Modules
Other Curricular Elements
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The Family Medicine Inpatient Service
Residents learn the majority of their acute care hospital
medicine on the family medicine inpatient service (FMIS), which
is supervised by our attending faculty. Attending physicians in
our department are responsible for the hospital care of the patients
in our practices. As a member of the team, you will participate
in managing hospitalized patients and deciding on the plan for
treatment, including whether consultants should be involved. The
success of this experience hinges on the teaching and clinical
capabilities of the attending faculty and senior residents. Our
family practice faculty also supervise the obstetrical care for
our patients. An exceptionally strong faculty has allowed us to
develop this, which offers a disciplined, scientific approach with
a unique family medicine perspective to the practice of medicine.
This system retains control of the patient within the family practice
attending-resident relationship and facilitates the delegation
of progressive responsibility for patient care from attending to
resident. Each of the hospitals has an FMIS, which functions as
the acute care support for the office practice.
Each FMIS provides exposure to a variety of
clinical problems and schedules frequent teaching conferences
with family practice and medical subspecialty faculty. Most
of the night and weekend call for the FMIS rotations is by
beeper and, like real-world family physicians, residents are
required to come to the hospital for newly admitted patients,
deliveries, or unexpected changes in patient condition.
Critical Care
The modules you spend in critical care will form the foundation
for critical care medicine needed in your upper-level years.
During this rotation, you will learn how to manage patients with
major and multiple organ failure under the guidance of the faculty
in the Department of Internal Medicine. Our residents are included
as a part of the unit team and are assigned patients in the CCU
and ICU. You will learn advanced cardiorespiratory and hemodynamic
monitoring and will acquire experience with ventilators, Swan-Ganz
catheters, and other invasive technologies. Examples of typical
diagnoses include myocardial infarction, pulmonary edema, renal
failure, GI bleeding, sepsis, and respiratory failure. On-call
averages every fourth night.
Pediatrics
During your pediatric
rotation, you will gain confidence in newborn assessment, resuscitation,
and stabilization in a busy
nursery. The faculty in pediatrics will supervise you as you
attend high-risk deliveries and learn how to manage distressed
newborns and meconium aspiration. Intubation and line insertions
are included. As part of the pediatric team at Children's Hospital
and South Buffalo Mercy Hospital, you will learn how to care
for the hospitalized infant and child. Fluid and drug calculations,
sepsis, diarrhea and dehydration, and asthma/croup/bronchiolitis
are examples of conditions that are common on this unit. An ambulatory
pediatric rotation emphasizing the common problems seen in office
practice is located at South Buffalo Mercy Hospital (SBM). The
patients seen in your family medicine center round out your pediatric
education with a community element.
Obstetrics and Gynecology
The
goal of the three required OB/GYN modules is to provide basic
instruction in common
problems in gynecology and to develop
a capability in normal deliveries. The hospital component includes
care of a variety of gynecologic conditions requiring surgical
diagnosis or treatment, as well as pre- and post-operative care.
The obstetrical block
experiences are concentrated at the Children's Hospital of
Buffalo and the Niagara Falls Memorial Medical Center,
where large numbers of patients are referred from the prenatal
clinics. The family practice residents are supervised in the
management of labor and risk assessment. There will be opportunities
for you to follow your families from your family medicine center
practice and deliver them under the supervision of our faculty
in family practice.
Surgery
Your two modules of general surgery are scheduled at Millard
Fillmore Suburban Hospital and provide basic experience in emergencies
and pre- and post-operative care of patients, including operating
room and minor surgery (lumps and bumps) teaching. Continued
education in surgery in the family medicine center refines ambulatory
surgery skills under the guidance of the family practice faculty.
Geriatrics
Your geriatric experience will be supervised by family physicians
with special training in geriatrics. These physicians direct
a skilled nursing facility and care for elderly patients with
a specially designed hospital team. You will learn about the
regulatory and medical issues of these institutions. Home visits,
nursing home experience and hospice care are also components
of this rotation.
Rural Health
You will have a choice of rural practices for your one module
assignment in rural medicine. We have a menu of family practice
offices with a strong track record of teaching students and residents.
Many practices offer overnight accommodations and most include
you in the hospital part of their clinical work.
Community Medicine
The community medicine curriculum offers a variety of exposures.
A number of voluntary, governmental, educational, and private
organizations participate in the program.
Buffalo: The Personal and Professional Touch
David My initial attraction to the University at Buffalo was
its proximity to Rochester, my wife's hometown. But the more
I learned about Buffalo's residency program, the more impressed
I became. The physicians I encountered here were so enthusiastic
about the family medicine programs! And I really liked the "community
hospital" feeling of Millard Fillmore Suburban. Also, the
fact that UB has an excellent Peds program (my wife was a pediatric
resident) made my decision easy.
"While I was in medical
school, I found that I enjoyed many different areas of medicine,
but I thought I would be bored if I focused
on one specific field. This realization led me to choose family
medicine. I wanted to be able to know my patients and handle
all of their health needs-not simply treat them for a specific
ailment and never see them again. I have completed rotations
in rural Louisiana, China, and Kenya, and I learned first-hand
how exciting and needed family medicine is, particularly in rural
areas and underdeveloped countries. I would like to make a difference
in the lives of medically underserved people in this country
and overseas. UB was and is an excellent choice, both academically
and for my long-term career goals."
-
David Holmes, M.D. (Graduate, Faculty Member and Physician
at Niagara
Family Health Center)
Emergency
Medicine
During your rotation in emergency medicine, you will be on the
front line in the treatment of emergency conditions with faculty
who are Board Certified in emergency medicine as your instructors.
You will develop a competence in the initial management of serious
emergencies.
ENT/Urology, Ophthalmology, Orthopedics, Cardiology, Dermatology
Teachers and offices for these core ambulatory experiences are
chosen from the University faculty at sites in the Buffalo area
that have been shown to excel in teaching family practice residents.
Rehabilitation Medicine
You will be involved in a full scope of rehabilitation activities
and will have firsthand exposure to physiatrists, occupational
and physical therapists, cardiac rehab, sports injuries, and
work hardening programs. You will learn which conditions can
be treated, and you will become familiar with the roles of various
modalities in treatment.
Conferences
The "university without walls" at
Buffalo facilitates the integration of teaching activities at
the affiliated hospitals
where our residency is based. There are numerous lectures, grand
rounds, and clinical case conferences sponsored by the clinical
departments that collaborate with us in training.
In addition, the Department of Family Medicine sponsors a core
curriculum each Thursday afternoon for all residents. The program
operates on a two year cycle and is designed to cover all the
basic and clinical science essential to family practice. Residents
are released from all rotations so they can attend.
Human
Behavior and Mental Health
A comprehensive program in Human Behavior
and Mental Health is fully integrated into the three years
of the residency. You will have and intern course, large
group instruction and small group case discussion in areas
including Mental Health, Behavioral Medicine (including
health behavior change, death & dying, caregivers,
chronic pain, chronic illness, mind-body interactions),
Advanced Patient-Centered Interviewing, Family Issues,
Violence and Health, Individual and Family development,
Use of Community Resources, Medical Ethics and Patient
Safety. Training activities include workshops and supervised
standardized patient interviews and feedback. Our faculty
are cognizant of the stress of residency training and adopt
a preventive approach with appropriate supports in the
context of advisor/advisee relationship.
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