LancasterGeneralHealth Family Medicine Residency Program

Our Program / Curriculum

Family Medicine Residency Curriculum

Our academic year is divided into 13, 4-week blocks. First year residents have protected time each week (no Friday overnights).

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  • Vacation: 3 weeks per year including either 1 week off for Christmas or New Year's
  • Wellness Sessions: 4 half days per year
  • CME: 5 days over 3 years
  • Practice Search Days: Up to 5 in the R3 year
  • Some other holidays and a total of 8 Personal Time Bank (PTB) days per year are in addition to vacation

First Year Rotations

 

The first-year curriculum provides comprehensive in-hospital training in a supportive team environment. Inpatient teams include upper-year residents and supervision by attending physicians. There is a night float system in place for coverage on our inpatient services, and an introduction to ambulatory care and one-half day per week continuity experience in the Downtown Family Medicine urban health center

  • 2 blocks Family Medicine Inpatient Service (FHS Ward)
  • 2 blocks Maternal Child Health/Obstetrics (each block includes 2 weeks of night float )
  • 2 blocks Inpatient Pediatrics
  • 2 blocks Emergency Medicine (each block includes 2 weeks of night float)
  • 1 block Outpatient Orthopedics
  • 1 block Internal Medicine Teaching Service
  • 1 block General Surgery
  • 1 block Behavioral Medicine
  • 1 block Community Medicine

Second and Third Year Rotations

 

The second- and third-year rotations provide a continuum of training experiences designed to sharpen and expand inpatient and outpatient skills. All residents maintain continuity experiences in both the urban (Family Medicine Downtown) and rural (Walter L. Aument Family Health Center) practices. More emphasis is placed on the personal responsibility of the resident in patient care. This includes office1based procedures, practice management, and collaborating with other members of the health-care team. There are five elective rotations during the last two years of training. Residents may choose to spend one block per year doing an away elective. Beginning in second year, residents may elect to do an area of concentration.


Required Second/Third Year Rotations

 
  • Family Practice Inpatient
  • Ambulatory Pediatrics
  • Inpatient Pediatrics (PGY II-Nursery/Lactation/NICU)
  • Internal Medicine
  • Geriatrics
  • Emergency Medicine
  • GI
  • Women’s Health
  • OB
  • Sports Medicine
  • Ophthalmology/ENT
  • Surgery/Plastic Surgery
  • Psychiatry/Behavioral Medicine
  • Neurology
  • Ambulatory Surgery/urology
  • Practice Management
  • Geriatrics
  • Practice Management

Longitudinal Training

 

In addition to the block rotations, residents have ongoing training in the following areas:

  • Addiction Medicine
  • Dermatology
  • Centering Pregnancy (group prenatal care)
  • Osteopathic Medicine
  • Integrative Medicine
  • Narrative Medicine

Areas of Concentration (AOC)

 

Residents have the option to focus on particular areas of interest. An area of concentration (AOC) requires at least 200 hours of dedicated training to further develop skills. The following AOCs are currently available:

  • Academic Medicine
  • Addictions Medicine
  • Adolescent Medicine
  • Genomics
  • Geriatrics
  • Global Health
  • HIV Medicine
  • Integrative Medicine
  • Medical Leadership/ Practice Management
  • Medical Spanish
  • Obstetrics
  • Palliative Medicine
  • Population Health
  • Research
  • Rural Health
  • Sports Medicine
  • Urban Underserved
  • Women’s Healthcare


Scholarly Activity

 

All residents are required to complete two scholarly activities, one of which must be a performance improvement (PI) project. Residents are mentored by faculty and collaborate with the research staff from the Lancaster General Health Research Institute.


Away Rotations to Work with Underserved Populations

 

Residents can spend one rotation in their second and third year in a setting where they can provide clinical service in a supportive, supervised setting. In the U.S., residents may choose to go to Sitka, Alaska or several Indian Health Services locations. International locations include Malamulo Hospital in Malawi and Shirati Hospital in northeast Tanzania. In the western hemisphere, many of our residents spend a four-week block working with the Mayan Medical Aid organization on the shore of Lake Atitlan in Guatemala. This is a combined medical service/language immersion experience where residents receive a half day of medical Spanish training, and the remainder in direct patient care to an indigenous population.


Didactics

 

Lancaster General Health has a long history of commitment to ongoing education. Conferences cover evidence-based approaches to a variety of medical topics and are presented by faculty members, local attending physicians, guest lecturers and residents. Morning report is held from 7:30-8 am, Monday-Friday.

In our block conference curriculum, residents of a different class (R1, R2, R3) meet each Wednesday to address knowledge and clinical skills sets that are relevant to their needs. Once a month this block session is expanded to include all years. The first-year resident block conferences address the knowledge and skill sets deemed essential for a successful transition to residency. The second year block curriculum has a major emphasis on procedural training and associated practice management. The third year curriculum includes a major emphasis on practice management, career planning and development, as is a forum for contemporary clinical topics and controversies.


Centering Pregnancy

 

In May 2019, the Lancaster General Hospital Family Medicine Residency Program was just the second family medicine program in the nation to be approved through the Centering Healthcare Institute certification process. Centering Pregnancy is a vital part of our training program. All residents are assigned a prenatal group during their second and third years. They learn group-facilitative skills as well as prenatal care, while working closely with five to eight women and their families. Residents interact with patients on a very personal level while educating and witnessing community building. As the primary provider for each patient, the resident will plan to attend those.

Pregnancy


Community Medicine

 

 

A Message from the Director of Community Medicine Rotation

Community medicine has always been a fundamental educational experience for residents at Lancaster General Health. Ever since Nikitas J. Zervanos, MD, named our department Family and Community Medicine more than 40 years ago, the concept that health care extends far beyond the office visit has been a core tenet of our educational mission. Now population health is taking community medicine principles and expanding them to a broader systems level to promote more effective health-care delivery. Both will play a key role in your training as a family physician.

Residents are given the opportunity to develop, expand and implement their own ideas about community medicine and service, as well as population health, throughout the three years of residency. The introduction to community medicine begins at program orientation when soon-to-be new interns engage in a cultural "scavenger hunt" designed to highlight the vital, ever-changing diversity of Lancaster County.

PGY-1 residents spend an entire block rotation exploring the concept and practice of community medicine and solidifying their interests in a particular area of the discipline. During this block, you will be involved in care of new immigrants to our county, interact with disability providers, visit with the city health department and engage in a comprehensive home visit assessment among others.

By the second and third year, residents will move beyond traditional community medicine principles and be actively engaged in an innovative population health curriculum. This curriculum will consist of various modules about population health principles and involve a scholarly activity. At the same time, residents will be involved in various health system committees to understand a "systems approach" to health-care delivery.

Community medicine and population health principles overlap at many points. Both are fundamental to training in family medicine. Our program is well positioned to capture the "real world" experiences of community service and combine that with higher level system and critical thinking skills necessary to promote change in our current health-care environment. We expect our residents to be leaders of health-care delivery in the future, and see our curriculum in community medicine and population health as vital to achieving that goal.

At Lancaster General Health, you will understand how and in what ways you can interact with the community at large, but also how to change the systems of care involved to enhance the overall health of a population. We expect residents to engage in activities befitting the name Family and Community Medicine. Community medicine and population health are necessary extensions of what goes on in the office and serves as a critical skill set providing holistic, culturally-sensitive and public health-oriented care to the population we serve.

William A. Fife, Jr, MD
Director of Community Medicine Rotation
Associate Director, Family and Community Medicine

 

About the Curriculum

The rotation/curriculum is broken down into one month of an intensive Community Medicine experience and various other curricular activities throughout the year.

Recent activities in the community over the past year have included:

  • Coordinating efforts to help vulnerable communities access Covid Vaccine and testing
  • Developing a street medicine program for homeless individuals in our community
  • Inspecting local restaurants and tattoo parlors with the City Health Officers
  • Providing health care to vulnerable populations at a free clinic
  • Participating in the annual Homeless census
  • Working with the agencies that provide educational opportunities for persons with developmental disabilities
  • Inspecting houses for Lead, with the State Lead Nurse
  • Visiting with United Way of Lancaster County officials
  • Providing health-related talks to women in a long-term drug rehab program
  • Visiting and working at the school-based health clinics
  • Surveying the health needs of the County Prison

Organizations Our Faculty and Residents Have Worked with Recently


Care Connections

 

Care Connections is our health-care delivery model for persons with complex health and social needs. It is an innovative, intensive, holistic and multidisciplinary primary care medical home, and one way Penn Medicine Lancaster General Health is transforming health care. The program began as a pilot within the Lancaster General Hospital Family Medicine Residency Program, and grew from 40 to more than 700 patients. All residents have a chance to rotate through Care Connections during their Community Medicine Rotation and can do a month elective at Care Connections