The New York-Presbyterian Hospital: Columbia University Medical Center (NYPH-CUMC) combines a strong emphasis on underserved and communityoriented care with the resources of a major academic medical center. The core of our training happens at the Farrell Community Health Center, our Family Medicine faulty and resident outpatient office located at 158th street in upper Manhattan. Most of the residency's inpatient rotations take place at the Allen Hospital -- a 200 bed community hospital branch of New York Presbyterian Hospital that is located three miles north of the main campus.

AMBULATORY CARE

Training in primary and preventive continuity care takes place principally at the Family Medicine at the Family Health Center. Our FHC has teaching sessions dedicated to skin procedures, colposcopy, musculoskeletal medicine, behavioral health, integrative medicine, and abortion/reproductive health that are taught by Family Medicine Faulty. Residents also work with Podiatry, OB/GYN, and GI specialists in our FHC. Outside of our office, residents rotate through general surgery clinics, urology, adult and pediatric orthopedics, rheumatology, gynecology/family planning, psychiatry, subspecialty pediatrics, dermatology, ENT, and dental clinics. Residents also spend three months totalin our busy pediatric and adult emergency departments. Residents have 3 months of elective time to pursue specific individual interests.

LONGITUDINAL EXPERIENCE

Essential Family Medicine core learning experiences that are incorporated continuously into their three years of training include the following: Behavioral Sciences, Health promotion, -disease prevention, diagnostic imaging, cardiology, didactic curriculum, community-oriented primary care, maternal care, family planning/reproductive health, adult and pediatric inpatient continuity, home visits, nursing home continuity, narrative medicine, quality improvement, and the research curriculum. We also received a grant through the Weil Foundation for residents to receive additional training in integrative medicine.

INPATIENT CARE

The Family Medicine Inpatient Service team (at the Allen) consists of one senior day resident (a PGY2 or PGY3), two first-year residents, and a senior night float resident. The service accepts patients admitted not only from the Emergency Department but also from the resident and faculty practices. Teaching in the inpatient service is provided by two faulty family physicians, a behavioral scientist, a PHD ethics/narrative medicine specialist, and a full array of subspecialty consultants. Most residents think that their experience at the Allen Hospital is one of the strengths of their residency experience at NYP/Columbia.

The Allen Hospital also provides our residents inpatient training in several of the other major specialties: general surgery, ICU, and obstetrics. During their two and a half months of maternity care training, residents experience the busy labor floor and postpartum care, working one-on-one with members of the Family Medicine faulty as well as Obstetrics faulty.

The remainder of require specialty experiences takes place at New York-Presbyterian Hospital: Columbia University Medical Center's main campus. Family Medicine residents learn pediatric inpatient care for one month under the supervision of the Department of Pediatrics at the Morgan Stanley Children's Hospital of New York.

Residency training occurs off campus as well. The geriatric rotation takes place at Schervier Nursing Care Center, where residents receive geriatric care training from Family Medicine physician faulty in both the ambulatory and skilled nursing facility settings. Starting in the second year, each resident has two continuity nursing patients that he/she will follow over time. Residents do home visits throughout their three years of training, caring and learning from their patients, as well as reflecting (through narrative writing exercises) on the experiences they witness within the fabric of their patients' daily lives.

LECTURE CURRICULUM

The didactic curriculum at the Family Medicine Residency Program is an important cornerstone of our residents' education. Thursday afternoons are dedicated to talks and workshops on a rotating series of topics. We have a diverse Family Medicine faulty involved in teaching. We offer lectures and talks from an outstanding group of world-class subspecialists from Columbia University College of Physicians and Surgeons. We also have access to some of the best medical educators from other New York and national institutions to lecture for our residents. And our own second and third year residents take part in presenting a wide variety of Family Medicine didactics. The residency takes an active role in getting resident feedback to constantly improve and diversify the didactic curriculum.

On Wednesday mornings, we have a Morning Report session before we start patient care. This is a resident led, case-based presentation focusing on common outpatient topics. Two years ago, one of our chief residents took the lead to develop an additional resident-led noon conference on Fridays in our Family Health Center. Our inpatient service also has its own didactic curriculum in addition to hands-on learning.

ROTATION

First Year

Family Medicine Inpatient Service          16 weeks

Obstetrics I                                            8 weeks

ICU                                                        4 weeks

Family Health Center                              4 weeks

Pediatric Inpatient                                  4 weeks

Ambulatory Pediatrics                             4 weeks

General Surgery I                                    4 weeks

Vacation                                                 4 weeks

Community Oriented Primary Care          4 weeks

Research/QI                                           longitudinal

Second Year

Women's Health                                      4 weeks

Behavioral Medicine                                4 weeks

Elective                                                  4 weeks

Musculoskeletal Medicine                       4 weeks

Neonatology/Newborn Nursery               4 weeks

Obstetrics II                                           2 weeks

Geriatrics                                               4 weeks

Pediatric Emergency Medicine                 4 weeks

Adult Emergency Medicine                      4 weeks

Family Health Center                              4 weeks

Family Medicine Inpatient Service           10 weeks

Vacation                                                 4 weeks

Research/QI                                           longitudinal

Third Year

Electives                                                8 weeks

Musculoskeletal Medicine                       4 weeks

ENT/Dental/Ophthalmology                   2 weeks

Dermatology                                          4 weeks

Practice Management                             4 weeks

Family Medicine Inpatient Service          10 weeks

Ambulatory Pediatrics                            4 weeks

Adult Emergency Medicine                     4 weeks

Behavioral Medicine                               4 weeks

Vacation                                                4 weeks

Research/QI                                          longitudinal

Please see our website for more information on the curriculum

Http://www.columbiacfcm.org