Frequently Asked Questions
What kinds of practices do your graduates end up in?In 2011, our graduates entered into a variety of different fields. One entered academic practice as a faculty member in New York. Another joined a private practice in Raleigh, while one joined a local community health practice close by. Two of our graduates entered into women’s health fellowships; one with c-section training, the other without. One grad will be working in an urgent care in Greensboro. Another will take a role in a community health center in Pennsylvania. And the other will stay on as a career development fellow in our department. Over the years about 60-65% of our graduates have stayed in North Carolina to practice medicine, and that trend seems to be increasing, with some recent years in which 100% of our graduates stayed in North Carolina. We have about 10-15% of our graduates who choose academic careers. The scope of practice varies, but those who do obstetrics tend also to include inpatient care. Others include inpatient medicine, but choose not to do obstetrics. Our goal is to train residents so that they can leave this program feeling competent to provide full-scope FP (delivering babies, inpatient care, procedures, ambulatory & ED care) if they choose. Lifestyle factors play a big part in graduates' choices about practice. What changes do you foresee in your rotation curriculum?Our overall approach to change is that we continue to build on what we believe to be a sound basic rotation curriculum with a continued mix of community and university hospital experiences and we continue to tweak our systems in ways in which we believe will serve to improve the quality of residents' experience here. 1. There have been some major changes to the curriculum in recent years in response to the requirement from ACGME limiting work weeks to an average of 80 hours and duty periods that do not exceed 24 continuous hours. With the input of residents and faculty, we successfully put into place some major changes on our Family Medicine Inpatient Service. First year residents now do a full month of day shifts, starting at 6am and ending at 6pm. Additionally, the first year residents cover two separate 2 week blocks of night shifts, both of which allow for conference attendance on Wednesday morning and once weekly continuity clinic. The second year residents continue to follow a q4 call schedule while on FMIS. When post call, the expectation is that the second year resident will leave by 9:30am in order to avoid duty hour violations. Third year residents serve as the FMIS team leader, modeling the lifestyle of an attending physician by working six of seven days of the week from 6am-6pm. Third year residents do not take overnight call while on inpatient. 2. We are excited to be able to continue six-week blocks of what we are calling Quality Improvement in Practice into both the R2 and R3 years. This rotation, originally funded by a Title VII Residency Training Grant, has now become a permanent part of our curriculum and allows us to combine a wide variety of experiences that focus on enhancing residents' outpatient training. There is work at a site with low-income patient populations, there is dedicated time to devote to CQI projects, an opportunity to lead Patient Safety conferences, there is a large portion of our practice management curriculum embedded within these blocks, and there is a senior scholarly project designed to develop skills in chronic disease models of practice management and improvement of patient outcomes. 3. In 2007-2008, we revamped our entire core conference series. We switched from traditional one hour "noon conferences" to a 18 month rotating curriculum with a half day format in which every Wednesday morning residents are excused from their clinical duties in order to attend interactive learning sessions that are built around a "theme month" concept. 4. In 2009, we changed our 3rd year rural community month experience to be exclusively devoted to work in a rural Emergency Department (Chatham Hospital). During this block rotation, our 3rd year residents work one-on-one with Family Physicians who staff that ED. 5. In the late summer and early fall of 2009, our residency program, along with the entire department, embarked upon a global strategic planning process in which we identified a number of areas that we would like to further emphasize in our curriculum to build upon our current "signature strengths". It is our tradition to concentrate on areas we hope to strengthen and improve as a team at our beach retreat. We are more than happy to share further details about these exciting initiatives for those who are interested. 6. In 2010, we have established "Areas of Concentration (AOCs)", in Healthcare Leadership, Sports Medicine, Geriatrics, and Underserved Care. This will allow residents with special interests in these areas to individualize their educational experience. There will likely be additional AOCs in the future. How much emphasis is there on maternal and child health?One of the many strengths of our program is our Maternal Child Health curriculum. Our program has been reported in the literature (Fam Med, 2003; 35:174-80) as a unique blend of education and patient care that combines the viewpoints and philosophies of family physicians and midwives. The RRC requires 3 months of OB/GYN -- we have 6 weeks of OB with obstetricians in a large community hospital and then 4.5 months of maternal child health with the FP faculty. Of those 4.5 months in the 2nd and 3rd year, only 1.5 months of that time is spent in "obstetrics", with the remainder being inclusive of care for newborns, young children, adolescents, sexual health, family planning, and STI treatment. The 'C' of MCH is also a strength of our program--newborn care, FMC children's acute care clinic, pediatric care at a health department, urban and rural pediatric settings are all part of residents' experience during MCH months. The residents also have 3 months of pediatrics with the Pediatrics services at Wake and at UNC Hospitals. Are changes in leadership anticipated?For several years now, we have been fortunate to have a Residency Director and an Associate Program Director who worked closely together as the residency leadership team. Our former residency director, Dr. Clark Denniston, was recently appointed to the position of UNC HealthCare's Designated Institutional Officer, or 'DIO', which is the title for the overseer of all of the residencies and fellowships at UNC. We are so proud of Clark and excited to have such impressive family medicine representation leading the charge for graduate medical education at UNC. Dr. Cristy Page, who has served as assistant program director since 2007 and was appointed to co-director earlier this year has taken over the role of Program Director. This is an easy transition for our residency as Cristy has been such an integral part of our leadership and has moved into this position seamlessly.
What is the accreditation status of the program?The residency program continues to achieve full accreditation with every site visit, and our next RRC review is due in January 2012.
What are the strengths and weaknesses of the program?Since this is such a common filler question during interviews, we are probably making it difficult for candidates by answering it here. On the other hand, for those who are creative they will be grateful for the opportunity to explore the question in depth using the list below as jump-off points or examine other avenues of inquiry entirely.
Weaknesses
With what innovations and leadership has the program and UNC Department of Family Medicine distinguished itself?We believe that one of the most important things a university-based program can offer is opportunity to engage in innovative change and advancement of the knowledge within the discipline. We can point to a significant list of ways that our faculty has worked to achieve distinction within the UNC University and Hospitals sytems as well as nationally. You will find here examples of exellence and achievement in:
What can you tell us about intensity of call?We follow the ACGME guidelines for frequency and duration of call and no more than 80 hours per week on average for any month. First years on FMIS service will have one month of days (6a-6p) and two 2 week blocks of nights (6p-6a). On other services, day shifts and night shifts vary in duration and schedule. As a second year, inpatient months are every 4th night call schedules. MCH in both the second and third year is a q3 call on average, but this is call from home, so when there are no active labor patients, residents do not stay in the hospital. Third year residents work from 6a-6p six days of a week while on inpatient (six separate times throughout the year). The change in duty hours requirements has significantly improved the consistency of recovery time following call duty hours.
How are residents viewed by staff in other departments of the institution?This is a common question we receive from candidates who are concerned about the way FM residents are treated in academic medical centers. It is our feeling that the high quality of our residents over the years has built a strong reputation among their colleagues in the institutions where we work, and that there is an expectation for strong clinical skills in the FM residents. Accordingly, we feel that the other departments treat their off-service FM residents as equal members of whatever team they are on. Additionally, our faculty hold several of the most important positions within the UNC system. Our chair serves as the Executive Dean of the Medical School. Our clinic director now oversees all of the clinics within the UNC outpatient clinic system. We hold leadership positions in the electronic medical record system, medical school education, and residency leadership. Do you provide computing devices for residents?The use of computers is increasingly important in the practice of modern medicine. The residency program aids residents in developing personal skills with information technology in many ways. Although we do not provide Personal Data Assistants (PDA's) or SmartPhones, they have become widely used in business and medicine, and our residents can use a portion of their educational funds to purchase these devices after approval from our IT department. Our recently remodeled Resident Business Center and Central Precepting area has been widely equipped with desktop computers at each of the resident's desks, with full internet access and printing capability.
What is the "Educational Allowance" and how can it be used? What are the annual salaries for residents?Every incoming intern has a total of $2,000 that can be used over the three years for educational expenses, including books, subscriptions and travel to conferences. Most residents have used it for 1-2 conferences, travel to elective rotations and subscriptions.
* R1 - $46,062
Will I have the opportunity to teach medical students?Yes! The opportunity to teach and to recruit medical students into Family Medicine is one of the attractive features of working at UNC. The University of North Carolina Family Medicine student program is a vital part of the Department's mission in the institution. Residents' interactions with students on clinical rotations are vital to attracting medical students to family medicine. Family Medicine interns also work with third year students when rotating on Pediatrics, Medicine, Surgery and Obstetrics services; our inpatient service frequently has Acting Interns. In third year our residents have an opportunity to precept under supervision in the FMC. All residents also help with coverage of the Student Health Action Coalition free clinic that is organized and coordinated by the medical students at UNC Medical School. The continued presence of psychiatry first-year residents on our service emphasizes the importance of gaining teaching and supervisory skills.
Where do your residents work?Our philosophy is that diversity of patients and patient care settings is crucial for resident training. The Family Medicine Center, where residents' continuity practices are located, serves a cross section of Chapel Hill. Just over half of the patients are adults between the ages of 20 and 60, with 25% of the patients over 65, 30% black, and 20% Medicaid. Most of the hospital rotations take place at either the University of North Carolina Hospitals, a tertiary care facility with comprehensive facilities or Wake Hospital, a large community hospital about 30-40 minutes away in Raleigh. Short rotations in other settings--local practices, rural community health centers and practices, the Student Health Service--provide specific clinical experience and exposure to other kinds of clinical settings.
In addition to more traditional conferences, this residency has conferences entitled "Evidence-based Practice" What is this conference?Evidenced based practice has been a staple of training at this residency since before its educational application was popularized. One manifestation of this is our conference series where Residents and Faculty take joint responsibility for presenting an interesting case or clinical question and an article that relates to the question. Discussion focuses on the quality of the evidence and whether it changes management of the clinical problem. Some of these conferences take the format of a formal debate about some aspect of clinical care. The topics are diverse and timely.
Are faculty members involved in research?The University of North Carolina ranks fifth in the country among departments of Family Medicine in NIH funding for research. Reports of research in this department has included prevalence of Disney cartoon characters shown smoking, relationship of residency program characteristics to Match outcomes, and prevalence of sexual concerns among female patients in outpatient clinics. Numerous other research projects have conducted investigation into rural health manpower, managing dizziness, nursing home effectiveness for Alzheimer patients, pap smear quality, and management of low back pain. Current research projects are exploring spirituality in medicine, effectiveness of acupuncture, and the treatment and management of osteoporosis.
Are fellowships available here?
The Department of Family Medicine and University of North Carolina are nationally renowned for the variety and quality of fellowship training available. Our fellows have gone on to take leadership roles in the AAFP and in departments across the country. Through our residency and fellowship training, almost 10% of all faculty in Family Medicine in the United States are graduates of the UNC Department of Family Medicine. Examples of our fellowship opportunities include: Primary Care Sports Medicine How does your selection process work? Should I expect further communication from you after the interview?We participate in the Electronic Residency Application System, and all applicants should consult their respective medical schools to learn how to use this system. Using the information available through ERAS we screen candidates' applications and will begin inviting individuals for interviews as early as we can, usually around September. We conduct formal interviews on most Mondays and Fridays November through January. The evening before interview days, some of our residents meet with candidates informally over meals provided by the department. Further application information is available via this link.
How successful has your program been filling positions through the Match?Since 1993 the program has successfully filled all its positions except one (in 1999) through the Match. That position was filled the day after with an exceptional candidate. Since 1999 we have been blessed with fantastic candidates who successfully match into our program. In fact, in 2011 we increased our program size from 8 to 10 residents per year and had no difficulty recruiting high-caliber, passionate residents to join our professional family. That being said, if you like what a program offers, it fits your career directions, and has the right combination of features to meet your personal needs, that is probably of higher significance than the program’s Match record.
What sorts of opportunities exist for my spouse, significant other or other family in the Triangle area?The Triangle has much to recommend it as a place to live. Three outstanding institutions (UNC, Duke, NC State) offer a wide variety of graduate programs and employment, as well as an excellent variety of cultural offerings. Unemployment is low, with many industries located in the Research Triangle Park and an economy that continues to have signs of growing. Finally, the climate allows year-round outdoor recreation. Both the ocean and the mountains are within "weekend distance." The attractiveness of the area combined with a very comfortable climate throughout the year have made the triangle area a very attractive retirement community as well. |
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