Identify the most likely diagnoses for each patient and establish a plan for diagnostic and treatment modalities. Demonstrate the construction of a medical record summary with accuracy and in compliance with expected format and the hospital’s medical records policies.
  • Formulate short and long term goals.
  • Obtain informed consent, and perform appropriate procedures.
  • Apply the methods of disease prevention and health promotion.
  • Understand the fundamental relationship among the individual patient, his/her family, and the community and demonstrate the ability to educate the patient and family about the diagnoses, evaluation and treatment of the disease.
  • Promote the patient’s compliance with treatment, prevention, and health promotion.
  • Coordinate the patient’s management at all levels of health care.
  • Demonstrate the ability to present data to other members of the team and consultants.
  • Play the role of the patient’s advocate; particularly when the patient is referred to secondary or tertiary care centers.
  • Provide continuous care for the patient’s physical, emotional and social problems.
  • Provide guidance to patients regarding advanced directives, end of-life issues
  • Practice cost-conscious ordering of diagnostic tests and therapeutics.
  • Function efficiently as the medical leader of the primary care team

3068
The OB/GYN Residency Program is a four-
year postgraduate training program accredited by the AOA for graduates from a Commission on Osteopathic College Accreditation (COCA) approved College of Osteopathic Medicine.

This program has been designed to provide the physician with advanced training in general OB/GYN to meet the needs of the medical school graduate desiring to become board certified in Osteopathic OB/GYN through the examination provided by the American College of Osteopathic Obstetricians and Gynecologists (ACOOG). The program will accept applications through ERAS (Electronic Residency Application Service) and participates in the National Matching Program. Our training program adheres to the AOA institutional and common program requirements, as well as to the specific program requirements for residency training in OB/GYN. The educational program will offer a well-structured curriculum with progressive supervision of the resident, facilitating their ethical, professional and personal development, while ensuring safe and appropriate care for patients. The resident will be exposed to an excellent education combining teaching, clinical service, compassionate patient care, and research.

Our institution will provide the trainees with an ethical, professional, and educational background in which the curricular requirements, as well as the relevant requirements for the residents’ work environment, scholarly activities, and core competencies can be achieved. There shall be special emphasis on the utilization of osteopathic principles and practices as a crucial component of the program. Our training will incorporate the application of osteopathic diagnostic and therapeutic measures as they relate to the total care of the patient in OB/GYN.

We are committed to uphold stability between education and service, as evidenced by work hourschedules inclusive of academic and research opportunities and attendance at clinical training and educational activities. Educational standards to be maintained and core competencies to be inspired are in full agreement with the AOA requirements. These basic standards similarly apply with respect to definitions and purposes, selection of residents, responsibilities of residents, andqualifications and responsibilities of the Program Director and faculty. Progressive supervision of residents by qualified teaching staff and adherence to proper working conditions and duty hours shall be in firm compliance with the aforementioned requirements.

Throughout the program, important time will be spent by the resident in a well-organized curriculum, including seminars, teaching conferences by the faculty and visiting lecturers,continuous case conferences, journal clubs, and individual supervision. Advancement to a higherlevel will be based upon the superiority of performance and the achievement of the corecompetencies done in the previous educational year. Criteria for graduation include successfulaccomplishment of the program’s goals and objectives set forth in all essential teaching rotations in the Residency Manual. Residents will productively complete all educational assignments for the prescribed 48 months of education. A scholarly paper or research paper shall be completed and approved by the Residency Research Committee. Residents shall satisfactorily prove proficiency in the core competencies.

Upon achievement of this program, residents will be prepared to either enter general OB/GYNpractice or continue into subspecialty fellowship training. Graduates shall possess the properclinical judgment, requisite skills, and a high order of knowledge about the diagnosis, treatment,and prevention of gynecologic or obstetric common disorders. The objectives for graduation will be reached when a resident is viewed as a solid clinician, able to use current literature, and able to negotiate a general practice. Graduates should have approachability of their own strengths andlimitations, and recognize the need for continuing their own professional development and possess lifelong learning habits. The program will also encourage the residents who may be interested in academic OB/GYN by introducing subspecialty education and research electives. This will provide an opportunity for education in general OB/GYN, and exposure to an OB/GYN fellowship.

Program Goals

  • Provide a comprehensive residency program, which adheres to the AOA requirements for residency in OB/GYN.
  • Promote the development of prerequisite knowledge, skills, and attitudes in agreement with the professional guidelines set forth by the American College of Osteopathic Obstetricians and Gynecologists (ACOOG).
  • Prepare residents to effectively pass the oral certification examination provided by the American College of Osteopathic Obstetricians and Gynecologists (ACOOG).
  • Provide residents with an extensive educational training environment, diverse in both didactics and clinical experience.
  • To expose trainees to a wide range of career opportunities available in the area of academics, research, clinical practice, and the various OB/GYN subspecialties.
  • To provide residents with an wide-ranging scope, sufficient volume and variety of clinical cases to hone the skills necessary for the patient care of patients.
  • Prepare excellent gynecologists for the increasing demand in the community.
  • Produce knowledgeable physicians for the independent, conscientious and effective practice of OB/GYN.
  • Graduate skilled gynecologists capable of providing high-quality OB/GYN.
  • Promote the growth of future leaders in research and clinical OB/GYN.
  • Inspire our graduates to practice in medically underserved communities and areas of critical
  • Need in our state of Florida when they complete their training.
  • Supervise the resident’s responsibilities for patient care with ongoing exposure to the fundamentals of the general core competencies (OMM, Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice Based Learning and Improvement, Professionalism, and Systems Based Practice).
  • Promote excellence in medical education, high quality patient care and scholarly activity.

Patient Care

Residents shall be able to provide patient care that is compassionate,appropriate, and effective for the treatment of health problems and the promotion of health

Medical Knowledge

Residents will demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

Practice-based Learning  & Improvement

Residents shall be able to investigate and evaluate and improve their patient care practice, as well as to appraise and assimilate scientific evidence based medicine.

Interpersonal and Communication Skills

Residents shall be able to prove interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients families, and professional associates.

Professionalism

Residents shall demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

System-Based Practice

Residents shall demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

OMM

Residents shall apply the Osteopathic Principles and Osteopathic Manipulative Medicine application to all clinical settings, as appropriate.

Objectives by Educational Level  OGME-1
At the completion of the first year the resident will be able to:
  1. Perform comprehensive H&Ps, including recognition of obstetric and gynecologic problems, indications for surgical intervention and identification of coexisting medical problems,
  2. Share data obtained from H&Ps with colleagues in an organized, clear, concise and logical manner in both written and oral forms,
  3. Discuss the basic ethical principles involved in the field of OB/GYN on a case-by-case example.
  4. Demonstrate an ongoing process of learning through regular study, reading, literature review, conference participation and attendance, and education of medical students.
  5. Sustain up-to-date and appropriate medical records.
  6. Use information technology to manage information and access on-line medical information.
  7. Demonstrate interest and improve skill in teaching the field of obstetrics and gynecology to students and staff.
  8. Acquire responsibilities as a physician, making judgments and decisions regarding patient care in basic settings with appropriate supervision.
  9. Act professionally and communicate well with colleagues, nurses, staff and other members of the health-care team.
  10. Achieve a score that is no lower than 1 standard deviation below the mean (for the year of training) on the annual CREOG in-service examination. (Residents with scores lower than 2 standard deviations below the mean are subject to academic probation at the discretion of the program director.)
  11. Obtain required certification in BLS, ACLS, NRP, and ALSO.
Ambulatory Objectives
  1. Select appropriate lab tests and diagnostic studies based on history and physical findings.
  2. Demonstrate ability and willingness to teach patients and families about disease processes and interventions.
  3. Act respectfully when interacting with patients, families and colleagues.
  4. Exhibit familiarity with recommendations for age specific care/screening/immunizations
  5. Recognize psychosocial problems of patients and their families.
  6. Perform an adequate speculum exam, Pap smear and cervical cultures.
  7. Perform an adequate and sensitive bimanual exam.
  8. Begin to demonstrate the proper selection and performance of diagnostic/therapeutic procedures including but not limited to: FNA, colposcopy, LEEP, Cryosurgery , Endometrial biopsy, word catheter placement.
  9. Demonstrate competence in counseling patients regarding contraception and in evaluating the appropriate use of modalities.
  10. Perform office based diagnostic tests such as wet-mount and interpret the results obtained
  11. Demonstrate proficiency in providing emergency medical care including airway management and CPR.
  12. Recognize urgent conditions requiring hospitalization, and be able to identify appropriate consultants.
  13. Recognize and treat basic emergency room problems
  14. Perform emergency procedures such as intravenous line, blood gas sampling, nasogastric tube placement, mask ventilation and others.
OGME-2
Upon the completion of the second year, the resident should be able to:
  1. Demonstrate ongoing development of the skills learned in the first year as well as developing new skills.
  2. Perform focused and efficient H&P with an increasing recognition of disease patterns and presentations.
  3. Communicate efficiently with staff and colleagues
  4. Demonstrate continued commitment to the field of obstetrics and gynecology.
  5. Demonstrate progress in learning through regular study, reading, literature review, conference attendance and participation
  6. Exhibits commitment to continuing education by assisting in the education of medical students and acting as a role model for junior residents
  7. Understand cost and other systems-issues with respect to diagnostic and therapeutic technology.
  8. Develop and complete the topic for your research presentation in your fourth year and submit that topic with all required documents to the Hospital Institutional Review Board before the end of the second year.
Ambulatory Care
 –
  1. Provide more wide counseling and education of patients and their families
  2. Manage basic non-gynecologic ambulatory problems including but not limited to: URI, otitis media, HTN, OM, asthma, gastritis, arthritis etc.
  3. Understand religious, political and cultural issues surrounding contraception and abortion, and discuss them with patients and families
OGME-3
By the end of the 3rd year of the residency residents are expected to:
  1. Continue to develop the skills learned in the first two years as well as well as developing the following skills.
  2. Research, develop and deliver a scholarly presentation on a topic in Obstetrics and Gynecology
  3. Continue to prove appropriate skill and commitment to the education of junior residents, medical students and other health care professionals.
  4. Demonstrate a general practice of evidence-based medicine
  5. Understand the common methods of health care financing and insurance coverage.

Ambulatory Care:

  1. Take responsibility for evaluating and diagnosing and managing common outpatient problems.
  2. Function as a counselor and educator with respect to issues of contraception, abortion, family planning and sexuality.
  3. Utilize resources to allow intervention in crises such as abuse, rape, etc. and perform appropriate exams with documentation.
  4. Perform basic office procedures with minimal supervision such as PAP, colposcopy with biopsy, FNA, HSG, J&D of abscesses, paracervical block, cyst aspiration, insertion and removal of contraceptive devices and others.
OGME-4
By the end of the final year of the residency residents are expected to:
  1. Continue to mature the skills learned in the first three years as well as develop the following skills.
  2. Supervise junior residents in the care of patients with complex problems and surgical conditions.
  3. Demonstrate a high level of scientific, clinical and technical knowledge about all aspects of general obstetrics and gynecology.
  4. Assume independent responsibility for patient care in general obstetrics and gynecology.
  5. Operate independently with a high level of technical skill and clear decision making.
  6. Demonstrate effective management of time in care of outpatients.
  7. Be able to lead discussions with junior residents and students regarding ethical, psychosocial and professional issues related to the practice of 08 I Gyn.
  8. Demonstrate an ability to obtain appropriate consultations and collaborations with specialists from other fields.
  9. Evaluate the skills and knowledge of junior residents and students and provide appropriate guidance for improving these skills.1
  10. Demonstrate ability and take responsibility for administrative issues in the practice of medicine.
  11. Demonstrate appropriate follow up of patients

3071-1The psychiatry residency is a four-year program, broadly based, with attention to the rapid advances in psychiatry and neurology including genetics, molecular biology, psychopharmacology, epidemiology, and imaging. Additionally, psychotherapy is recognized as a valuable component of psychiatric practice and competence in several modalities will be assured through clinical experience and intensive supervision. The Graduate Medical Residency training program has been designed to provide the osteopathic physician with advanced and concentrated training in the specialty of psychiatry and to meet the needs of the osteopathic medical school graduate desiring to be board certified in Osteopathic Psychiatry. Our training program is compliant with the Basic Standards for Residency Training in Psychiatry, which is approved by the American Osteopathic Association (AOA) and the American College of Osteopathic Neurologists and Psychiatrists.

Physicians in the specialty of general psychiatry are proficient in the diagnosis, treatment and prevention of psychiatric disorders and the common medical and neurological disorders that relate to psychiatry. The osteopathic concepts of caring for the whole patient and the incorporation of osteopathic principles of the integrated function between the musculoskeletal and nervous system are incorporated into the program. There is a special emphasis on the utilization of osteopathic principles and practices as a key component of the Residency Program in Psychiatry residency training and integrated throughout the program. Training shall incorporate the application of osteopathic diagnostic and therapeutic measures as they relate to the total care of the patient. Therefore the residents will be required to demonstrate competence and knowledge in the essential osteopathic principles appropriate to this specialty.

Residents will also be afforded the opportunity to develop adequate skills to organize and record data, such as history, mental status examination, diagnostic techniques and procedures, and laboratory tests in the initiation of appropriate therapy. Upon completion of this program, residents are prepared to either enter general psychiatry practice or continue into subspecialty fellowship training and to take the certifying examination in psychiatry.

Curriculum Description
Residents shall take on responsibility for and be the primary treating clinician involved in the diagnosis and management of a significant number of patients with major psychiatric disorders at our base institution and at affiliated participating sites. We will provide opportunities for experience in the treatment of common medical and neurological disorders. Residents shall be exposed to the proper number of patients of all ages, both sexes, and diverse ethnic, racial, social-cultural and economic backgrounds. We are committed to increase progressively the amount of resident responsibility as they progress in training. Residents will be allowed reasonable amounts of time for educational activities outside of patient care.
Neurology
This experience shall be a supervised clinical experience during two months in PGY-1
There will be an experience with patients with a broad range of severe acute and chronic major psychiatric disorders. Residents must have major responsibility over 24 hours for the diagnosis and treatment of suitable numbers of such patients on the inpatient, partial hospitalization and day treatment service for 4 months and not more than 12 months.
Ambulatory Experience
The program has designed an outpatient (ambulatory) psychiatry training experience of 12 continuous months in PGY-3. Residents shall be exposed to an adequate number and variety of patient cases in our outpatient’s settings. Our residents will be exposed to severe and chronic psychiatric disorders in all outpatient settings.
There will be experiences available with community mental health centers and other demanding community based care organizations. Individual psychotherapy including psychodynamic, cognitive, behavioral, biological and short-term therapies is an essential part of our training. In addition, residents shall have a long-term psychotherapy experience with some patients seen weekly for one year or more.
Child and Adolescent Psychiatry Experience
 
Residents will have exposure to child and adolescent psychiatry during two months in PGY-2, under the direction of expert physician’s board certified in child and adolescent psychiatrists. Residents will have responsibility for the evaluation and management of both, children and adolescents with a wide range of psychiatric disorders. This experience will be outpatient based preferably.
Consultation-Liaison Experience
 

A consultation-liaison experience shall be provided with a minimum duration of four months. There shall be experience involving patients on medical-surgical services during the weekday, and some of this experience will be outpatient based.
Emergency Psychiatry
 

Residents shall, under the direction of qualified faculty, participate in the evaluation, triage and management of patients presenting to the psychiatric emergency service. This experience must include training in the management of and contact with patients who are suicidal and who present the threat of physical violence. During the rotation our residents will have training in forensic issues of relevance to emergency psychiatry.
Geriatric Psychiatry
Residents will receive a vast experience in geriatric patients with a vast variety and volume of psychiatric disorders in older patients, in which residents have primary responsibility for diagnosis and treatment. Our community has a high volume of geriatric patients.
Substance Abuse
We have designed an educational experience related to patients with substance abuse problems. Residents must have experience with detoxification and management as well as an understanding of community resources.
Forensic Psychiatry
Residents will have an educational experience dealing with forensic psychiatric issues through a required rotation in PGY-3, and through the longitudinal-didactic curriculum during the four years of training. Civil commitment during on-call responsibilities will not be considered a sufficient experience to fulfill this requirement.The curriculum of psychiatry has included experience with couples, families and groups.Residents shall be training in settings where psychological and neuropsychological testings are regularly used. The experience shall be with their patients and there must be opportunities for residents to gain a basic understanding of common psychological and neuropsychological tests
Practice Management

Clinical training includes interaction with managed care organizations, medical ethics and practice management.Residents shall interact with other mental health professional’s teams. Residents will have interaction with psychologists, social workers, and psychiatric nurses.
Didactic Curriculum
The didactic curriculum is a significant constituent of the psychiatry residency training program. The curriculum has been structured so that residents are excused from all responsibilities during delivery of regularly scheduled didactic material. Residency related activities are mandatory. We have an organized, regularly scheduled curriculum for the entire four years of the program. It includes a broad base and a sufficient depth survey of the field of psychiatry from biological, psychological and social points of view. The following elements are required in our didactic curriculum:
  • Psychopharmacology and clinical sciences as relevant to psychiatry.
  • Major theories of development through adulthood and old age.
  • Major psychological theories including psychodynamic, behavioral and cognitive.
  • Material from other social sciences relevant to psychiatry.
  • Major treatment modalities utilized with acutely and chronically ill patients.
  • Cross-cultural and gender issues relevant to psychiatry:
    • The way in which psychiatric disorders may present in   different cultures.
    • Epidemiological differences in psychiatric disorders in different cultures.
    • Issues around sexual orientation, racial and ethnic issues, and religious issues.
      • Psychiatric epidemiology
      • Training in critically reading medical literature
      • Clinical case conferences in which case presentation skills, differential diagnosis, and case formulation and treatment are discussed: Theory and practice of commonly use psychotherapies including short- term.
Forensic Psychiatry
Health care economics and managed care issues
  • Transition into practice information
  • History of psychiatry
  • Techniques of couple, family and group evaluation and therapy

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