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15-Minute Video
 
Lawrence Family Medicine Residency 34 Haverhill Street, Lawrence, MA 01841
Tel: 978-725-7410  Fax: 978-687-2106
EMail: residency@glfhc.org
Curriculum
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Critical Care Medicine - ICU/CCU          Back Return
Assessment and management of the critically ill patient admitted to the intensive care unit and the acute cardiac patient requiring admission to the coronary care unit is taught under the supervision of GLFHC faculty as well as the specialists and other private physicians in the hospital.  Respiratory support, management of fluid and electrolyte imbalance, standards of hemodynamic monitoring and resuscitation, as well as nutritional support are integrated into the multidisciplinary approach to the care of the critically ill patient.   Residents will develop procedural skills, such as intubation and central line placement.  Residents receive training in advanced cardiac life support, the fundamentals of critical care and the direct resuscitation of patients.

Emergency Medicine                 Back Return
Residents receive 3 weeks of emergency medicine training at Lawrence General Hospital in each of the second and third years.  Residents are paired with emergency department staff physicians so they benefit from both one-on-one teaching and high-volume, hands-on experience.  Residents learn to perform common emergency room procedures such as suturing, splinting and casting, joint aspiration, intubation and slit-lamp examination.

Geriatrics                                    Back Return

The Geriatric Rotation is a longitudinal experience acquired through the inpatient internal medicine rotation, outpatient clinic, core lectures, home visit program and, during the second and third years, regularly scheduled nursing home visits. During these experiences the resident will develop the knowledge, attitudes and skills required for appropriate care of the elderly. Continous Quality Improvements skills and projects are particularly emphasized.  The experience also includes exposure to palliative care principals and hospice.

Surgery                                       Back Return
Residents spend one month on in-patient surgery in their second year, taking call every 4th – 5th  night during this month.  They have  significant OR experience both with scheduled and emergency surgical cases, procedural opportunities such as central linesintubations, and V starts, and carry the trauma-code- and STEMI-code pagers. Each day, there is a 1-hr protected didactic block to learn pertinent primary care surgical topics. During this month, their focus is in-patient OR cases and the peri-operative hospital roundings on these patients.

The remaining 4 weeks of surgery occur mostly in the 1st and 3rd years and are out-patient oriented, mostly working one-on-one with general surgeons, surgical sub-specialists and family physicians. Their focus is to learn and perform minor office surgery and to master pre- and post-operative evaluation.  The initial work-up of patients with common conditions such as hemorrhoids, hernia,  or malignancy of the breast or bowel, are taught.  These are outpatient weeks with emphasis on outpatient procedural skills, many of which are performed in our own GLFHC Procedures clinic which is staffed by family physician faculty.

Urology                                      Back Return
 Residents work directly with private urologists in their offices and in the hospital.  Residents learn to diagnose, manage, and, when appropriate, refer a variety of pediatric and adult urologic conditions.  In addition, residents learn to evaluate, initiate therapy and refer patients with impotence or infertility.

Orthopedics/Sports Medicine     Back Return
The resident learns to evaluate and manage orthopedic conditions commonly encountered by family physicians.  Mastery of the musculoskeletal exam, pediatric orthopedics, procedures such as splinting, casting and joint aspiration, and interpretation of X-rays to diagnose fracture or dislocation are among the skills stressed.  In addition, we cover sports medicine, particularly in regard to training regimens to prevent and recuperate from injury.  Residents may have the opportunity to participate at the orthopedic clinic at the base of the Sugarbush ski resort in Vermont and/or rotate in the sports medicine fellowship program at UMASS.

ENT and Ophthalmology             Back Return
On the ENT rotation, residents learn to perform a complete ENT exam and become familiar with the diagnosis and management of common problems including epistaxis, foreign body removal, acute and chronic infections, benign and malignant neoplasms, and hearing loss.  On ophthalmology, residents learn to diagnose and treat commonly encountered eye conditions and become familiar with the management of cataracts, glaucoma and retinopathy.

Practice Management                 Back Return
The Practice Management curriculum allows residents significant flexibility to develop skills applicable to the type of practice that they are choosing to pursue after residency.  Career development/job search, practice improvement skills, malpractice and risk management, office practice management, and personal finance are also covered.   Residents have longitudinal sessions scheduled across their three years which are mainly self-directed.  The hours in these sessions are supplemented by some Practice Management group time early in their internship, as well as bi-monthly conferences they attend, and the reading/research/project work they do on their own time

Language Instruction & Annual Trip to the Dominican Republic                   Back Return
As many of our patients speak Spanish, an intensive, two-week language course is provided to residents as part of their initial orientation with ongoing instruction  throughout at least the first year.  Because most of the health center staff are bilingual, interpretive services are always readily available.  While it is neither expected nor required that new residents speak Spanish, we are confident that they will develop Spanish communication skills by the end of their first year. In addition, there is an annual trip to the Dominican Republic which functions as an opportunity to see and experience the country of origin of half our patient population, as well as to have a break in the middle of winter in a tropical setting.  The residents use vacation time to attend, and half of the expenses are covered by the residency, while the balance is paid by the resident (many choose to use their CME to cover the balance). 

Specialty Clinics                   Back Return
In order to promote better care to our patients and hands-on experience for the residents, we have incorporated more and more in-house specialty clinics so that the residents have the opportunity to take care of the patients while a precepting physician supervises.  Presently, we have the following specialty clinics, which all residents are scheduled to participate in during their three years:  ADHD clinic, Colposcopy, Procedures, Gynecology, General Surgery, Pediatric Acute Care,  Pediatric Cardiology, Growth and Nutrition, Wound Care, and “Mass Cares” Pediatric HIV Clinic.