North Memorial Curriculum and Call

Family medicine residents are directly responsible for a portion of medical student clinical education during clinical experiences and clerkships.

Medical education features a closely connected cycle of teaching, learning, and progressive responsibilities; senior learners teach junior learners, and all learners are involved in ongoing professional and personal development.

Residents of the University of Minnesota family medicine residency programs have many responsibilities, including those of supervisors and educators. Most medical students encounter family medicine residents as teachers during the Family Medicine Clerkship. Therefore, residents receive instruction about clerkship/rotation goals and objectives as well as training in teaching methods.

The Residents as Teachers Curriculum provides formal instruction for residents and fellows on effective teaching skills, student assessment, and medical student mistreatment. The training includes podcasts and supplementary materials covering feedback techniques, competency-based assessment, work-hour policies, and clerkship learning objectives. As part of their orientation to the University of Minnesota Office of Graduate Medical Education, residents must complete the required modules, review policies, and submit an attestation form.  

First Year

Residents spend two half-days per week at Broadway Family Medicine Clinic, building their own patient practice. Preceptorship is conducted by program faculty and community physicians.

First-year residents have the following schedule, divided into 13 four-week periods.

Diabetes/Podiatry

Two weeks, no vacation. Combination rotation where residents participate in the education of diabetic patients, including nutritionist visits. Residents also learn to recognize systemic disease manifestations in the foot and lower extremities as well as the management of common foot disorders.

Emergency Medicine

Four weeks, no vacation. Residents work shifts in the Level I trauma center, learning care of acute medical and trauma patients, and honing office skills on the “fast track” outpatient side of the ER. A wealth of opportunity is available for learning procedures ranging from laceration repair to orthopedics to eye trauma.

Family Medicine Service

Twelve weeks, divided into two-four week blocks, no vacation. Residents and the family medicine faculty run our own inpatient service. They manage all cases including medical admissions, procedures, and our own ICU patients. The first-year resident admits patients during daytime hours and one evening per week, supervised by the senior resident and faculty.  Daily teaching rounds are conducted by the family medicine service chief and by family medicine faculty. Radiology rounds are part of this curriculum as well as opportunities to teach medical students.  Additionally, each resident will spend one week working medicine and OB “flying night float” towards the end of the year. This shift is from 9 pm to 7 am.

Hospice and Palliative Care

Two weeks, vacation allowed. A two week experience working with patients and their families, both in the hospital and in their homes. Residents attend staff meetings, do home visits, interact with families, and receive didactic sessions from physicians, nurses, social workers, and clergy.

Integrated Clinical Skills

Four weeks, no vacation. This rotation focuses on skill building for ambulatory care. Bread and butter family medicine mini-lectures are taught by senior residents, and interprofessional faculty help residents hone their communication skills. Functional topics, such as EMR enhancement, coding, and quality improvement are covered; and community health and outreach is introduced.

Neurology

Four weeks, vacation allowed. Residents work one-on-one with a neurologist, providing many opportunities in the evaluation and management of outpatient neurological problems. Residents also work with hospital patients requiring neurologic consultation and admit patients to the neurology service.

Night Float

One week, no vacation. Each resident will spend one week covering Broadway patients on medicine and OB as the night float resident towards the end of the year. This shift is from 9 pm to 7 am.

Obstetrics

Six weeks, divided into two-week blocks, no vacation. Inpatient obstetrics is taught by our faculty with help from the OB/Gyn laborist group in a busy labor and delivery environment (100 deliveries per month). The hallmark of this experience is the collaborative relationship between family medicine and obstetrics, leading to a 14% C-section rate in a high-risk population. Residents assist and/or perform vaginal deliveries, C-sections, and amniotomies; monitor placements; and evaluate non-stress tests and oxytocin challenge tests. There is also opportunity to do ultrasounds in the clinic.

Opthamalogy

One week, no vacation. Residents work in a busy ophthalmology group practice and have the opportunity to observe and participate in surgery and care for acute eye injuries. The goal of this rotation is to master the eye exam.

Orthopedics and Sports Medicine

Four weeks, vacation allowed. This is primarily an outpatient experience, combining time in a busy orthopedic office and a sports medicine office, with emphasis on gaining knowledge in musculoskeletal medicine. Residents gain skills in the assessment and treatment of common orthopedic problems, cast application, and joint injections and aspirations.

Otolaryngology

Two weeks, vacation allowed. An outpatient experience with otolaryngologists who examine and discuss patients with residents. Otolaryngologic surgeries provide opportunities to review anatomy of the ear, nose, pharynx, and sinuses.

Pediatrics (Outpatient)

Two weeks, no vacation. Residents will gain an increased understanding of normal pediatric development as well as of common pediatric illnesses and complaints that are frequently present in an outpatient family medicine practice. The goal of this rotation is to become skilled in well-child exams, parent counseling and anticipatory guidance, learning from seasoned family medicine experts. This rotation also provides the opportunity to learn from a patient population whose needs and concerns are different from those at Broadway Family Medicine.

Pediatrics

Four weeks, no vacation. The rotation at Children’s Hospitals and Clinics of Minnesota teaches management of a variety of general pediatric inpatient problems and includes weekly educational lectures. Residents gain extensive exposure to common acute pediatric illnesses such as dehydration, asthma, RSV, influenza, and pneumonia. A senior resident and staff pediatricians supervise residents.

Two weeks, vacation allowed. Residents work one-on-one with a private surgeon. Inpatient general surgery teaches surgical patient assessment and management, including preoperative history and physical examinations, consults, post-operative follow-up, and discharges. Residents are first-assist on many cases and have opportunities to perform simple surgeries.

Urology

Two weeks, vacation allowed. This is primarily an outpatient rotation, focusing on workups of common urologic problems. Residents have the opportunity to participate in surgeries and gain experience in evaluating and treating urologic cancers, erectile dysfunction, hydrocele, benign prostatic hyperplasia, transurethral resection of the prostate, vasectomies, and other urologic issues.

Second Year

Second-year residents become more involved with the care of patients from Broadway Family Medicine Clinic. Each second-year resident is in clinic three half-days per week.

Cardiology

Four weeks, vacation allowed. Residents work one-on-one with cardiologists, learning management of common cardiac problems and invasive monitoring, gaining experience placing central lines, and performing stress tests.

Chemical Dependency

Two weeks, no vacation. Experience with outpatients and inpatients at University of Minnesota Medical Center on the West Bank. Resident participates in group and family sessions and attends lectures to learn about evaluation and treatment, after care, effects on families, and how and when to prescribe mood-altering substances to chemically dependent persons.

Community Health

Four weeks, vacation allowed. Our unique community health curriculum enables residents to work together on a community health project longitudinally throughout their second year of residency.

Family Medicine Service

Eight weeks, no vacation. Our own inpatient service is run by the residents and family medicine faculty. We manage all medical/surgical admissions, including all varieties of medical problems. Residents work as daytime members of the family medicine service from 8 am to 5 pm and one evening per week. During the evening and overnight hours, the resident is responsible for covering inpatients on our service, admitting Broadway patients, and patient phone calls.

Intensive Care Unit

Four weeks, vacation allowed. Gain experience with stabilization and management of acutely ill patients. Teaching is done by nephrologists, pulmonologists, intensivists, internists, trauma surgeons, nurses, nutritionists, and clergy. Residents also learn ventilator management and how to insert chest tubes, central venous lines, and pulmonary artery catheters.

Nephrology

Two weeks, vacation allowed. Residents work with nephrologists performing inpatient consults and managing ICU patients. They also spend time in a nephrology clinic learning to manage chronic renal failure, resistant hypertension, and other renal disease.

Night Float

Three weeks, one week at a time, no vacation. Three times during the second year, residents will spend one week covering Broadway patients on medicine and OB as the night float resident. This shift is from 9 pm to 7 am.

Obstetrics

Four weeks, no vacation. A continuation of the learning experience that began in the first year. Opportunities exist for teaching medical students, attending weekday conferences with the perinatologists and OB/GYNs, and managing obstetrical patients. Night work is included.

Pediatrics

Four weeks, no vacation. The rotation at Children’s Hospital and Clinics of Minnesota teaches management of a variety of general pediatric inpatient and emergency room problems. Second-year residents also take on more supervisory responsibilities.

Pediatrics Emergency Medicine

Four weeks, no vacation. A supplement to our ER rotations at North Memorial Hospital. This rotation is designed to give residents more experience assessing, diagnosing, and treating acute "bread and butter" pediatric illness and injury in the high volume suburban ER at Maple Grove Hospital.

Renal

Two weeks, vacation allowed. Residents will gain an understanding of the kidney and associated diseases, including acid-base and electrolyte management and conditions that are frequently present in a general family medicine practice and may be further referred to the nephrologist.

Third Year

Third-year residents spend more time in clinic, averaging four half-days per week.

Third-year residents spend more time in clinic, averaging four half-days per week.

Advanced Emergency Medicine

Four weeks, no vacation. Residents spend additional time in the ER to review and enhance cognitive and procedural skills in emergency medicine with more responsibility than the first-year rotation. Sites available include North Memorial Medical Center, a Level I trauma center, and outstate community hospital emergency departments.

Dermatology

Four weeks, vacation allowed. Residents rotate in a private, suburban dermatology practice with two physicians, seeing patients independently after their first few days on rotation. Residents will gain an understanding of basic dermatologic conditions, treatments, and procedures.

Electives

13 weeks, vacation allowed. Electives help residents personalize their training, taking into account future practice needs. Many residents set up rural, regional, national, and international rotations. Residents are also encouraged to develop electives that meet their own educational objectives. Available electives include advanced obstetrics, gastroenterology, infectious disease, rheumatology, sports medicine, procedures, research, plastic surgery, and more.

Family Medicine Service

Six weeks, no vacation. Our own inpatient service is run by the residents and family medicine faculty. We manage all medical/surgical admissions, including all varieties of medical problems. Residents spend six weeks as the chief of our inpatient service, providing education and supervision for first- and second-year residents. Residents are on service work one weeknight, and some have some weekend rounding. Daily teaching rounds are conducted by the service chief and one of our faculty members.

Geriatrics

Four weeks, vacation allowed. A comprehensive geriatric experience with geriatricians and geriatric nurse practitioners based in long-term care, transitional-care centers, and outpatient clinics. Focus will be on learning a comprehensive geriatric assessment and leading family meetings and care conferences.

Gynecology (Outpatient)

Four weeks, vacation allowed. Learn office gynecology emphasizing routine care, oncologic evaluations and treatments, menstrual irregularities, infertility work ups, and birth control counseling/prescribing. Training in colposcopy is included.

Night Float

Two weeks, no vacation. Twice during the third year, residents will spend one week covering Broadway patients on medicine and OB as the night float resident. This shift is from 9 pm to 7 am.

Obstetrics 

Two to four weeks, or more as desired, no vacation. This is a continuation of the learning experience begun in the first and second years. Opportunities exist for teaching medical students, attending weekday conferences, and managing high-risk obstetrical patients. Residents may participate in gynecologic surgery cases for further experience. Residents spend two half-days per week in clinic, where there are opportunities to do ultrasounds.

Pediatrics (Outpatient)

Four weeks, no vacation. Residents rotate with dedicated and knowledgeable pediatricians in outpatient pediatrics clinics. Experiences include pediatric opthalmology oral health. Learning occurs through didactic lectures and hands-on case management.

Practice Management and Ambulatory Family Medicine

Four weeks, no vacation. Residents will enhance their knowledge of practice management through a combination of readings, discussions with clinic management, assignment completion, and self-reflection. The rotation includes 10 modules, each consisting of a half-day of education on numerous topics that are relevant to the practicing family physician in today’s healthcare system. Residents will also enhance and refine their clinic skills, focusing on efficiency.

Sports Medicine

Four weeks, vacation allowed. Residents work with fellowship-trained primary care sports medicine physicians as well as sports physical therapists. Duties include coverage of the Robbinsdale Cooper High School training room and Wednesday sports medicine clinic at Broadway Family Medicine Clinic. Additional opportunities exist to cover college sports and local mass sporting events (e.g., Twin Cities Marathon and USA Soccer Cup).
 

Electives help residents personalize their training, taking into account future practice needs.

Senior residents enjoy up to 28 weeks of elective time over two years. Four weeks in each second- and third-year are reserved for “away” time, allowing residents to travel and explore other opportunities.

Our elective catalog has been developed by residents, faculty, and administration to include more than 40 options. A sampling of electives follow:

• Policy and advocacy
• Eating disorders
• Rheumatology
• Acute injury
• Research
• Sexual health
• Teaching

Rural electives

While our clinic is deeply rooted in North Minneapolis, approximately 20% of our graduates practice in rural settings. To support these interests, our residents enjoy rural elective opportunities. Many of these electives can be completed while maintaining continuity clinics, allowing residents to complete additional “away” electives. Options include the following:

• Family medicine and Native American health in Grand Marais, Minnesota
• Full-spectrum family medicine in a rural setting in the Minnesota towns of Willmar, Staples, and Wabasha

Many residents are motivated to set up new rural, regional, national, and international rotations. Residents are also encouraged to develop local electives that meet their own educational objectives. Supportive advising and administration help make this possible.

The longitudinal curriculum includes integrated training in behavioral medicine and community health. Curricular emphasis is available in the following topic areas:

• Policy and advocacy
• Underserved and international medicine
• Sports medicine
• Research
• Osteopathic medicine

Our clinic is closely involved with community programs such as The Ladder, a mentorship program for North Minneapolis youth interested in a career in health care. 

Conferences, workshops, lectures

Tuesday afternoons are reserved for conferences, workshops, and lectures. Our didactics curriculum is designed around adult learning models and utilizes residents to lead and teach.

Recognizing that medical knowledge has a brief half-life, our goal is to promote lifelong learning skills that will keep your knowledge fresh after you leave residency. Our core faculty provide or facilitate talks each week, with contributions from behavioral health, pharmacy, emergency medicine, and other sub-specialties.

In addition to traditional lectures, some of our unique content include the following:

Antibiotic Boot Camp

Year 1

Family medicine service schedule

Two shadow call shifts with a second- or third-year resident in house.

• Five to six weekend call shifts
• Saturday or Sunday, 7:30 a.m. to 9 p.m.

Responsibilities

• Answering clinic patient phone calls
• Caring for inpatients from the family medicine service
• Working up admissions from the ER
• Participating on the medical emergency team

Obstetrics schedule

• Shifts are 10 or 14 hours, three to four times per week; no 24-hour shifts

Years 2 and 3

Family medicine service schedule

• Five to six-weekend shifts (Friday, Saturday, or Sunday)
• Friday overnight shift, 5 p.m.–7:30 a.m.
• Saturday or Sunday, 7:30 a.m. to 9 p.m.

Responsibilities

• Answering clinic patient phone calls
• Caring for inpatients from the family medicine service
• Working up admissions from the ER
• Participating on the medical emergency team

Obstetrics schedule

• 10- or 14-hour shifts; no 24-hour shifts