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Residents become active participants in community health initiatives in collaboration with community stakeholders.  In order for the health team to be functional and to make a significant contribution to the community, residents do spend some additional time in the community.  However, it is our experience that resident members of the team support each other and share the responsibility of the project so as not to be overwhelmed due to the competing demands of residency training.  We hope that over a three-year period these health teams will make an important contribution to Lawrence as well as provide residents with a positive experience in a collaborative model of community health improvement.

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Inpatient Adult Medicine                                   Return
Inpatient teaching is provided by core family physician faculty and selected primary care internists and specialists.  Because many of our patients have had poor access to comprehensive care in the past, the variety and complexity of medical problems is truly a remarkable teaching resource and an opportunity for residents to see the difference quality health care can make in someone’s life.   Residents often manage patients in ICU/CCU when on Medicine.  Teaching rounds, noon conferences and grand rounds highlight patient problems and treatment plans.  There is a weekly Adult Medicine case conference presented by a resident and a faculty member.  Thoughtful and selective diagnostic testing and specialty consultation are taught.  Performance of common inpatient procedures is expected with appropriate supervision.  Residents learn the importance of nutritional support, physical therapy, and social services.  Ethical issues relating to critically ill or dying patients are also addressed.

Outpatient Medicine                                          Return
Outpatient medicine is the heart and soul of family practice.  Residents manage their own panel of outpatients from one to six sessions per week throughout their three-year experience.  All patients are presented to faculty preceptors not only for guidance with medical management and procedural skills, but also to interweave the cross-cultural, linguistic, behavioral, and community medicine principles taught in other areas of the curriculum.  The Outpatient Curriculum committee focuses on enhancing the clinical experience with didactic lectures, resident presentations at outpatient conferences, private precepting of complicated patients outside of clinic time, workshops on practice management, and the continuous improvement of the precepting skills of the faculty. 

Obstetrics                                                    Return
Residents receive longitudinal training in obstetrics by providing care to prenatal patients of the health center.  Residents deliver their own patients whenever possible and provide the preconceptual, prenatal and postpartum care to those women.  Extensive support services are available to help care for socially or medically high-risk patients.  The hospital has approximately 1500 deliveries per year, half of which are GLFHC patients. Block rotations in obstetrics provide labor and delivery experience as well as experience with caring for mother-baby pairs postpartum.  All of  the family physician faculty practice obstetrics and supervise residents for the majority of their experience.  Obstetrician/gynecologists or OB fellowship trained family physicians are available twenty-four hours a day for consultation.  Residents first-assist at C-sections and at postpartum tubal ligations.  There is a weekly OB case conference presented by a resident and faculty member.

Inpatient Pediatrics and Neonatology                Return
Inpatient pediatric training experiences are provided on the pediatric ward and in the newborn and special care nurseries in each of the three years (see chart on page 4 for details).  In addition, there is one month of training in neonatology.  Residents attend daily attending rounds and weekly pediatric grand rounds.  There is also a weekly pediatric case conference.   Inpatient pediatric training aims to teach residents to assess the newborn, ill infant or child comprehensively and to diagnose and manage most common pediatric conditions.  Mastery of common procedures, providing important health education and integrating the social and psychological aspects of illness into the management plan are key objectives of the pediatric training.

Dermatology                                                        Return
The Dermatology rotation is at least 60 hours, in block rotation and longitudinal form.  Residents work directly with a dermatologist, seeing both private and clinic patients.  They gain experience in comprehensive diagnosis and treatment of skin lesions, as well as office procedures.  In addition to clinic experience, there is a didactic curriculum over the course of the three years.

Gynecology                                                        Return
In addition to acute and longitudinal care of female patients during their own clinic time, residents are scheduled for 5 weeks of outpatient gynecology rotation time over the 3 years of residency.  During the gynecology rotation, residents attend special clinics and work with gynecologists and sub-specialists.  Residents are also involved in the inpatient care of women with gynecological problems and participate in minor surgical procedures at the hospital.  Several workshops take place during the first year of residency for intensive teaching of gynecological procedures.  The health center also has a very busy colposcopy clinic and does approximately 450 procedures each year, which allows the residents opportunity to practice this procedure.