At UNC Family Medicine, our goal is to train full scope family medicine physicians. Our Department provides both comprehensive inpatient and outpatient training, including training in hospital medicine, intensive care, family centered perinatal care, behavioral health, practice management, sports medicine, point-of-care-ultrasound, LGBTQI+ care, Hep C and HIV care, and geriatrics. We also build time into the schedule so that residents can explore electives, and tailor the program to their unique path. Explore our program components below.
The department operates our own Family Centered Perinatal Care (FCPC) service at UNC Hospital. We care for the patients of our continuity practices as well as those who seek their prenatal care at partnering community practices/health departments. Emphasis is on longitudinal care throughout the pregnancy and after birth.
During their Family Centered Perinatal Care (FCPC) rotations on this service, residents work with Family Medicine faculty to develop skills in continuity and family-oriented obstetrics, outpatient gynecology, neonatology, developmental pediatrics, and adolescent care. One of the most rewarding experiences of this rotation is the care of the family unit, from the prenatal visits to the newborn weight checks and beyond. Continuity is built into the curriculum at multiple levels. Initially, each patient is assigned an FCPC team, comprised of 5-6 residents, based on the due date and when those residents are on service. This ensures patients have met their provider prior to delivery. Following delivery, the dyad follows-up with a member of their FCPC team in clinic. Residents work one-on-one with attendings in an apprenticeship model of care.
We take pride in the opportunity to run our busy Family Medicine Inpatient Service (FMIS) at UNC Hillsborough Hospital. This setting allows residents in all three years of their training to care for a diverse mix of patients from the UNC Family Medicine Center, the Piedmont Health Services clinics, and from other local Family Medicine community practices under the supervision of Family Medicine attending physicians. This academic community hospital has an open intensive care unit, allowing our residents to provide care for our critically ill patients in partnership with an intensive care attending consultant. Residents have the opportunity to train in procedures including central line placement, paracentesis, thoracentesis, lumbar punctures, intubation, and ventilator management. In addition to patient care, working on FMIS provides opportunities to teach medical students and other residents as our third-year residents take on leadership roles within the team.
Residents also spend time at Chatham Hospital, a rural 25-bed critical access hospital staffed entirely by family physicians from the Emergency Room to the Intensive Care Unit. Family physicians even staff the labor and delivery and perform C-sections. This is truly a unique environment that allows for great hands on training and more opportunities for autonomy. Working at this hospital really rounds out the full-spectrum training at UNC!
Resident training is enriched through a variety of outpatient experiences that help us to prepare for a future continuity practice. Rotations dedicated to sports medicine evaluation, enhanced procedural skills, dedication to vulnerable populations, and quality improvement in medicine all support ongoing improvement in the care of patients in the clinic setting. In all of our continuity sites, we are dedicated to caring for the people of our state.
Residents have their own continuity clinic for at least one-half day as an intern, two half days as a second year, and four half days on average as a third year. A large interprofessional team works in each of our continuity clinic sites, truly providing a robust opportunity to provide care for each patient. Resident physicians are celebrated teachers, working with medical students or advanced practice provider students in their continuity clinic during second and third year. They also precept other residents alongside a faculty member as a third year.
The behavioral health curriculum is longitudinal and designed for residents to think and learn about behavioral health issues throughout residency. The curriculum includes teaching in the inpatient and outpatient clinical settings, individual one-on-one meetings with behavioral health faculty, community visits, structured didactics, and select readings. There is also a unique experience to provide primary care, detox, and behavioral health care at WakeBrook, an inpatient and crisis unit in Raleigh. The combination of didactic and clinical activities is designed to create an appreciation for the role of behavioral health in primary care and to provide a diverse and challenging educational experience.
As an ongoing part of residents’ development, practice management is incorporated into all three years of the program. Time is allocated in the second and third years to learn the principles of practice management, visit community practices, and learn career planning. Seminars, workshops and other conferences on practice management topics are a regular part of the conference curriculum. Residents also have the opportunity to learn about systems-based practice by attending monthly team and all clinic business meetings. During second and third years of training, our exposure to leadership within the clinic expands as we become involved in the clinic supervisors meeting as well as by leading the monthly team meetings.
Here at UNC, we value and recognize the importance of point-of-care ultrasound as an important skill in diagnosing and treating your patients. We are continuing to grow the POCUS training for our residents. Currently, we offer monthly POCUS sessions at our didactics that include a mixture of lecture and hands on scanning. We cover a number of topics (cardiac, soft tissue, pulmonary, renal/bladder, MSK, DVT, etc.) to prepare you to use ultrasound in the clinical setting. These sessions our led by our own POCUS faculty or other expert faculty within UNC. You will get experience using several different devices ranging from the handheld Butterfly to the SonoSite PX, which is the ultrasound used by our inpatient service. You will have access to an ultrasound on nearly every rotation and each clinic site has a dedicated ultrasound because we want you to always have the option to use POCUS.
In addition to didactics and practical learning during rotations, you will have the option to teach POCUS at the UNC medical school, participate in a 2-week interdisciplinary POCUS elective at UNC, sign up for the POCUS area of concentration, and can spend extra time with faculty or sonographers to further develop your skills.
Please reach out to one of our lead POCUS Faculty, Ryan Paulus, DO at firstname.lastname@example.org if you have any questions regarding our POCUS training!
UNC Family Medicine is fortunate to have seven family physicians with a certificate of added qualification in geriatrics. Every second year resident spends a one-month rotation with a variety of these geriatricians, working in a short term nursing facility, a continuing care retirement community, a geriatric assessment clinic, and in panel management. Throughout the course of three years, residents have special geriatric workshops in their intern year (Geriatric Master Class and AGES dayback), as well as a dedicated month of geriatric focused didactics in the conference curriculum. Elective experiences are available to work with palliative care services and other community partners in caring for older adults.
Another major component of the curriculum is the conference didactic schedule. Weekly didactics for all 3 classes of residents are conducted on Wednesday mornings during protected time from clinical responsibilities. As part of their commitment to education, faculty run the inpatient and FCPC services while residents attend conference. The conferences are organized around 18 monthly clinical themes, so that the full curriculum rotates through twice during each resident’s time with our program. In addition to lectures on clinical topics, each month includes one Wednesday that largely centers on resident reflection and wellness, as well as recurring longitudinal sessions during the other weeks that are focused on behavioral health, ultrasound, advocacy, procedures, evidenced-based medicine, and lifestyle medicine. We strive to incorporate health equity learning in an integrated manner across all didactic sessions, in addition to including lectures that specifically focus on health equity topics. Our didactic sessions are taught by faculty and residents within our department, as well as our primary care and specialist colleagues throughout the health care system, experts from our community, and faculty from the UNC School of Public Health. In addition to the important learning that happens during conference, it also serves as an intentional space for residents to reconnect and build community with one another and with our program.
A concentrated month in the first year is devoted to orienting residents to the Family Medicine Department and to developing fundamental skills as new family physicians. Educational themes include interviewing and counseling skills, outpatient procedures, preventative health, and the management of common outpatient diseases. The month also provides an opportunity for our new residents to meet faculty and get to know the Family Medicine staff. In the second year, another month is devoted to a Family Medicine experience, which includes increased clinical time, career exploration, resident wellness, and developing new clinical skills
Three months of elective time during the second and third years of residency provide individuals with plenty of opportunity to tailor the program to meet their particular educational needs. Residents have used the time to round out a variety of areas of outpatient medicine, take an intensive inpatient rotation, explore international medicine, explore practices in communities where they may consider employment after residency, as well as acquiring an understanding of complementary and alternative health care.
We strive to provide our residents with the highest quality clinical education available. But it is also our goal to help young doctors learn to listen and understand their patients — we teach them what it means to practice in a patient-centered medical home.
We at UNC Family Medicine are proud to offer students a variety of courses, experiences and resources to further inspire and nurture student interest in this important and fulfilling field! Leaders in the U.S. are recognizing the value of primary care and we are excited to show you our discipline and teach you fundamental skills relevant to all disciplines of medicine.
Our department has a long history of successful fellowship training through a number of program. We strive to give back to the healthcare workforce by training future leaders in family medicine: our commitment to rural care, vulnerable populations, and evidence based practice is unrivaled.