Full Spectrum Family Medicine
Our mission is to “…train and empower the next generation of family medicine leaders and educators to provide broad spectrum, team-based care in diverse communities and practice settings.” Our residents are encouraged to explore their interests, learn from broad spectrum family physicians as well as many UW specialists, and practice as broadly as they wish.
Family Medicine Service: Resident led inpatient service caring for adult medicine, obstetric, and newborn patients.
Family Medicine faculty teach reproductive health, obstetrics, inpatient medicine, procedures, newborn care, sports medicine, LGBTQ+ care, addiction medicine, and more.
Watch: UWFM Broad Spectrum Training
Watch: UWFM Reproductive Health
Watch: UWFM Behavioral Health
Watch: UWFM Global Health
Watch: UWFM Sports Medicine
Highlights of the Curriculum
The Practice is the Curriculum
In July 2022 we launched our version of “clinic first.” The goals are to improve continuity for residents and their clinic patients, improve patient access, prioritize resident availability for continuity care, improve resident wellness, and reinforce that the clinic is where we learn to be family physicians.
We transformed the curriculum to create more time in clinic for residents, especially during the R1 and R2 years. Mini-blocks during some of our more inpatient heavy rotations allow protected clinic time that is free from inpatient responsibilities. Resident schedules are more predictable allowing for return visits for patients who need them.
We measure patient-facing and resident-facing continuity to ensure that we are meeting our intended goals and check in regularly with residents and faculty to evaluate any changes.
Diverse Training Sites
- Rotations at UW Medical Center Montlake, UW Medical Center Northwest, Harborview Medical Center, Seattle Children’s Hospital, Veteran’s Administration, and many additional community sites
- Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Residency Network opportunities – experience the five state region during elective rotations
Collaborative Learning
- Learn from FM residency faculty, FM department faculty, and faculty from specialties across UW Medicine
- Work with incredible resident peers within the residency and across UW
- Behavioral Health: Addiction Medicine clinic, Behavioral Health Warm Handoffs, Behavioral Health Integrated Program (BHIP), consulting psychiatrist in clinic
- Fully integrated onto services outside of Family Medicine as a fellow resident with the same expectations and opportunities (e.g. Pediatrics, ICU, Hospital Medicine, Obstetrics)
Areas of Concentration
UW Medicine and the Department of Family Medicine provide almost endless options for electives and AOCs
An Area of Concentration (AOC) is a framework for family medicine residents who elect to pursue more advanced, in depth training in an area of interest with the goal of gaining additional skills and knowledge for future practice or career goals. An AOC is not a requirement and occasionally a resident may wish to pursue more than one AOC.
The concept of focused training has been part of family medicine graduate education for decades. Many of us have expertise in specific areas of family medicine that we have developed on our own. This expertise not only can enhance patient care outcomes, but also can lead to sharing of skills and resources with colleagues and learners via teaching or other scholarly work.
The overall goals are to provide an opportunity to recognize a resident’s extra efforts, encourage and recognize scholarly activity and presentations, encourage resident participation in national meetings, provide a framework to showcase areas of excellence, and help interested students identify opportunities that may meet their specific needs.
The requirements for an AOC are:
- A written plan designed by the resident with faculty input that identifies the area of study with competency-based goals and objectives and an evaluation component
- At least 2 months or 200 hours of training in the AOC, above and beyond ACGME requirements
- A scholarly project completed for the AOC, which should be presented and evaluated locally. Presentation at the state and/or national level is encouraged
- Attendance at a national meeting related to the AOC
- Journal club presentation of an article in the chosen area
The AOC should be documented through a portfolio of materials that include the above.
Ideally, an AOC should be identified and started early in the R2 year, although development later is acceptable if requirements can still be met by graduation. The initial steps are to identify an area of interest and a faculty mentor who agrees to work with the resident in that area. The resident is responsible for submitting the plan for the AOC, developing the portfolio, and completing the requirements. A certificate will be presented at graduation acknowledging the completion of the AOC and will be included in summary evaluations sent to future employers.
Examples of recent AOCs include:
- Musculoskeletal Medicine
- Reproductive Health
- Sports Medicine
- Scholarship and Research
- Clinician Educator
- Quality Improvement
- Global Health
UWFMR is a RHEDI program (Reproductive Health, Education in Family Medicine)
- UWFMR is a RHEDI program. Abortion and contraception training are integrated into the curriculum. All residents will gain exposure to abortion care (medication abortion, procedural abortion, post-procedure care, pregnancy options counseling) and contraceptive care (includes IUD/implants insertion and removal, vasectomy counseling). Residents may opt out of clinical abortion training, though residents are expected to attend didactics on abortion and at least observe at required training sites, including Planned Parenthood. Abortion care is integrated into our primary care clinics at Northgate and Harborview.
- We teach and employ a reproductive justice framework into all aspects of the Sexual and Reproductive Health (SRH) curriculum. Residents learn to identify patterns of reproductive injustice that profoundly shape contemporary medical practice, and SRH in particular. We discuss and model respectful and equitable abortion and SRH provision for LGBTQIA+ people and people with disabilities.
- Residents with special interest in SRH skills may consider completing an Area of Concentration (AOC) in SRH and/or apply to obtain additional training in abortion procedures or vasectomy procedures through local and national elective rotations.
- All of our residents will learn:
- Non-coercive, non-judgmental patient-led contraception counseling
- Management of patients who are using all forms of pregnancy prevention, including LARCs
- Patient centered counseling for patients with a positive pregnancy test, including non-coercive, non-judgmental options counseling
Procedures
We strive to provide as many patient needs as we can in our clinics and on our hospital service. The following are examples of some of the procedures for which a resident may gain proficiency or at least exposure during residency.
Examples of procedures:
Outpatient procedures
-
- Skin: biopsies (punch, shave, excisional biopsies), cryotherapy, dermoscopy, laceration repairs.
- Lumps and bumps: I&Ds, lipoma and cyst excisions
- MSK: joint injections and aspirations, ultrasound, casting and splinting
- Reproductive health: IUD and Nexplanon insertions and removals, terminations (medical and surgical), endometrial biopsies, colposcopies, vasectomies
- Newborn circumcisions
- Other: thrombosed external hemorrhoid treatments, tongue tie release, anoscopy
- Point-of-Care Ultrasound for GYN, OB, Sports Medicine
Inpatient procedures
-
- Vaginal deliveries and Cesarean assist
- CVC and arterial line placements
- Lumbar punctures (adult and pediatric)
- Thoracentesis, paracentesis
- Fracture reductions
- Colonoscopies
- Intubations
Example block schedule for all three years of residency
*Please note these are sample schedules.