Beaumont HospitalProfessional Education

Family Medicine Residency, Wayne

Curriculum

Rotations

1st year
Orientation - 1 month

This rotation allows our incoming interns a stress-free transition period into residency. During this month members of our faculty will provide didactic sessions on core medical subjects that will better prepare you for your upcoming rotations. In addition, you will begin to learn about the business of medicine which includes billing, coding, office dynamics, and much more. You will also start seeing patients several half-days throughout the month. This will give you the opportunity to learn how the office operates. We also take this opportunity to introduce you to the surrounding community and to those organizations with whom we interact. Last but not least, we all get together to have fun and socialize with our new residents at our annual picnic. This is a traditional event and is attended by faculty, residents, office staff and their families. Here are some comments made by residents who have recently passed through orientation: 

"Orientation made for an easy transition from medical student to resident." 

"Orientation alleviated many of my fears and stresses about starting my residency. It also gave me the opportunity to meet all of my fellow residents and most of the faculty."


Family Medicine Inpatient Service - 2 months

Our inpatient medicine service is a full service Family Medicine Team run by our very own faculty and residents. One of the things that distinguish us from many other family medicine programs is the degree of control our residents have over our inpatient medicine service. We run our team from the bottom up. Our interns are the primary care givers and are encouraged to take an active role in managing their patients. The seniors provide teaching and guidance while overseeing admissions and discussing key management issues. The attending plays the role of a mentor and ensures that the team's management plan is sound and evidence based. While always being there for questions or concerns, our attendings also promote independent thinking and problem solving on the part of the residents to better prepare them for life after residency. They also offer unique insights into cases gained from their years of experience as family physicians. 

Our team is generally composed of 2 interns, 3-4 senior residents (PGY II and III's), 0-2 medical students, and a supervising faculty member. While our team admits for many private family physicians in the area, the decision-making and care of the patient are placed solely under control of the team and its supervising physician. This ensures a more constructive day spent with one faculty member and consistency in the care of our patients. 

Interns are never left alone on call. A supervising resident is in-house with them at all times for teaching and practical purposes. 


Pediatrics - 2 months 

The first year pediatrics experience is divided into one month of inpatient pediatric floors and one month of pediatric emergency medicine. During your inpatient floor experience you will work with a pediatric attending, a transitional year resident, 2-4 Wayne State medical students, as well as a 1-2 second year family practice resident. You will work with children from birth to age 18 who have a variety of pathology. The large majority of what you will see will be the medical conditions common to children, "the bread and butter." You will also be responsible for rounding on the busy clinic newborn nursery service. In the ER you will have the opportunity to see a large amount of pediatric urgent care and work up patients to be admitted. You will be able to gain proficiency with procedures such as LPs and blood draws under the supervision of our pediatric ER faculty. During afternoons you will also attend the outpatient clinic in the professional building. 

As a second year you will take on a more supervisory role on the inpatient pediatric service. You will assume responsibility for overseeing the newborn nursery and supervising interns taking pediatric admissions. 

Most frequently requested info about the pediatrics experience: 
There is no overnight call.  Resident can expect one weekend day on service per week.

Interns are never in-house alone- there is always a second-year resident and/or a pediatric attending in house and the NICU is right next door.


Obstetrics - 2 months 

Beaumont Wayne has a busy community, state-of-the-art L&D unit. Both months of OB as an intern will be spent on the Labor and Delivery floor at Beaumont Hospital, Wayne. Since there are no OB residents rotating at Annapolis, this gives you an opportunity to get a great deal of hands-on experience early on in your residency. However, the option is available for the resident to spend their second month at Beaumont Hospital & Medical Center, one of the busiest obstetrical programs to southeastern Michigan with over 5,000 deliveries per year.  During both months you will learn common obstetrical procedures n active role mentoring our residents during this month. You will also learn common obstetrical procedures such as amniotomy, IUPC and FSE placement, as well as episiotomy/laceration repair and their indications. You will also have the opportunity to go through the credentialing process for circumcision and first assisting on Cesarean Sections if you so choose. Continuity OB patients that you will follow in your office throughout their pregnancy supplement this experience. You will deliver these patients and then take care of both the mother and the infant postpartum. 


Orthopedics/Sports Medicine - 1 month 

During this rotation you will spend time with a local orthopedist seeing and diagnosing common musculoskeletal problems. Under their guidance you will perfect your musculoskeletal physical exam. You will also be given the opportunity to further practice your casting/splinting and learn to do joint injections when indicated.


Geriatrics - 1 month 

Our first year geriatrics rotation offers a wonderful introduction to the care of our growing geriatrics population. This strong foundation is then expanded upon longitudinally throughout the next two years as residents take responsibility for nursing home calls, rounds, and admissions on a rotating basis. The rotation is based at Wayne Health and Rehab , a large comprehensive senior center that offers area seniors independent and assisted living as well as skilled nursing care. During this rotation you will see outpatients who live in the independent and assisted living areas and have a number of common geriatric conditions. You will also make rounds in the skilled nursing facility. This experience will enable you to gain comfort with both nursing home practice and office geriatrics.


Surgery - 1 month 

Don't panic! This isn't the surgical rotation you remember from medical school. During this month you will work with one of our excellent surgical faculty doing office procedures and evaluating surgical problems in the office setting, as well as required to scrub cases with them, serve as assists, and close for them. There is no in-house call and no weekend commitments. We feel this approach provides the family medicine resident with the experiences they need to handle common surgical problems and procedures.

ICU - 1 month 

Our ICU is based at Beaumont Hospital, Wayne, which maintains a busy 16-bed combined Med/Surg intensive care unit. It is staffed by a group of full time intensivists who are extremely dedicated to teaching our residents. They are always happy to take time out to teach and supervise procedures. Our in-house ICU rotation provides the intern with a rich, one-on-one, learning experience in this setting. There is no overnight call and weekend rounds are limited. You have the opportunity to attend the fundamentals of critical care course.


Cardiac Consult - 1 month

Beaumont Wayne is one of the Top 100 Cardiac Care Centers in the country. We have a large volume of cardiac related procedures and surgery. As such, we have an extremely busy 17-bed CCU and cardiac step down unit. During your time here you will see and learn to manage the acute coronary syndromes, life-threatening arrhythmias, and many other cardiac problems. You will again have the opportunity to work with the intensivists and continue to hone your inpatient procedural training by performing thoracentesis, intubation, central lines, PA catheterizations, and arterial line placements.


2nd year

Family Medicine Inpatient Service - 3 months
see description above.

Pediatrics - 2 months
see description above.

Elective - 1 month


Newborn Nursery – 1 month

The second year resident is responsible for all babies who are born in Beaumont Hospital, Wayne.  This is an excellent opportunity to learn about routine care of the well newborn, however your experience will not be limited to well newborns.  There is still a wide range of pathology seen at the hospital, including sepsis, respiratory distress, GI bleed and structural heart disease.  You will become an expert at newborn examination and be able to recognize and initiate treatment on a variety of different neonatal pathologies.


Gynecology - 1 month 

During this rotation you will work one-on-one with a GYN faculty and see patients in the GYN clinic. You will also become proficient doing appropriate GYN procedures that you may someday practice in your office (e.g. colposcopy, LEEPs, IUD placement to name a few). This experience supplements the GYN you will see in your own office practice.


Cardiology - 1 month 

The second year cardiology rotation occurs in the office of a local cardiologist. This experience allows us to work side by side with local Cardiologists to learn the latest trends in cardiovascular medicine and health. This rotation will reinforce concepts of the outpatient management of the number one cause of morbidity and mortality in the US today. You will also learn the fundamentals of how to order, interpret, and perform cardiac stress testing if this is something you wish to pursue in the future.


Behavioral Health - 1 month 

During this rotation you will work with psychiatrists, psychologists, and other behavioral science faculty. You will learn how to diagnose and manage the common psychiatric problems that often present in the primary care setting. These include anxiety, depression, bipolar disorder, schizophrenia, anorexia nervosa, and bulimia as well as the various personality disorders. You will also learn to manage common psychiatric disorders in children. You will learn about behavioral modifications therapies used to treat a variety of different disorders.

Our residency program reflects Beaumont's commitment to the community. Many of our faculty are engaged in offering services at various sites in the community. Residents work closely with them, as well as other community representatives during this rotation. During your time with us you will develop an appreciation of the physician's role in the health of the community and develop a more complete understanding of your patients. 

Here are  some of the many activities in which you will be involved

  • caring for children and adolescents at our outreach clinics in local elementary and high schools
  • ensuring the safety of high school athletes at their various sporting events
  • working with women and children at a local domestic violence center
  • learning about community resources for the under or uninsured
  • working with employees at the local Ford Motor Company Plants as part of our occupational health curriculum
  • these, combined with many other elective opportunities ensure a well-rounded community exposure

Procedures - 1 month 

Our program prides itself on the degree of procedural training that our residents receive. This is made possible by both our outstanding faculty as well as our dedicated sub-specialists. Residents are given the opportunity to become proficient in office procedures such as colposcopy, vasectomy, joint and trigger point injections, I & D's, endometrial biopsy, indirect flexible laryngoscopy, excision/destruction/biopsy of the various "lumps and bumps." In order to ensure that our residents receive adequate exposure, we have incorporated an entire month dedicated to procedures into our second year curriculum. This allows the residents to supplement the procedures they perform on their own patients with experience gained by a more concentrated experience with patients that come from the faculty pool. Our residents, under the supervision of our faculty as well as ICU and CCU staff physicians, often perform inpatient procedures such as central lines, arterial lines, Quinton catheters, PA catheters, trans-venous pacemakers, lumbar puncture, thoracentesis, paracentesis, and chest tube placement.


Emergency Medicine-  1 month 

During this rotation you will learn to manage urgent and emergent conditions in our busy ER. Also, you will further hone your urgent care procedural skills such as casting, splinting, and suturing. This rotation consists of an average of 12 shifts during the one month rotation.

3rd year

Family Medicine Inpatient Service - 2 months

See description above.


Practice Management - Longitudinal study

One of the many things that distinguish our program from many others is our dedication to teaching the resident about the business of medicine. Practice management is taught longitudinally throughout all years and culminates with focused teaching the third year. During this longitudinal third year experience we discuss office/practice design, interviewing, contracts, economics, documentation, administrative issues, as well as strategies for balancing personal life and family with work. This has been well received by our residents and we expect this to prepare them to thrive in the real world and aid them in developing a lucrative practice that tailors to their needs and interests. 

A recent graduate had this to say about practice management: "It helped me prepare for interviews, evaluate offers, and ultimately find a practice that was perfectly suited to me." 


ENT/Ophthalmology - 1 month 

This outpatient sub-specialty rotation provides exposure to some of the common ENT and eye problems that will often initially present in your office. You will do 2 weeks of ENT and 2 weeks of Ophthalmology. You will learn to evaluate and treat a variety of these conditions under the guidance of a local otolaryngologist and ophthalmologist. You will also get the opportunity to perform ENT procedures such as indirect flexible laryngoscopy, learn how to obtain a good eye exam for your diabetic patient and ophthalmology emergency management. There is no call or weekend commitments with this rotation.


Urology - 1 month 

During this month you will learn to manage common urologic disorders that will likely present in your office. You will also learn about various treatment options and services provided by urologists as well as the indications for referral. Under the guidance of a urologist you will also perform urologic procedures that lie within the scope of family practice (e.g. vasectomy). There is no call or weekend commitments with this rotation.


Electives - 3 months 

Choose from a multitude of existing electives or design your own. One of our resident's favorite electives is the experience offered at Mackinac Island. (Note: This rotation is not sponsored or run by our program and residents from other programs in Michigan also participate.) You will serve as the island physician for 2 weeks to one month. An attending physician is present on the island at all times to answer questions, however, the majority of the time you will work independently. Of course, there is also plenty of time to enjoy the old world sights and sounds of the historic island. Living accommodations are provided in new apartments conveniently located just above the clinic. Our residents have found this to be a valuable experience that lent them confidence in their transition to becoming attending physicians.


Transitional Care Medicine – 1 month

During this month the resident operates as a sub-attending, on the Family Medicine Inpatient Service. This rotation is devised to teach the residents systems based practice and patient safety. The resident is in charge cataloguing any safety events and reporting them in the hospital system. The resident also works closely with the attending and our Care Manager to ensure the safe transition of our patients to their next level of care. The resident has the opportunity to attend and participate in our Hospital Quality and Safety meeting, Medical Staff Professional Review Committee, and the weekly Safety Event Response Team meeting where ever safety event is discussed and managed. The resident also has the opportunity to participate in local and system-wide Root Cause Analysis meetings. There are no weekends and no call for this rotation.


Sports Medicine – 1 month

Under the direction of our Sports Medicine trained Family Medicine faculty, the resident will learn thorough joint exams including the use of ultrasound in diagnosis and treatment. Our residents learn joint injections, casting and splinting as well as general care of athletic injuries. Through our participation with the Wayne-Westland school district, the residents can attend and participate as the sideline team physician.



Nephrology – 1 month

Given the frequency of kidney disease in patients, we devised this rotation as a one-on-one experience with a nephrologist who is also one of our intensivists, in order to meet our residents’ and our patients’ needs. The experience includes both inpatient and outpatient consults and individual didactics with the nephrologist covering the all of the common conditions and workups for kidney disease. 


Clinic – 1 month

The third year is a perfect time to do a clinic month in order to experience daily life as a practicing physician. Included in this month is mentorship in quality improvement in the outpatient setting which is a lifelong skill needed in medicine today. Each resident owns an outpatient quality marker and is the team leader during their third year with a goal of improving our performance on that marker. All of this is done under faculty mentorship and with a multi-disciplinary team.


Ambulatory Pediatrics – 1 month

While our clinic has a large pediatric and adolescent population, we include an ambulatory pediatric experience with community pediatricians treating a wide variety of acute and chronic pediatric conditions including TB, HIV, autism and ADHD.

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