Curriculum > Year 3
Curriculum - Year 3
YEAR 3
Subspecialty Selectives: Third-year residents have a longitudinal experience with a variety of sub-specialty areas during FMC Longitudinal A and B.
Population health: An overall goal of our residency program is to train residents to meet the population health needs of underserved communities. The population health block is an innovative 2 week experience during the 3rd year with the goals of providing residents with on-site exposure to the work of public health agencies and federal and city based projects in chronic disease management as well as to participate in interdisciplinary teams providing care and services to vulnerable populations.
Learning Objectives
At the completion of the rotation, Residents will: |
Where/How Learning Occurs
|
Competency Addressed
|
Evaluates the presenting problem using a focused investigation |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Performs a competent and appropriate physical examination |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Prioritizes the probable and potential diagnoses to ensure that attention is given to the most likely, most serious and most readily treatable options |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills |
Presents a well-organized and understandable case to the attending |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Presents a well-organized and understandable diagnosis and plan to the patient |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Medical Knowledge
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Locates and utilizes evidence-based resources in the care of an individual or patient group |
Explore website resources: UpToDate, MDConsult, etc |
Practice-Based Learning |
Accepts and incorporates faculty feedback |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Assists patients with complex disease processes, ensures access to necessary ancillary services and coordination of care with specialists if indicated |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Works with colleagues to share responsibilities for patient care and administrative tasks |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Systems based Practice
Professionalism |
Works together with staff in a manner that fosters mutual respect and facilitates an effectively run practice |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Understands and acts on ethical principles |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Professionalism |
Completes the task of the defined session so that all necessary tasks are accomplished in a timely, organized and professional manner |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions |
Patient Care
Systems based Practice
Professionalism |
At the completion of this experience residents will be able to:
1. Understand the role of community-based organizations and health centers in
enhancing the health of individuals and populations, and in augmenting the
health delivery system.
2. Identify specific health and social needs of selected vulnerable populations.
3. Identify barriers to care for specific vulnerable populations
4. Assist members of vulnerable population to overcome internal and external barriers to health and medical care.
5. Understand the role of community health education in disease management in
selected populations.
6. Understand and implement methods for assessing the health needs, assets and barriers of populations/neighborhoods.
7. Provide care to vulnerable populations with cultural and linguistic competence |
Homeless outreach, JFMA office, Community Partners (i.e. St. Elizabeth’s, JeffHOPE, Health Centers), informal discussions
Selected Readings:
a. Project Home. A nationally-recognized non-profit organization addressing homelessness and poverty in Philadelphia.
b. Weinstein LC, Plumb JD, Brawer R. “Community engagement of men”. Primary Care: Clinics in Office Practice 2006;33:247-259.
c. Kindig D, Stoddart G. “What is population health?” Am J Public Health 2003;93:380-83.
d. OCC Review of Street Homelessness, Winter 2005-2006.
e. Gladwell M. “Million-dollar murray”. The New Yorker February 13, 2006. Dept. of Social Services.
f. Blueprint to End Homelessness. www/blueprintoendhomelessness.org.
g. Geringer D. “”Resurrection: North Philly neighbors bring drug-infested blocks back from the dead”. Philadelphia Daily News, April 30, 2002.
h. Fagan K. “Success in the city of brotherly love: the city that knows how – Philly Philadelphia effort stems tide of homelessness – can S.F. learn from it?” Sunday, June 13, 2004. www.sfgate.com.
i. “Health Literacy: A prescription to end confusion”. Committee on Health Literacy Board on Neuroscience and Behavioral Health, Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Institute of Medicine of the National Academies. Washington, D.C., www.nap.edu
j. Mitka M. “Chronic homeless in intervention spotlight”. JAMA 2006;295(20):2344-2345. |
Medical Knowledge
Patient Care |
Cardiology: Residents have a 2-week rotation in cardiology. The goal of this rotation is enhance the clinical skills in cardiology and learn appropriate indications for diagnostic modalities.
Learning Objectives
At the completion of the rotation, Residents will: |
Where/How Learning Occurs
|
Competency Addressed
|
Evaluates the presenting problem using a focused investigation |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Performs a competent and appropriate physical examination |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Prioritizes the probable and potential diagnoses to ensure that attention is given to the most likely, most serious and most readily treatable options |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills |
Presents a well-organized and understandable case to the attending |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Presents a well-organized and understandable diagnosis and plan to the patient |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Medical Knowledge
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Locates and utilizes evidence-based resources in the care of an individual or patient group |
Explore website resources: UpToDate, MDConsult, etc |
Practice-Based Learning |
Accepts and incorporates faculty feedback |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Assists patients with complex disease processes, ensures access to necessary ancillary services and coordination of care with specialists if indicated |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Works with colleagues to share responsibilities for patient care and administrative tasks |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Systems based Practice
Professionalism |
Works together with staff in a manner that fosters mutual respect and facilitates an effectively run practice |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Understands and acts on ethical principles |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Professionalism |
Completes the task of the defined session so that all necessary tasks are accomplished in a timely, organized and professional manner |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Patient Care
Systems based Practice
Professionalism |
Upon completion of the rotation residents will be able to:
1. perform comprehensive cardiovascular history and physical exam;
2. demonstrate competence in interpretation of 12 lead ECG;
3. exhibit timely and cost effective use of diagnostic modalities in assessing the ambulatory cardiac patient including exercise and pharmacological ECG, echocardiographic and nucleotide stress testing, ambulatory ECG monitoring, echocardiography;
4. assess and manage common ambulatory cardiac diagnoses including HTN, CAD, CHF, valvular disease, atrial fibrillation;
5. Demonstrate appropriate use of common pharmacotherapeutic agents in office including antihypertensives, diuretics, digoxin, coumadin, nitrates, anti platelet agents, lipid lowering agents. |
JFMA office, Outpatient Cardiology (Dr. Poll, Dr. Cooper, Dr. Watson), informal discussions. |
Medical Knowledge
Patient Care |
Procedures/COPC: On this longitudinal rotation, residents focus on a variety of office procedures for a half-day per week six weeks. In addition, COPC occurs on Wednesday afternoons (Please see Community Medicine Goals and Objectives).
Learning Objectives
At the completion of the rotation, Residents will: |
Where/How Learning Occurs
|
Competency Addressed
|
Evaluates the presenting problem using a focused investigation |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Performs a competent and appropriate physical examination |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Prioritizes the probable and potential diagnoses to ensure that attention is given to the most likely, most serious and most readily treatable options |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills |
Presents a well-organized and understandable case to the attending |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Presents a well-organized and understandable diagnosis and plan to the patient |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Medical Knowledge
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Locates and utilizes evidence-based resources in the care of an individual or patient group |
Explore website resources: UpToDate, MDConsult, etc |
Practice-Based Learning |
Accepts and incorporates faculty feedback |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Assists patients with complex disease processes, ensures access to necessary ancillary services and coordination of care with specialists if indicated |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Works with colleagues to share responsibilities for patient care and administrative tasks |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Systems based Practice
Professionalism |
Works together with staff in a manner that fosters mutual respect and facilitates an effectively run practice |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Understands and acts on ethical principles |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Professionalism |
Completes the task of the defined session so that all necessary tasks are accomplished in a timely, organized and professional manner |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching. |
Patient Care
Systems based Practice
Professionalism |
Residents learn a variety of techniques for removal of skin lesions, treatment of subcutaneous infections, flexible sigmoidoscopy and colposcopies. |
JFMA outpatient office, Mazzoni Center, Specialty office, Community Partners, informal discussions and teaching.
Selected Readings:
a. Wright, Thomas. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Journal of lower genital tract diseases
2003; 7(3): 154-167. *available on line at asccp.org under "consensus guidelines"
b. Wright, Thomas. 2001 consensus guidelines for the management of women with cervical cytological abnormalities. Journal of Lower Genital Tract Disease 2002: 6(2): 127-143. *available on line at asccp.org under "consensus guidelines"
c. “A nice review of case studies takes you through cytology reading, colposcopy, pathological diagnosis, and mananagement guidelines. It's on Jeffline from our very own Charles Dunton (a well know cervical pathologist) and is a great resource.
d. "Colposcopy Image Library" by Drs. Gregory Brotzman, Mark Spitzer and Barbara Apgar. http://jeffline.jefferson.edu/jeffcme/online/case_studies.html
e. "Colposcopy Image Library" by Drs. Gregory Brotzman, Mark Spitzer and
Barbara Apgar |
Medical Knowledge
Patient Care |
Day Float: Residents will be available and flexible to respond to evolving needs in the day-to-day care of FMC patients in both the inpatient and outpatient setting.
Learning Objectives
At the completion of the rotation, Residents will: |
Where/How Learning Occurs
|
Competency Addressed
|
Evaluates the presenting problem using a focused investigation |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Performs a competent and appropriate physical examination |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Medical Knowledge
Patient Care
Interpersonal and Communication Skills |
Prioritizes the probable and potential diagnoses to ensure that attention is given to the most likely, most serious and most readily treatable options |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills |
Presents a well-organized and understandable case to the attending |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Medical Knowledge
Patient Care
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Presents a well-organized and understandable diagnosis and plan to the patient |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Medical Knowledge
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Locates and utilizes evidence-based resources in the care of an individual or patient group |
Explore website resources: UpToDate, MDConsult, etc |
Practice-Based Learning |
Accepts and incorporates faculty feedback |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Practice-Based Learning
Interpersonal and Communication Skills
Professionalism |
Assists patients with complex disease processes, ensures access to necessary ancillary services and coordination of care with specialists if indicated |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Patient Care
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Works with colleagues to share responsibilities for patient care and administrative tasks |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Systems based Practice
Professionalism |
Works together with staff in a manner that fosters mutual respect and facilitates an effectively run practice |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Systems based Practice
Interpersonal and Communication Skills
Professionalism |
Understands and acts on ethical principles |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Professionalism |
Completes the task of the defined session so that all necessary tasks are accomplished in a timely, organized and professional manner |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions. |
Patient Care
Systems based Practice
Professionalism |
Residents are to check in daily with the inpatient team to assist with Admissions, complete work on the team, and supervise interns and students.
Residents may be needed to assist on outpatient care in order to ensure continuity of deliveries and peer FMC hours.
Residents will also see consults in conjunction with the hospital service attending, including preoperative clearance and co-management of patients on other services. |
JFMA outpatient office,
Inpatient hospital service, rounds, discussions.
Selected Readings:
a. Agarwal, MD, and Swartz, MD, “Acute Renal Failure”, American Family Physician, {April 1, 2000})
b. Zanger, Solomon, Gersh, “Contemporary Management of Angina: Part I. Risk Assessment.” American Family Physician, {December 1999})
c. Johnston, MD, PhD, “Transient Ischemic Attack”, The New England Journal of Medicine, {Vol. 347; No. 21; November 21, 2002
d. Gibbons,, MD, et al., “ACC/AHA 2002 Guideline Update for Exercise Testing”, www.acc.org |
Medical Knowledge
Patient Care |
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Medical Knowledge
Patient Care |
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