Curriculum

Our Goal as faculty is to Instill the philosophy of:

• life-long learning 
• on-going self-assessment and improvement
• Osteopathy

Year 1

Year 2

Year 3

We also have Emphasis Tracks for:

• Hospitalist
• We have a Focus available for MSK/OMT and POCUS training within our program

• Allergy/Immunology
• Chemical Dependency Unit
• Endocrinology
• Hematology/Oncology
• Infectious Disease
• Psychiatry
• Nephrology
• Nutrition
• OMT
• Palliative Care
• Pathology
• Peripheral Vascular Disease
• Rheumatology
• Plus more

Emergency medicine

You must contact the EM chief one month prior to let them know your clinic schedule.

Residents will be required to spend one month in first year and one month in second year in the Emergency Room. Farmington Hills’ ER sees over 45,000 cases per year. 13 ten hour shifts per calendar month (12 ten hour shifts if the family medicine resident takes a one week vacation). The 13 shifts will be composed of the following: 

• A week end consisting of a Friday, Saturday and Sunday 9 pm to 7 am shift in the acute care area
  • The resident might choose to perform these shifts on their call weekend
    • Three 9 am – 7 pm acute care shifts
    • Seven 1 pm – 11 pm urgent care shifts
• The resident may attend the 8 am – noon Emergency Medicine education conferences on Wednesday if there are no conflicts with their clinic or family medicine didactic education requirements
  • It would be preferred that the FM resident work in the ER during that time and schedule to be done by Family Medicine didactics at 3 pm
• All efforts will be made to free the family medicine residents for any required clinical or didactic requirements of the family medicine program

Family medicine

Residents will spend one month each year of their residency in their Family Medicine Clinic.

PGY1

• You will work under the mentor-ship of the senior residents to learn the flow of the clinic and our EPIC EHR system. Your rotation will be scheduled “early” in your residency to enable you to more fluidly incorporate yourself into the ambulatory setting.
• You will also be assigned half day per week as your clinic day for the year with your own schedule.  The only rotations you will not be able to participate in your clinic day is during your ICU rotation and Corewell Health Royal Oak in patient pediatric rotation.

PGY 2 & 3

• You will have 3 half days per week throughout your 2nd and 3rd years. The schedule is made for six months at a time and switched up every 6 months to allow you to work with all of your core faculty
• You will spend one month each year on family medicine at FVE. You will maintain your normal three half days clinic schedule.  When you do not have a schedule, you will be working as the “urgent care visits” doctor for the day.  You will also be assisting your attendings and fellow residents as needed or delineated by the preceptor
• The resident will spend ½ day weekly during their R1 year (except while on block nights and ICU rotation). They will spend three half days during R2 and R3 years
• The experience must include minimally:
  • 40 weeks/yr. in the clinic
  • visits must include acute, chronic, well care of all ages
  • must have at least 24 months of long term/ambulatory experience
  • 1650 patient encounters
  • 165 of the encounters of patients under 10 yrs. old
  • 165 of the encounters of patients over 60 yrs. old
  • care also includes follow up on labs/radiology/telephone/email/group visit encounters

Health Systems Management: one month or 100 hours. Hours met through lectures, SCS, committee assignments, clinic meetings, department meetings, rotations. Also during your PGY2 year on family medicine you are to complete the Business webinars that are in the family medicine manual.

You may work at another Family Medicine office as an Elective upon the approval of your PD.

General surgery

Residents will have a mandatory one month rotation of General Surgery at Farmington Hills during the PGY1 year. You will work under the supervision of a Board Certified General Surgeon. Your schedule will be set by the Chief Surgery resident. You will be responsible for rounding on Post-op patients, performing H&P's, attendance and participation in the operating room suite.

Geriatrics

Residents will spend one month with a Boarded family medicine geriatrician during your PGY2 or 3 year. You will make rounds in the hospital and will see patients in the ambulatory clinic. Home visits as needed will be required during this rotation.

Gynecology/women's health

R3 year

One month in the outpatient OB/Gyn office, Monday - Friday. This rotation encompasses full spectrum ambulatory care of the obstetrical and gynecologic patient will be seen under the supervision of a board-Certified OB/GYN physician. Rotations are set up through Farmington Hills.

Intensive care unit

A 1 month mandatory rotation on ICU during your PGY1 year.  During this month you will be making rounds and working with the Intensivist in the Critical Care Unit.  You will be working nights during this rotation.  Your schedule is determined by the critical care resident.  You will not participate in your Ambulatory Clinic or FM didactics during this month.

Internal medicine/in-patient clinic rounder

During PGY 1, 2 & 3 years one month will be spent on the Inpatient Internal Medicine services (During PGY1 an additional month is spent on another internal medicine service at Farmington Hills for a total of two months of internal medicine during year one). The emphasis is to develop skills for the inpatient management of acutely and chronically ill patients including decision making skills for consultation and referral.  This will be one of your “continuity clinic rounding” times. You will be responsible for our clinic patients assigned to the service. The rotation will be specifically with Dr. Rossi’s group.

Rounding with core faculty

You will coordinate rounding of our clinic patients with the family medicine attendings during the weeks to enhance transitions of care and participate in NMM rounding on our patients with Dr. DeLand and Craib.

During PGY1 year you will be responsible for Night call one week of your month and weekend coverage.  

Neurology

Residents will spend one month (mandatory) during PGY3 year, Monday - Friday. You will be assigned to the Farmington Hills Neurology Service. You will be assigned patients by the Neurology Resident and rounds and teaching at the hospital done daily.

Obstetrics

• During the first year, residents will spend one month rotating on Labor & Delivery
• Resident will also assist is deliveries of Dr. Rice/Lanzilote
• Resident will also be on the team for FM deliveries
• During the second year residents will be assigned to a specific attending OB/Gyn and will be in labor and delivery and also when they have no active labor patients they will attend to prenatal patients in the office and be on call for deliveries
• Residents will be expected to learn prenatal care, antepartum and post-partum management
• Residents will have the option to participate in the Corewell Health Wayne FM OB service for a more robust OB experience and higher exposure to continuity and Family Medicine deliveries
• During the third year, residents will spend one month in an OB/Gyn office or hospital learning various gynecological procedures in the diagnosis and treatment of the diseases of the reproductive system and prenatal care and postnatal care
• Residents who intend to practice OB may rotate through Corewell Health William Beaumont University Hospital, Royal Oak where they will receive intensive training on the Labor and Delivery Ward

R1 year

• Resident will attempt to schedule rotation during 2nd half of year
• Rotation will consist of two weeks labor and delivery days. You may have “on call nights” if desired during the week to enhance delivery numbers
  • One week of nights of labor and delivery
  • One week on prenatal service with Dr. Zajak and Dr. Dargin

You may go to Surgery with the attending if there are no patients in labor and deliver. They can be “on call” with their attending for deliveries during this time. Specifically, residents can attend surgeries, which would enable them to scrub and perform D&Cs in the operating room.

R2 year

Choice 1: OB at Corewell Health Wayne with the Family Medicine service labor and delivery.

Choice 2: OB at Corewell Health Farmington Hills with the Family Medicine service labor and delivery.

Residents will work with a specific attending and work in Labor and Delivery during the month. If there are no active labors for that group, then the resident will work in the office seeing prenatal patents and be on call for any delivery patients. First priority delivery. If there are no deliveries “on the boar,d” you may scrub in for surgery to enhance your skills at the gynecologic exam and D&Cs.

Collaboration with the ob/gyn residency for obstetrics/prenatal care

Maternity care in the Corewell Health Farmington Hills Family Medicine Program.

OB Clinic: Suite 316
Monday: 12 pm - 4 pm
Wednesday: 8 am - 12 pm
Friday: 8 am - 11 am

To schedule prenatal care visits: Put a hold on your schedule for 1 hour. Call the OB, and they will place on their schedule.

Make a confirmation appointment with OB when:

• Beta > 5000 and type and rh ordered
• Place order for US in Epic and then go to OB office to have pt schedule the US there

Ob/Gyn Skills Lab

• 2nd Tuesday of the month from approximately 8:30 am - 9:30 pm
• The labs held in July/Aug/Sept include the skills presentation to get you going for OB rotation
• Residents can attend the other labs that may be pertinent, which are also on Gyn procedures
  • Contact Dr. Wickham regarding your schedule
• Karen DenBravens is the office manager for OB

Pediatrics

By the completion of your pediatric and ER rotations, the resident must have Logged the following to meet minimal AAFP requirements:

• 250 ill pediatric patients in the ER or hospital setting
• Minimum 75 in-patient encounters
• Minimum 75 ER encounters
• 40 newborn encounters (in all/any settings)

(Keep logs of these patients with dates and initials and hand them in to the Program Manager to be added to your Portfolio/File). You must also have seen 165 pediatric patients in the FM office. We can download this from Nthrive so you do not have to log those visits.

The Neonatal resuscitation course will be held in the first months of the academic year for all PGY1 residents for privileging for newborn rounding.  

Newborn rounds will be made regularly for the family medicine clinic newborn patients. Dr. None's newborns under the supervision of Core family medicine faculty.

Farmington Hills (PGY 1 &2)

• Resident will spend one month during year one and two with Farmington Hills Pediatricians
• You will be responsible for Newborn rounding with the attending physician, and after rounding, you will work in the ambulatory Pediatric Office. The rotation is Monday - Friday
• The Family Practice residents, in addition to their own responsibilities (listed in the manual), will also be responsible for the student didactics during their pediatric rotation at Farmington Hills

Corewell Health Royal Oak general pediatric floor

This is a one-month mandatory rotation during your PGY1 year. During this month, you will be assigned patients on the rounding service on the General Pediatric Floor at Corewell Heaslth Hospital, Royal Oak. Your primary responsibility is to this service. They will give you one to two days to attend your continuity clinic, but the days will be determined by the need for coverage (days and nights with some 24-hour shifts).

Ambulatory pediatric (Gendelman PGY3)

Residents will spend one month during your PGY3 year in the pediatric ambulatory office, Monday through Friday.  Rotations are set up with Dr. Gendelman in Commerce. You will be responsible for evaluation and treatment of a wide variety of pediatric problems, including well care under the supervision of a board-certified pediatrician. 

Podiatry/Wound Care

Residents will spend two to four weeks on the Podiatry Service. You will work out of the Podiatry Residency clinic office and Office consults on the podiatry service. You will be seeing podiatric visits and wound care visits. Hospital wound care is available at Dearborn three days weekly and at the podiatry clinic four days weekly. Grand rounds are daily at the hospital.

Radiology

An optional two-week rotation during the 2nd year. Residents will learn basic radiology as it applies to office-based practice. Residents will also learn when and how to order appropriate testing for a variety of conditions (US, MR, CT). Radiology lectures and review of films during clinic hours by attendings will be given also.

The equivalent amount of teaching (per ACGME guidelines) is also attained through the ambulatory clinic reviewing films and Point of Care Ultrasound training.

Sports medicine

Residents will spend 1 month during PGY2 or 3 year with a Sports Medicine Board Certified physician in the outpatient setting (Monday - Friday). During the rotation, they will see a wide variety of Musculoskeletal Problems of all age groups. They will enhance their NMM skills in patient care under supervision.

Surgery electives

ENT

One month will be spent with a Board-Certified ENT physician. This is an Office-based rotation, Monday – Friday. You will work with the ENT surgeon in the office seeing, evaluating, diagnosing, and treating a wide variety of conditions.

Ophthalmology

A two-week rotation with a board-certified ophthalmologist is recommended. This is an office-based rotation Monday -Friday. You will spend time seeing and evaluating patients in the outpatient setting and improve your skills, diagnosis, treatment plans, and competency regarding your eye exam and use of ophthalmology equipment.

Orthopedic Rotation

• one month Surgery Elective
• Where: Farmington Hills. (May be taken at Corewell Health William Beaumont University Hospital, Royal Oak)

Description and Expectations:

• Residents should provide their clinic schedule to the senior residents on the first day of service so that we can best schedule their rotation
• Residents will have 1.5 days of their own clinic that they must attend as well as Wednesday afternoon education (3 pm -6 pm). A full month would be a better experience
• Education/Morning report for Orthopedic is 6:30 am - 7 am, Monday and Friday at Farmington Hills. Wednesday is our education day as well from 7am - 11 am. We'd like the family medicine residents to be present for these educational activities
• It will be required for residents to round and see consults with orthopedic residents in the morning so that they can see what immediate postoperative patients look like and to help formulate basic plans. Rounding is typically done prior to education. This can be coordinated with the orthopedic residents the evening before
• Rotating residents will spend 1 day per week in the OR to see what their patients will go through when they are referred for total joints or other procedures. Additionally, it will hopefully give them the opportunity to learn some basics of suturing, etc
• Residents will rotate at multiple clinics. In the past, residents have stuck to Lennox/Linard clinic, however, we'd like to try to get them into clinic with other surgeons as well, including some of our Arthroplasty, Sports, or Trauma offices. This may require them to travel to Dearborn at times. Efforts to base them at Farmington Hills will be made pending availability of orthopods

Urology

You may spend 2-4 weeks with a board-certified urologist in the out-patient setting, Monday - Friday. There are several urologists you may choose to work with, seeing and evaluating patients in the office setting. If you are interested in becoming competent in performing vasectomies this is the time to set that up.

Medicine Electives

It is highly advised to utilize MKSAP as one of your reading bases for the following rotations.

Allergy/Immunology

Residents may spend 2-4 weeks in the ambulatory setting with a board-certified allergist/Immunologist.  This rotation can be during PGY2 or PGY3.

Cardiology

• PGY2 year: One month with Corewell Health Heart Health Center in the ambulatory office seeing patients with board-certified cardiologists.
  You do have the option of also rounding at Farmington Hills with the fellows during the month and observing in the cath lab.
  
• Pulmonary:
  During PGY2 or PGY3 year you may rotate with Dr Kaplan and Heal in their office for your Pulmonary month.  
  You will also work with the Board-certified Sleep specialist at the office and the Nurse Practitioners that work in the office.

GI

PGY2: One month rotation to work with the Board-Certified Gastroenterology group in the ambulatory setting of their office. For those interested, you may also work with the attendings and fellows in the endoscopy suite in the morning.

Hematology/Oncology 

Elective of One month with one of the groups of board certified Heme/Onc physicians at the Farmington Hills Campus. The rotation would be both inpatient and outpatient with the attending physicians.

Nephrology

This is a one-month rotation Monday - Friday. It is Farmington Hills hospital based. You will work with the rounding nephrology team during the week. You will be assigned patient care and will be making rounds prior to teaching rounds and participate in teaching rounds.

Dermatology

An elective of 2-4 weeks may be taken of Dermatology. There are several board-certified dermatologists to choose from.  The rotation is ambulatory-based.  You are expected to be in the office Monday - Friday, except on your clinic days. If the office is not open on one of the days it is expected you will come to the Residency Clinic to see patients.

Derm Offices available for rotation: LaCasse, Mahon, Clays, Kerwin

Rheumatology:

This is a one-month rotation, Monday - Friday.  It is in the rheumatology outpatient clinic. You will see patients in the rheumatology office with a board-certified rheumatologist.

Endocrine

This is a one-month rotation, Monday - Friday. You will be working in the outpatient office of board certified endocrinologist. You will be seeing patients in the office under the supervision of your attending endocrinologist. Our recommended office is with Dr. Eddleson. Their office sees a wide variety of endocrine diagnosis.

Physical Medicine and Rehab

This may be taken as a 2-4 week rotation Monday - Friday. You will work in the outpatient setting with Dr. Kovans’ group. You will be exposed to a wide variety of patients for rehab, pain management, PT, Occupational Therapy, and other various modalities to help patients with mobility, rehab, and pain. Added options to the rotation if it is for a full month:

• Work with the Physical Therapists in the South Pro Building for one week of the rotation
• Work at Wolverine Orthotics for 1 of the weeks to expand your knowledge of prosthetics

Miscellaneous

Community Service/Health Care Disparities

This is a two-week mandatory “course” and exposure for all 2nd year residents. It is offered in the Spring and Fall. There is a set curriculum of didactics and days where you will work on various community services. We will be scheduling the elective as a six-day course over two weeks. The residents will be participating in the elective on Monday, Wednesday, and Friday of each week. This will allow the residents to still have their clinics on Tuesday & Thursday each time.

Community Service includes: Homeless shelter, working at schools, free clinics, Mission trips, and health screenings. In Brighton and Ann Arbor.

Integrative Medicine

This is a One-month rotation in the Outpatient setting, Monday - Friday. You will work at either the Corewell Health West Bloomfield office or main campus.  You will spend time seeing patients while working in a collaborative environment of patient management with: Naturopath, Nutrition, Massage Therapy, Yoga, and Wellness counseling. The experience is supervised and overseen by a board certified Internist.

Also, as an option you may complete an Integrative Medicine Curriculum delivered On Line through Arizona University. This is 200 hours of online learning. If you are interested it is suggested you start your PGY1. You will at upon completion of your residency have a special certificate of completion. The fee for your participation (paid to Arizona University) will be from your yearly stipend.

OMM

This is a 2-4 week elective rotation in the outpatient setting of a board certified NMM trainer.  You will see patients and participate with hands on diagnosis and treatment of a variety of Neuro/musc/skeletal complaints utilizing the Osteopathic tenants.

OMM in-patient rounding

In-patient rounds will be made during the week with core family medicine faculty. Resident responsible will be either the resident on: IM In patient rounder or the resident on family medicine for the month.

Pediatric Emergency Medicine

This is an elective rotation designed to enhance your pediatric urgent/emergent abilities to assess, evaluate, and treat sick children.

Options:

• two-week rotation at Farmington Hills. You will be “allowed” to “cherry pick” all emergency medicine visitors to see only the pediatric patients.  You will be assigned 7-8 shifts that will be scheduled around your clinic days
• four weeks at Corewell Health Royal Oak Pediatric ER.  You will spend one month there working specifically in the Pediatric emergency medicine. You will be adherent to their schedule and will not be able to participate in your continuity clinic during that month