Family Medicine

The goal of the Family Medicine Residency Training Program is the training of a family physician who is prepared to provide comprehensive and continuous primary care to all age groups of both sexes in either a military or civilian setting. To achieve this goal, the following aspects of training are emphasized:

• To impress upon each resident that the responsible practice of medicine is a lifelong learning process and the residency years merely represent a continuum of this process between medical school and practice.
• To instill a holistic approach in the care and management of patients.
• To develop a healthy, self-critical, self-evaluation attitude.
• Acceptance of the wider range of responsibilities (i.e., health aspects of large troop units, tactical and logistical aspects of military medicine) of Family Medicine in the military setting as compared to a civilian setting.
• Understanding that a family doctor is but one member of a health care team.
• Commitment to patient education.
• Recognition that for the overall well being of any individual physician, he or she must lead a full and stable life and indulge in activities outside the realm of medicine.

 First Year

• Family Medicine Clinic (1/2 day per week. Responsible for 25 families)
• Orientation (2-week block)
• Cardiac Care Unit (4-week block)
• Dermatology (4-week block)
• Emergency Medicine (4-week block)
• Family Medicine Inpatient Team(12 weeks in 3 blocks)
• General Surgery (4-week block)
• Intensive Care Unit (4-week block)
• Newborn Nursery (4-week block)
• Obstetrics (4-week block)
• Gynecology (4-week block)
• Preventive Medicine (2-week block)
• Pediatrics (4-week block)

Second Year

• Family Medicine Clinic (2-3 half days/week. Responsible for 75 families)
• ENT (2-week block)
• Procedures (4-week block)
• Family Medicine Inpatient Team (10 weeks in 3 blocks)
• Family Medicine Night Float (4 weeks in 2 blocks)
• Peds elective  (4-week block)
• Obstetrics (8 weeks in 2 blocks, one block is in Ft. Carson, Colorado)
• Sports Medicine (4-week block)
• Pediatrics Clinic (4-week block)
• Urology (4-week block)
• Orthopaedics (4-week block)
• Ophthalmology (2-week block)

 Third Year

• Family Medicine Clinic (3-5 half days/week. Responsible for 150 families)
• Electives (10 weeks in 3 blocks)
• Family Medicine Inpatient Team (10 weeks in 3 blocks)
• Family Medicine Night Float (4 weeks in 2 blocks)
• General Surgery Clinic (4-week block)
• Cardiology (4-week block)
• Obstetrics (4-week block at Procedures)
• Psychiatry (4-week block)
• Trauma (4-week block)
• Cardiology (4-week block)
• Family Medicine Outpatient Clinic (4-week block)

 Human Behavior and Mental Health

Top priority is placed in the Behavioral Sciences as it relates to family physicians. This aspect of training is integrated throughout the entire residency experience, beginning with the first month of internship where an introduction to the behavioral sciences is integrated into the orientation program. Residents spend approximately 1 hour per week in small-group sessions devoted to dealing with the psychosocial aspects of patient care. Doctor-patient interactions, interviewing and counseling skills, the family life-cycle, medical ethics/values and the emotional health of the physician are areas of special attention. This portion of family medicine training is the integrating cement of our curriculum and leads to a holistic orientation to the individual's and family's medical care. Residents also spend a four week block rotation in the Department of Psychiatry at the American Lake Veteran’s Administration Hospital . This provides the resident with some experience dealing with psychiatric patients who require inpatient or outpatient care.

Adult Medicine

Twelve months of internal medicine provides a well-balanced mixture of hospital and ambulatory care experiences. Residents receive nine months of training in inpatient medicine and three months of internal medicine training in the ambulatory setting. All residents receive CCU and ICU experience. Cardiology, Geriatrics, and GI are also required rotations. Many other medical subspecialty rotations are available on an elective basis to fulfill or exceed the minimum required ten months of internal medicine training.

Maternity and Gynecologic Care

Our family medicine residents learn the fundamentals of obstetric care during a four-week block rotation with the Madigan Obstetrics service. They then hone their skills both by caring for their own family medicine obstetrical patients on a longitudinal basis and through three more months of obstetrical training during their second and third years. Residents gradually take on increasing levels of responsibility as they rotate with the busy obstetrical practices at Fort Campbell and Fort Sill . Four weeks in gynecology clinic expose the first year resident to both common and complicated gynecologic problems in the ambulatory setting.

Surgical Care

During the first year of training, family medicine residents spend four weeks on the General Surgery service gaining familiarization with the diagnosis and management of surgical disorders and emergencies. Residents concentrate on the pre-op evaluation and post-operative care of patients, and how to make an appropriate and timely referral for surgical specialty care. While spending four additional weeks in the General Surgery Clinic, our third-year residents develop technical proficiency in surgical procedures which family physicians may need to perform. In addition, second and third year residents each spend four weeks developing proficiency in procedural skills under the tutelage of the Family Medicine faculty. Four weeks of orthopedics is required in the second year with the resident taking primary call and responsibility for initial evaluation and definitive management of common orthopedic problems including fracture reduction. The residents also spend four weeks with our Sports Medicine staff, developing proficiency in the prevention, evaluation and management of athletic injuries. ENT, Urology, and Ophthalmology rotations round out the required six months of surgery and surgical subspecialties.

Care of Infants and Children

First year residents spend four weeks caring for low-risk newborns and an additional four weeks on the general pediatrics ward. During their second year the residents enhance their pediatric outpatient skills during a four week block in the pediatric clinic. Second year residents can tailor their pediatric training to their own needs through a second mandatory pediatric rotation. During this rotation, residents can concentrate on neonatal intensive care, adolescent medicine, developmental pediatrics or general pediatrics.

Dermatology

Second year residents spend four weeks with the dermatology department developing familiarity with the diagnosis and management of common skin disorders.

For additional information please contact:

Director, Family Medicine Residency
Madigan Army Medical Center
ATTN: MCHJ-FP
Tacoma , Washington 98431
(253) 968-1340 or DSN: 782-1340