Training Sites and Educational Experiences
UNC Family Medicine Center
The Family Medicine Center (FMC) located contains over 50,000 square feet for outpatient care, teaching and administration. The first floor houses the clinic. The second floor includes offices for faculty and staff and a conference wing.
What do our patients look like?
Over 60 clinicians provide over 60,000 patient visits annually. The racial mix of our patients is 56% Caucasian, 28% African American, and 16% other ethnicities.
Approximately 20% of patients are covered by Medicare, 12% are covered by Medicaid, 14% commercial, 43% by managed care plans, 10% are self pay and 1% covered by other health insurance plans.
UNC Family Medicine Center Continuity Care Clinic
Over the course of three years in the program, residents’ practices grow. Interns have a continuity panel of 75-100 patients (from 2-7 patient visits per half day) with a total of 200 or more visits. By second year, panels are between 150 and 200 (7-10 visits per half day) with 500 or more patient visits. By third year, residents average 350 patients (10-11 visits per half day) and can expect to have over 1,000 visits by the end of the year. When residents see patients in the Family Medicine Center, there is a minimum of one faculty preceptor available for questions for every four residents.
Residents learn to work as a team while developing longitudinal relationships with patients and coworkers. The clinic is structured around four separate teams of clinical support staff, residents and attendings. Within these teams, we strive for personal and team continuity with our patients, in addition to a one-on-one physician to medical assistant structure. Our clinic is strengthened by the resources we have to share with patients. On site financial counseling, nicotine dependence programming, nutritionists, social workers, lab and x-ray services, as well as pharmacists, acupuncture, and physical therapy allow us to provide comprehensive care for our patients. The clinic also houses a very robust procedural/skin clinic that the residents work in along with a Sports Medicine clinic housed in its own procedural suite. The clinic medical directors take great pride in providing each resident a diverse patient panel that appropriately grows as the resident continues through the program. Our clinic welcomes patients of all ages, including obstetric care. Our clinic is constantly evolving to meet the unique needs of our patients including Medication Assisted Treatment (MAT) for opioid use disorders, gender affirming hormone therapy, and point-of-care ultrasound.
During the course of training our residents have the opportunity to work in special clinics that are part of the FMC practice. These clinics include a skin and procedures clinic, colposcopy clinic, sports medicine clinic and exercise tolerance test clinic. Skin and procedures clinic provides experience with vasectomies, a variety of biopsies, nail, cyst, and lipoma removals, and other opportunities when they arise.
In the sports medicine clinic, there are ample opportunities for MSK ultrasound and injections. Alternative medicine contributes to this array with an acupuncture clinic within the FMC. This variety gives residents a broad exposure to a wide range of issues in outpatient clinical care and an opportunity to interact with a variety of different providers
Family Medicine Months
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..
A major component of training at UNC Family Medicine is the conference curriculum. Every Wednesday morning is devoted to structured learning using small group and seminar style techniques. Each month covers a specific theme. The curriculum is based on an 18 month time period so that each resident has the opportunity to learn and apply the information twice. Embedded in the Wednesday Conference block are also opportunities for Intern Support and Finding Meaning in Medicine.
University of North Carolina Hospitals
This 803 bed tertiary care teaching facility provides a unique opportunity for learning the management of diseases in a
technically sophisticated environment. It also serves as the community hospital for Chapel Hill. UNC Hospitals support a comprehensive range of residencies of excellent quality and strong reputations across the country. Family practice residents work closely with, and learn with, residents in other specialties. There is a full range of diagnostic and therapeutic services available within the institution.
Family Medicine Inpatient Service (FMIS)
The Family Medicine Inpatient Service provides a strong presence for Family Medicine in the UNC Hospitals system.A major portion of inpatient medical training for FM residents occurs on this service. Residents rotate through the service for 8 weeks in the first year, 12 weeks in the second year and 6 weeks in the third year of residency. This rotation consists of a broad spectrum of inpatient family medicine with educational emphases on the management of acutely ill patients, selection of therapeutic agents, appropriate consultation, and skills in interviewing, physical exam and critical appraisal of the literature. Multidisciplinary care is emphasized with case managers and pharmacists as key members of the team who actively participate in rounds.
Family Medicine Maternal and Child Health Service (MCH)
The Family Medicine Maternal and Child Health service provides obstetrical and newborn services for patients seen at the FMC practice and with our Underserved Track residents at Prospect Hill. Second and third year residents cover this service. The focus is on continuity of care by providing prenatal care, assisting in labor and delivery, and then following the new dyad to the postpartum floor and after discharge from the hospital. The MCH service also handles the inpatient obstetrical care for women who seek their health care at the Orange County Health Departments and other Family Medicine community practices. Additionally, our MCH service provides physician backup to a freestanding birthing center operated locally by midwives. Our MCH service delivers approximately 450 babies per year.
Other UNC Rotations
Family Medicine residents also complete rotations in other departments at UNC hospitals. In the first year, the Emergency Department experience provides an opportunity to evaluate and care for emergent medical problems and determine patient dispositions. During procedures, residents spend time in the ED focusing on procedural skills including suturing, I&D’s, and ultrasounding. During second and third year, residents rotate through the Pediatric Emergency Departments at UNC and Wake Med Hospitals. Portions of the ENT, dermatology, and sports medicine rotations also occur at UNC hospitals, satellite clinics of UNC and private practice clinics.
Wake Medical Center
WakeMed is an 870-bed, private, not-for-profit health care system serving eastern North Carolina. It is located in Raleigh
approximately 35 minutes from Chapel Hill. Below are some interesting facts about this community hospital:
- Wake Med is home to North Carolina’s first freestanding Children’s Emergency Department. It is a national model and serves more than 40,000 children each year.
- The WakeMed Heart Center ranks number one in volume among all North Carolina hospitals in providing cardiac care and is also one of the highest volume heart centers in the United States.
- Mobile critical care services offering ground and air transport for adults and children.
- Hosts one of eight mother’s milk banks in the world.
- Two nationally accredited Chest Pain Centers.
- Pediatrics specialists in surgery, neurology, endocrinology, orthopaedics, neonatology, child development and more.
Wake Med is Wake County’s only:
- Level I Trauma Center as designated by the North Carolina Office of Emergency Medical Services.
- Neuro intensive care unit and dedicated neurosciences inpatient unit.
- Children’s inpatient unit and intensive care unit – staffed around the clock by pediatric intensivists.
- Children’s diabetes and asthma programs.
- Emergency Services Institute focusing on research, emergency preparedness and response in the event of community emergencies and disaster either natural or man-made.
- Patient Simulation Center for training health professionals.
With over 35,000 admissions, 100,000 visits in the emergency department, and close to 5,000 deliveries a year, residents report that Wake Med is an excellent site for community-based training. Family Medicine residents spend a total of six months at Wake in the first year and 1 month in the third year.
Pediatrics (1 month each on inpatient, outpatient clinic and the Pediatric Emergency Department) at Wake Medical Center has always been very popular and provides core experiences in pediatric problems. Teaching on this service consistently receives high ratings from our residents. Residents adapt to the day shift and night float system in place by the pediatrics service, serving as a member of the team covering the pediatrics floor during the inpatient month and as a cross-cover during the outpatient month.
The six-week obstetric rotation centers on a very busy labor and delivery service. Residents average 30-80 deliveries a month. Time is also spent in the prenatal care and GYN clinics.
Residents do a month of general inpatient surgery at Wake where they have a wide range of learning opportunities available. Residents are involved in procedures in and out of the operating room and participate in adult, pediatric, and obstetrical traumas that present to the Wake Med ED. Outpatient surgical procedures are done in the clinics and residents also see patients for pre-operative assessments and postoperative follow-up.
Chatham Hospital (CH) is a 25-bed Critical Access Hospital, located in Siler City, NC, that is part of the UNC Health Care System. This hospital has a 76-year history of providing health care to the residents of Chatham and surrounding counties. The hospital provides surgical, medical, pediatric, and emergency services. Community based outpatient services in the area of Diabetes Education, Physical Therapy, Imaging, Cardiac Rehabilitation and Pulmonary Rehabilitation are also offered. As a critical access hospital, Chatham Hospital is able to utilize beds to provide interim care to patients who no longer require acute medical care, but need additional time and care for strengthening and recuperation before returning home. The 10-bed emergency department provides full-service around-the-clock care to more than 1,200 adults and children each month. UNC Healthcare bases a helicopter for transport on the grounds of Chatham Hospital.
Piedmont Health Services
The UNC Department of Family Medicine has had a long and fruitful partnership with Piedmont Health Services (PHS).
PHS is a Federally Qualified system of seven community health centers in central North Carolina and PACE (Program of All-inclusive Care for the Elderly). All facilities are within forty miles of the UNC School of Medicine.
- PHS started the first Community Health Center in North Carolina at Prospect Hill over 40 years ago.
- The clinic also delivers multidisciplinary care to their patients with services that include Pharmacy, Case Management, Nutrition, Dental and Farm Worker outreach.
- PHS is one of the most important sites for prenatal care for underserved and minority patients with over 1,200 deliveries annually.
- Additionally, as one of the key safety net providers in the area, they play a central role in many of the regional community health programs.
Its central facility is in Carrboro, adjacent to Chapel Hill in southeast Orange County, and six others are located in the surrounding counties of Chatham to the south, Caswell to the north and Alamance to the west. Like much of North Carolina, these counties are predominantly rural, 40% are below poverty level and 50% of the population is African American. The centers also serve a significant and increasing number of Hispanic patients and in some clinics more than half the patients are primarily Spanish-speaking.
Resident involvement with PHS patients and practitioners allows for hands-on learning of the unique skills, knowledge and competencies needed to care for diverse populations. These populations include rural, minority, immigrant and migrant populations in a resource constrained environment. During different rotations, all residents have the opportunity to work at PHS sites, including PACE. PHS patients requiring hospitalization are admitted to the Family Medicine Inpatient Service at UNC. The PHS site at Prospect Hill serves as the continuity site for our residents participating in the Underserved Track.
Updated September 2018