Our Educational Philosophy and Curriculum
As adult learners in the 21st century, our residents have a myriad of educational opportunities through which they are able to grasp the full scope of family medicine and be prepared for any type of clinical practice. Along with our strong academic partnership with New York Medical College, we have the best combination of a diverse patient population along with an unopposed program here at Hoboken University Medical Center. This allows for a complete educational experience for our doctors in training.
Our curriculum meets all residency review requirements for Family Medicine. It is designed to provide residents with a comprehensive background in the broad aspects of this specialty. This includes a strong ambulatory care experience focusing on a team-based approach and the patient centered medical home (PCMH) philosophy, along with exposure to inpatient, pediatric and geriatric care. We believe in the family physician’s role to care for patients throughout their life cycle and in various environments.
In addition to block rotations, residents receive an in-depth longitudinal experience in areas including but not limited to practice management, ambulatory care, behavioral health, radiology and orthopedics/sports medicine.
Fostering strong doctor-patient relationships is a core skill stressed in our Family Medicine Residency Program. Along with following their continuity patients throughout their ambulatory rotations, our residents also make home visits to care for home-bound patients and those discharged from the hospital setting as needed. They also follow patients in the nursing home setting.
There are many modalities by which learning is fostered. Evidence-based medicine is at the core and residents have a variety of resources available for patient care and learning.
Morning Conferences are designed to offer an array of topics presented in the form of case-based conferences, practice management discussions, weekly board review, as well as outpatient and photo potpourri sessions.
During case studies, family medicine residents develop presentation skills, which illustrate the diagnosis and management of common and unusual disease processes. Discussions of differential diagnoses, appropriate testing, and referral management provide an integrated approach to patient care.
Grand Rounds are held weekly and include prominent guest speakers discussing a broad spectrum of topics and are usually organized by the hospital’s Director of CME who incidentally is a faculty member of our Family Medicine Residency Program.
Workshops are presented on specific skills vital to the practice of family medicine. Topics include motivational interviewing, suturing techniques, casting and splinting, joint injections, ACLS review, and the musculoskeletal exam. We do learning OSCEs and role playing to teach and evaluate clinical and supervisory skills.
Residents have a lot of fun with these hands-on sessions. The sessions provide the opportunity to practice techniques in a safe, supportive environment while fostering cooperation and teamwork.
Twice a month, residents actively participate in journal club. Through these journal clubs we incorporate the practical application of evidence-based medicine. We review articles from peer-reviewed professional journals including American Family Physician, Practice Management and Medical Economics to name a few.
Research and Scholarly Activities
Residents are expected to pursue scholarly activities. Most residents choose to do a quality improvement project as the focus of their work as this is directly applicable to clinical practice. Our research director, Dr. Ping Chen provides strong support in these endeavors, and works closely with the residents throughout their process of initial planning to final publication. Residents are supported and strongly encouraged to present their work and have done so at our hospital Grand Rounds, and also at various other venues such as New York Medical College Research Day where they have also received accolades for their work.
Some research topics that have been presented recently are:
- Are We Adequately Screening and Treating for Lipid Disorders in Patients with Increased Risk for CHD (Coronary Heart Disease) at The Center for Family Health?
- Diabetes Education Among Residents, Are We Succeeding?
- Are We Appropriately Implementing the Preventive Services Recommended by the United States Preventive Services Task Force to Prevent Disease in Women Ages 18-75?
- Assessment of Knowledge and Comfort of Insulin Among Nurses.
- Evaluation of the Uses of Weight Based Insulin Correction Scale For Management of Hyperglycemia on an Inpatient Service.
- Implementation of HPV Vaccination in a Community Clinic Setting: How Are We Doing?
- Does Reaction Time Correlate with Rate of High School Football Injuries?
- Barriers in Treating Sexual Dysfunction in Family Medicine Residency Program.
Some of the above work has also taken on the role of practice and quality improvement projects for subsequent residents and medical students.
Rotation Schedule 2013-2014
3 months Obstetrics/Gynecology (2 wks. prenatal outpatient/2 wks. L & D)
2 months Inpatient Family Medicine Team
2 weeks Inpatient Medicine/Hospitalist Team
1 month Surgery (VA Medical Center)
1 month Outpatient Family Medicine (Endocrine Clinic, Podiatry Clinic, ENT, Practice Management, QI Projects)
1 month Inpatient Pediatrics (St. Joseph’s Medical Center)
2 weeks Neonatology (St. Joseph’s Medical Center)
2 weeks Cardiology with afternoon at NHC
2 weeks Orthopedics/Sports Medicine
2 weeks Outpatient Pediatrics
2 weeks Inpatient Adult Medicine
2 weeks Emergency Medicine
1 month Vacation
1 month Elective
1 month Gynecology
1 month Pediatric ER (St. Joseph’s Medical Center)
1 month Inpatient Family Medicine
1 month Outpatient Family Medicine at NHC
1 month Emergency Medicine
1 month Surgery
1 month ICU
1 month Inpatient Medicine/Hospitalist Team
2 weeks HIV Medicine
2 weeks Medical Subspecialties (Neurology, Nephrology, Pulmonology, Hematology/Oncology, Rheumatology, Infectious Diseases)
1 month Night Float
1 month Vacation
3 months Family Medicine (Inpatient/Outpatient Charge)
1 month Surgical Subspecialties (VA Medical Center)
1 month Dermatology
1 month GI (VA Medical Center)
1 month Orthopedics/Sports Medicine
1 month Pediatric Subspecialties
2 months Electives
2 weeks Night Float
2 weeks Occupational Medicine
1 month Vacation
The goal of our Practice Management curriculum is to prepare our residents for the realities of medical practice so they can enter the work force with the confidence and expertise needed to run efficient quality driven medical homes. We have a formal didactic and longitudinal curriculum.
The didactic portion includes lectures on topics including but not limited to billing and coding, risk management, corporate compliance, EMR, alternative practice types, etc. In addition, we are building a residency year specific curriculum geared towards the specific needs of each class. For example, 3rd year group discussions may be focused on job search, contract negotiations, etc.
Our longitudinal curriculum lends itself to “learning by osmosis” over the course of 3 years via daily experiences along with one-on-one coaching by faculty on practice management issues, i.e. , preceptor guidance in proper coding as residents see patients; an advisor’s advice regarding office conflict resolution; and daily monitoring of schedule evaluating factors such as no show rates, late arrivals, length of visit, to work towards an efficient, productive and accessible practice. We also conduct monthly health center operations meetings to allow residents to be well informed about the practice and encourage them to be active participants in clinical operations.
Residents also have blocks of time during each year where they are “outpatient charge” and focused solely on their ambulatory care experience. During this time, they are encouraged to work on practice and quality improvement projects.
Our resident ambulatory care experience is based on the philosophy and principles of the patient centered medical home (PCMH). In being as such, it focuses on a team-based approach, promotes clinical excellence, while maintaining strong patient partnerships. We like to think of each year of residency as it pertains to their ambulatory care experience as PCMH 1, PCMH 2 and PCMH 3.
We offer a comprehensive outpatient experience. All residents have their designated continuity care days per week, number of days vary depending on year of residency. In addition, the 2nd and 3rd years have blocks of time focused solely on outpatient care at the Neighborhood Health Center during which they take a lead role with an extensive focus on the daily operations of the outpatient office practice. Along with seeing their continuity patients, they also have open schedules for walk-in patients, learn the art of triaging appointments, review all laboratory and diagnostic results and learn to appropriately manage any abnormalities with their preceptor. They also participate in practice improvement projects and act as resident preceptors to Ross and NYMC medical students.
In addition to their outpatient practice, as part of their longitudinal ambulatory care exposure, residents also rotate through specialty clinics. First and second year residents spend 8 hours per week in podiatry clinic which counts towards their orthopedics rotation. Second and third year residents spend 4 hours per week in the endocrine clinic and also have a procedure clinic 8 hours per week where they are trained in doing minor outpatient surgical procedures, skin biopsies, joint injections and spirometry.
Our residents have an excellent team of outpatient role models. Along with our well-rounded Family Medicine preceptors, throughout the course of 3 years, our clinical psychologist, Dr. Giuliana Capone, offers behavioral health guidance and live interview feedback on resident-patient encounters. We also have a psychiatrist on staff to assist with outpatient management of psychiatric illness and psychotropic medication management. Our faculty pediatrician, Dr. Sophie Pierog, offers assistance to our residents through their pediatric visits.
Dr. Giuliana Capone, our faculty psychologist, supervises this training experience which includes real time observations of the patient interview with immediate constructive feedback, didactics, workshops, and presentations on behavioral health topics. The resident is taught how to identify psychological and emotional difficulties as well as instructed on how to implement short-term therapeutic techniques to help their patients.
Additionally, residents obtain training on the diagnosis and management of psychiatric illnesses by our faculty psychiatrist who also offers guidance in prescribing psychotropic medications.
Patients may also be referred to our affiliated Community Mental Health Center if needed.
Along with a diverse patient case load comes interesting and unique radiologic images. Throughout their various inpatient medicine rotations over the 3 years, residents have weekly radiology rounds with Dr. Mirza, a board certified radiologist, who reviews cases explaining not only the images and their significant findings but radiologic techniques as well. There is also a monthly lecture series dedicated to radiology. Residents also have the ability to do a radiology rotation during their elective time.
In addition to being a rotational experience, residents have ample exposure to this specialty throughout their residency. Rotations in their first and third years are primarily held at Gotham City Orthopedics, our affiliated outpatient orthopedic practice led by Dr. O. Gonzalez, a specialist in sports medicine and Dr. S. Lager an orthopedic surgeon. Here residents attend to minor procedures including but not limited to manipulation, injections, and ultrasound guided techniques.
Along with the above, for residents with an interest in surgery, further opportunity in the operating room is always welcomed by the surgeons. Longitudinal exposure to the management of the most common orthopedic/sports medicine related injuries is also a prominent part of the residents’ outpatient continuity care experience.
Medicine Hospitalist (see link and content below) (Picture of Dr. Lim)
Obstetric Hopitalist (create link/see content below) (Picture of Dr. Vogel)
Pediatric Hospitalist (create link/see content below) (Picture of Dr. Moshet)
In addition to working directly with the family medicine service inpatient team, each resident gets additional inpatient experience while working with a group of board certified Internal Medicine physicians. This group of physicians is known as the Hospitalist Service, organized by Dr. J. Lim. This service is similar to a traditional inpatient service, but essentially cares for patients that do not have a primary care physician or do not have a primary care physician with hospital privileges. Residents in this rotation work directly with the hospitalist on admissions, consults, daily management, and discharge planning.
Obstetrics and Gynecology is an integral part of the family medicine experience and training. At Hoboken University Medical Center, our residents have access to extraordinary hands-on experience while rotating through this part of their training. We currently have an Obstetric Hospitalist service, during which, each resident works closely with a board certified obstetrician, organized by Dr. E. Vogel, assisting in managing the care of Obstetric patients and delivering babies throughout their first year three month rotational experience.
The Obstetric Hospitalist program is a newer field in which the obstetrician acts as a hospitalist primarily responsible for intrapartum and postpartum management of obstetric patients, as well as gynecologic emergencies. New additions to the Labor and Delivery floor include our very own Labor and delivery Emergency Room in which many of these acute issues are evaluated.
As family physicians in training, our residents learn the concept of promoting wellness and serving the entire family’s medical needs. This is probably most evident when working in the newborn nursery with our pediatric hospitalists. After following their pregnant patient through the course of her pregnancy providing prenatal care and then participating in the delivery of her newborn infant, residents learn the basics of newborn nursery care and assist in preparing the new parents for the infant’s hospital discharge and follow up medical care.
The Pediatric “Hospitalists” primarily Dr. O. Moshet, act as the residents’ preceptors, teaching them nursery routines and educating them on problems that may affect the neonate, along with guiding through the newborn’s first visit, teaching them the basic guidelines of well child care.
Community Outreach Activities:
Our residents and faculty are active in our community as well. The following lists some of the projects and out-reach activities in which we are currently involved:
Community Oriented Primary Care (COPC) Program
Every year we focus on a community-based project and are currently working with the HOPES Headstart Pre-school Program focusing on childhood obesity.
We are the school physicians for the Hoboken school system. Our residents perform pre-participation sports physicals at our local high school, as well as scoliosis screenings and pre-school physicals in our elementary schools. They also participate as a member of the medical team at our local high school football games.
Our residents participate in local health fairs including our hospital-sponsored annual 5K Run, as well as hospital and community sponsored health fairs providing education and services to our community.
Health maintenance/screening education is provided to members of the community in the form of open forums that are held periodically.
- New York Medical College Family Medicine Residency at CarePoint Health Hoboken University Medical Center122 Clinton Street
Hoboken NJ, 07030