Christiana Care’s Family Medicine Residency Program was one of only 14 programs in the nation to receive recognition as a P4 program (Preparing the Personal Physician for Practice), whose training innovations have led to transformation and changes in the content, structure and location of residency training.
Examples of changes to our first-year curriculum:
Sample schedule for Emergency Medicine
|Traditional obstetrics||Ambulatory reproductive care|
|Inpatient surgery||Outpatient surgery|
|Tertiary ICU||Tertiary ICU + Community ICU|
|1 office session/week||2.5 average sessions/week|
Some highlights of the program’s transformation:
Enhanced training in high-quality ambulatory care
To ensure adequate training as experts in ambulatory care, residents will increase their time spent caring for patients in the ambulatory setting. Immersion in outpatient medicine will include interns who have traditionally spent 90-95 percent of their first year caring for hospitalized patients.
Individualized curriculum and interest tracks
While our primary goal is to train residents in core family medicine, we strongly believe in nurturing the interests of residents. With our longitudinal curriculum, we are able to tailor the curriculum to an individual resident’s needs and interest.
To create the most positive transition you’re your residency experience, we devote the first month of internship to orientation.
The purpose of this month is to:
- Immerse interns in ambulatory family medicine in the first month of training.
- Allow residents to become thoroughly comfortable with our office, our staff, our faculty and our residents before going to other services and rotations.
- Provide interns with an early sense of belonging to the Family Medicine Department.
The components of this orientation are:
- Shadowing to learn flow.
- Meeting the nurses, front desk staff, preceptors, residents, etc.
- Ambulatory didactics.
- Billing and coding.
- EMR training, pearls, practice.
- TransforMed principles.
- Chronic disease management.
- Evidence-based medicine.
- Inpatient orientations.
- “A day in the life of an intern.”
- Interns will have at least seven office-hour sessions in the first month of training
Thursday afternoon conference
Residents attend resident conference every Thursday morning, unless on a rotation from which they cannot be excused.
Conference consists of a mix of lectures and small-group case-based learning. Residents give various presentations, including morning report and morbidity and mortality report.
Sample Year 1 Schedule for Family Medicine Residency Program
|Rotation||Number of Weeks|
|Ambulatory Reproductive Health||6|
|Family Medicine Outpatient||10
Broken into two four-week blocks and one two-week block, spaced throughout the year. Includes one to three weeks of night float.
May not be taken during inpatient rotations.
Program Years 2-3
The second- and third-year curriculum is longitudinal and incorporates core family medicine training with the innovative elements our transformative approach.
Sample Upper Year Schedule for Family Medicine Residency Program
|Sample P4 Week|
|AM||Office Hours||Sports Medicine||Office Hours||Lecture||ENT|
|PM||Cardiology||Office Hours||Outside Continuity Site (such as a Wellness Center)||Office Hours||Office Hours|
Sporadically through the year, upper-year residents will cover our inpatient service for two weeks at a time.
|Sample Week During “WHIP”|
|AM||Inpatient Team||Inpatient Team||Inpatient Team||Inpatient Team||Inpatient Team|
|PM||Inpatient Team||Inpatient Team||Inpatient Team||Inpatient Team||Inpatient Team|
- Second-year orientation will be held to transition first-year residents to upper-year status.
- Continuity time in the Family Medicine Center (at the Foulk Road and Wilmington Annex locations) serves as the core of resident training.
- Experience in a broad spectrum of care, including nursing home, geriatric assessments, OB clinic, pediatric ER, medical student clinic and Claymont Clinic for uninsured.
- Six to eight weeks of daytime, inpatient coverage and three weeks of night float as part of Wilmington Hospital Inpatient Service (WHIP).