St. John's Curriculum and Call

The following is information about St. John's curriculum and call.

Longitudinal experience: family medicine center
The family medicine center is the cornerstone of the resident’s clinical education.

Rotations and electives
View rotations for each year of residency and elective options

Global Health
Opportunities include international and global-local electives, courses, seminars, conferences, and a fellowship supported by the U of M, a Top Best Global University rated by U.S. News and World Report and a Top World University in the United States rated by QS World University Rankings. 

Didactics
Information on the fundamental critical care support course, hospital didactics, and conferences.

Programmatic courses
The department sponsors several required and optional one- to two-day programmatic courses. Topics include women's health, sports and musculoskeletal medicine, community health, and more.

Call
St. John's handles call differently than most programs.


Residents as teachers

MORE ABOUT RESIDENTS AS TEACHERS

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 eight University of Minnesota family medicine residency programs have many responsibilities, including that 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.

Resources

Resources are available to aid residents in development as teachers.

  • Residents Teaching Students: Developed by family medicine medical student education director David Power, MBBS, MPH, and colleagues, it provides an overview of several teaching strategies. One of these is a common teaching method used by both residents and faculty, known as the One Minute Preceptor.
  • Faculty advisors and residency directors also can connect residents with resources to enhance teaching abilities.

St. John's Longitudinal Experience: Family Medicine Center

St. John's Longitudinal Experience: Family Medicine Center

The family medicine center at Phalen Village Family Medicine Clinic is the cornerstone of the resident’s clinical education.

Through the provision of continuity care for patients in a model clinic, residents will learn a full spectrum of diseases and conditions that are present in general family medicine and understand essential practice management tools, which will enable them to be ready to practice as effective clinicians after residency.

Residents develop their own panels of patients in the busy outpatient clinic. The number of shifts per week will vary with the rotation and academic year of the resident, as shown in the following:

First-year residents

  • 1 to 2 shifts per week
  • 155 to 212 office visits per year
  • Patient panel size: 50-70

Second-year residents

  • 3 to 4 shifts per week
  • 614 to 862 office visits per year
  • Patient panel size: 270-590

Third-year residents

  • 4 to 5 shifts per week
  • 974 to 1,030 office visits per year
  • Patient panel size: 150 to 310

The clinic serves a patient population that includes first- and second-generation immigrants from Laos, Burma/Myanmar, and Mexico. Residents will see patients for preventive visits and a wide range of short-term and chronic conditions, exposing them to the full range of family medicine practice.

Residents will also have the opportunity to learn and perform a number of procedures on their own continuity patients and with faculty.

Rotations and Electives

St. John's Rotations and Electives

First-year rotations

The first year of residency emphasizes inpatient care. Residents spend one to two shifts per week at Phalen Village Family Medicine Clinic, where they work in teams providing continuity of care. The preceptor-to-resident ratio in the clinic is 1:3.

ADULT INPATIENT MEDICINE
Two non-consecutive months. No vacation permitted. Inpatient.
As a member of the Phalen service/in-patient team, residents gain an understanding of the broad range of medical conditions present in a general family medicine practice and are managed in the hospital by family physicians. Mornings involve rounding on patients on the service.

CARDIOLOGY
One month. Vacation permitted. Inpatient
Residents gain an understanding of cardiology and cardiac-associated diseases and conditions frequently present in a general family medicine practice. Patients may be further referred to cardiologists for evaluation and treatment.

CLINIC I
One month. Vacation permitted. Outpatient.
Residents will develop skills that will allow them to become more competent in clinic. This will be done through focusing on agenda setting, visit efficiency, negotiating a plan, and patient follow up. Time will also be spent in video reviews, a self-assessment, and learning to work as part of a multi-disciplinary team.

EMERGENCY MEDICINE I
Vacation permitted. Inpatient.
Residents gain an understanding of conditions that frequently present to the emergency room setting and will learn how these overlap with and differ from conditions presenting to the family practice center. Residents work a minimum of 200 hours in the ER. Residents may work some evening and/or weekend shifts.

PULMONARY MEDICINE WITH ICU
One month. Vacation permitted. Inpatient.
Residents will gain an understanding of diseases and conditions that are frequently present in the critically ill adult and will learn procedural skills relevant to their care.

NEONATAL INTENSIVE CARE UNIT
One month. Vacation permitted. Primarily inpatient.
Residents gain an understanding of common neonatal and pediatric diseases and conditions while spending time in the Level II nursery. Residents are responsible for managing the Phalen newborn, pediatric, and post-partum service, as well as following newborns in the NICU and working with the neonatologists and neonatal nurse practitioners at the hospital.

NEUROLOGY
One month. Vacation permitted. Primarily inpatient.

Inpatient neurology
Rounding with a neurologist most mornings, residents gain an understanding of neurology and associated diseases and conditions that are frequently present in a general family medicine practice and may be further referred to the neurologist.

OBSTETRICS
Two non-consecutive months. No vacation permitted. Inpatient.

Residents gain an understanding of maternity care, labor and delivery, and postpartum care as well as the roles of and partnership between the family physician and obstetrician in the care of pregnant women. Residents will develop or refine the knowledge and skills necessary to become competent in the evaluation and management of the pregnant woman in the perinatal period, obtain proficiency in multiple perinatal procedures, and competently triage the moderately ill pregnant woman and recognize urgencies in antepartum care.

PEDIATRIC WARDS AT CHILDREN'S HOSPITALS AND CLINICS OF MINNESOTA
One month. No vacation permitted. Includes some night float and weekends.

Residents will gain an understanding of common inpatient pediatric diseases and conditions.

SURGERY
One month. Vacation permitted. Primarily inpatient.

Residents achieve competency in the diagnosis and appropriate management of common surgical problems seen in the primary and secondary care settings.

Second-year rotations 

Residents learn to manage a wide spectrum of medical problems, including those characteristic of the traditional specialty disciplines. This occurs in both hospital and clinic settings and includes an emphasis on office procedures, patient care, and office management.

Residents are scheduled three to four shifts per week at Phalen Village Family Medicine Clinic, providing care to their own panel of patients, including a panel of continuity OB patients.

BEHAVIORAL MEDICINE
One month. Some vacation permitted. Outpatient.

Residents will recognize interrelationships among biological, psychological, and social factors in all patients and will promote healthy behavioral responses to health and disease in patients, colleagues, and themselves. Residents will spend time with clinic behavioral medicine specialists. Locations include the UMN Program in Human Sexuality Center for Sexual Health and one week at the Hazelden addiction treatment center in Center City, giving residents an understanding of the identification and treatment of substance abuse and addiction.

CLINIC POPULATION 
One month. Vacation permitted. Primarily outpatient.

Residents will understand the population management activities of a family medicine physician and team at the clinic level and intentional integration with community partners and activities. Residents will further develop leadership abilities within the healthcare team and will have an understanding of their patient panels.

COMMUNITY HEALTH
One month. Vacation permitted. May include inpatient and/or outpatient.

Community health is learned longitudinally over the three years of residency. The goal of the community health month is for the resident to understand how a community is defined and the various components of community health, and to develop an appreciation of how a practicing physician can integrate care of the community into practice.

DERMATOLOGY
One month. Vacation not permitted. Outpatient.

Residents gain an understanding of dermatology and skin-associated diseases and conditions that are frequently present in a general family medicine practice and may be further referred to the dermatologist. Residents have the opportunity to perform dermatologic procedures and exams independently and under supervision.

EMERGENCY MEDICINE II
Vacation permitted. Inpatient.

Residents increase their understanding of conditions that frequently present to the emergency room setting. Residents will build upon the hours spent in the ED as a PGY1 and will meet the 200 hour requirement during this rotation. Residents may work some evening and/or weekend shifts.

GERIATRICS
One month. Vacation permitted. Primarily outpatient.

Working with family medicine physicians at a home visit service, residents gain an understanding of the common health and aging issues of the geriatric population that will enable them to provide competent care to elderly patients in a general family medicine practice. Residents will also rotate with palliative care specialists to ensure residents gain an understanding of palliative care as a discipline and philosophy of care and how it's applied in both inpatient and outpatient settings.

MUSCULOSKELETAL AND SPORTS MEDICINE
Two non-consecutive months. Some vacation permitted. Primarily outpatient.

The musculoskeletal experience will provide extensive exposure to orthopedic conditions and sports medicine. Residents will rotate through Summit Orthopedics and the Sports Medicine Clinic at the CSC. The rotation also may include sideline coverage and Johnson High School training room. Residents will review radiographic imaging and practice splinting, casting, and immobilization techniques. This rotation will be structured to foster proficiency in the basic evaluation and assessment skills of orthopedic patient care.

PEDIATRIC INPATIENT SERVICE
One month. No vacation permitted. Primarily inpatient.

Residents gain an understanding of pediatric diseases and conditions as well as normal growth and development. Residents are responsible for managing the Phalen newborn and post-partum service. This rotation also includes coverage of the clinic at Face to Face, an organization that serves at-risk youth between the ages of 14 and 24.

PHALEN SERVICE/INPATIENT ADULT MEDICINE
Two non-consecutive months. No vacation permitted. Inpatient.

As a member of the Phalen service/inpatient team, residents gain an understanding of the broad range of medical conditions present in a general family medicine practice and are managed in the hospital by family physicians. Mornings involve rounding on patients on the service.

Third-year rotations

The third year emphasizes attainment of advanced technical and conceptual medical skills. Continuity of care, comprehensive family medicine, family dynamics, practice management, consultative medicine, and surgery services strengthen the curriculum. Four to five shifts per week are spent at Phalen Village Family Medicine Clinic.

CARDIOLOGY
One month. Vacation permitted. Inpatient

Residents gain an understanding of cardiology and cardiac-associated diseases and conditions that are frequently present in a general family medicine practice. Patients may be further referred to cardiologists for evaluation and treatment.

CLINIC III
One month. Some vacation may be permitted. Outpatient.

Residents will develop and hone the skills of outpatient family medicine. They will work with clinic leadership to develop an understanding of essential practice management tools and Quality Improvement.

COLORECTAL SURGERY AND UROLOGY
One month. Vacation permitted. Outpatient.

Colorectal surgery
Spending two shifts per week with a busy colorectal surgeon, residents gain an understanding of colorectal-associated diseases and conditions that are frequently present in a general family medicine practice. Patients may be further referred to colorectal specialists.

Urology
Residents gain an understanding of a wide variety of urologic conditions, becoming proficient in the diagnosis, treatment, and decision-making process regarding consultation with a urologist. Residents spend time with multiple urologists at four area clinics to ensure a broad exposure.

GYNECOLOGY
One month. Vacation permitted. Outpatient.
Residents gain an understanding of gynecologic diseases and conditions that are frequently present in a general family medicine practice.

HOSPITAL LEAD
Two non-consecutive months. No vacation permitted. Inpatient.

As the chief member of the Phalen service/inpatient team, residents gain an understanding of the broad range of medical conditions present in a general family medicine practice and are managed in the hospital by family physicians. Mornings involve rounding on patients on the service. Residents on the chief rotation gain an understanding of the role and duties of a family medicine hospitalist.

NEPHROLOGY
One month. Vacation permitted. Inpatient and outpatient.

Residents will gain an understanding of the kidney and associated diseases and conditions that are frequently present in a general family medicine practice.

PEDIATRIC EMERGENCY
One month. No vacation permitted. Inpatient.

Residents gain an understanding of common neonatal and pediatric diseases and conditions while developing skills in pediatric emergency medicine.

PULMONARY MEDICINE
One month. Vacation permitted. Outpatient.

Residents gain an understanding of pulmonary diseases and the management of common pulmonary disorders encountered in primary care. Two to three shifts over the month will be spent with a pulmonary sleep medicine specialist, providing residents an understanding of this topic as well.


Electives

Electives provide an opportunity for residents to tailor their education according to their interests. Rotations are available at other University of Minnesota family medicine residencies.

Didactics

St. John's Didactics


Fundamental critical care support

First-year residents attend a two-day fundamental critical care support course to prepare for increased involvement in the ICU when on call.

Hospital didactics

Noon didactics are held every Wednesday and Thursday over lunch. We also have a three-hour didactic block on the second and fourth Tuesday of every month. This includes both in-depth look at topics of importance as well as hands-on skill workshops such as splinting.

Conferences

  • Medical conferences
    Residents are allowed up to three days to attend conferences that explore or further a medical interest, e.g., dermatology, international medicine, marathon medical management, orthopedics, and wilderness medicine. Conference attendance must be approved by the program director.

Call

St. John's Call

As an intern, you are never alone. There is always someone ready to help.
—Jeremy Peterson, MD, former resident

St. John's handles call differently than most programs.

  • Weekday house officer responsibilities are assigned to a second- or third-year resident on a core rotation.
  • Residents develop the call schedule.

Schedule

  • With few exceptions, rotations end at 5 pm and do not extend into the evening or weekend.
  • If not on call, residents generally have evenings and weekends free.
  • After-hours call is typically 1 in 5-6 nights for first-year residents, and 1 in 12 weekdays and 1 in 6 weekends for second- and third-year residents.
  • No night float.

Short/long call

We use a short/long call system for first-year residents, minimizing lost learning opportunities by keeping residents in the hospital when the most supervision and teaching capacity is in place. Overnight call experiences occur on weekends and holidays.

Short call: Monday-Thursday's call team consists of one first-year and one senior resident until 10 pm. At 10 pm, the first-year resident leaves the hospital and the senior resident assumes responsibility for admissions and patient care.

Long call: Friday-Sunday's call team consists of one first-year and one senior resident, both responsible for patient care responsibilities.

When on call, residents practice full spectrum family medicine, with appropriate backup, including deliveries, admissions, and hospital rounding.