Family Medicine Residency Curriculum

In addition to the ACGME required rotations for Family Medicine, some curricular highlights include:

  • Addiction medicine rotation and longitudinal, medical-home based MAT clinics

    • Training includes time in both the academic addiction treatment center and in the medical homes, including our own resident MAT clinic.

    • All residents are trained in Medication-assisted treatment and receive suboxone waivers during residency.

  • Family Medicine Obstetrics

    • 3 months of FM-Obstetrics

    • 10 Family Medicine Faculty practicing OB

    • Opportunity for high volume low risk deliveries

    • Elective options for maternal fetal medicine/high risk rotations

  • Highly-rated rural rotation in the second year, which can be done in the far-reaches of the state.

    • Can include full-spectrum rural Family Medicine

    • Includes local housing

    • Great opportunity for immersion in true rural family medicine experience

  • Gynecology and Family Planning rotation

    • Options-counseling training

    • Long term contraception training and gynecologic procedure training embedded in the Family Medicine Medical Homes

    • Optional termination training

    • Ultrasound training

  • Family Medicine Procedures

    • Residents paired with FM faculty who have their own dedicated procedure clinics

    • Procedure clinics also occur during various rotations (i.e. GYN, sports medicine)

    • Hands-on experience doing office-based procedures, including:

    • Skin biopsy, joint injection and aspiration, vasectomy, and gynecologic procedures (IUD, Nexplanon, endometrial biopsy).

  • Sports Medicine Curriculum, MSK Ultrasound, and Sideline Sports

    • Two dedicated rotations in orthopedics and sports medicine

    • Includes monthly didactics, musculoskeletal and injection workshops

    • Fellowship-trained sports medicine doctor is core faculty at residency clinic site, provides training in ultrasound-guided injections

    • Optional sideline sports coverage includes Milton High School Football (Friday Night lights), UVM division 1 sports and St. Michael’s College Division 3 sports, as well as mass events (VT City Marathon)

  • Global Health Curriculum

    • Funded global health elective opportunity to well-established international training sites in the Dominican Republic, Uganda, Vietnam, or Zimbabwe.

    • Longitudinal global health/alternative culture curriculum includes time at Burlington's Community Health Center (CHC), a Federally Qualified Health Center, where residents gain experience caring for immigrant populations and the underserved.

    • Residents also care for the CHC patients on our inpatient hospital service and labor and delivery, allowing for a richness of diversity in their clinical practice.

For more detailed information on rotations included in each year of residency, please click below:

Year 1 - Highlights and Rotation Blocks

Year-1-Highlights-and-Rotation-Blocks

As a first-year resident, you develop knowledge and skills in hospital and outpatient settings. You also build your own family medicine patient practice at the Family Medicine Center at least one half-day a week and become a part of the Milton community. Outpatient months are free of call.

Highlights for PGY1s unique to our program (UVM) include:

  • On most rotations, Wednesdays are protected for PGY1s-
  • Didactics in the morning and Milton Clinic in the afternoon
  • Intern “chat” every Wednesday from 1:30-2 pm with faculty to cover basics of clinic and inbox management
  • Wednesdays are great for class bonding
  • Balint twice per month to connect with your classmates
  • Facilitated small group support
  • Lots of faculty support in clinic and FM inpatient setting
  • Graded increase in patients seen
  • Step wise approach to autonomy
  • TAs/preceptors readily available on site with great teaching
  • Full patient continuity panels transitioned from graduating PGY3 to incoming PGY1s
  • Patients comfortable and familiar with resident physician as their primary care doctor
  • Allows for continuity of care and management of chronic disease right away for PGY1s

PGY1- Rotation Block Schedule

Inpatient Pediatrics

2 months

Obstetrics

2 months

Family Medicine Hospital Service

2 months

Inpatient Cardiology

2 weeks

Medical ICU

1 month

Urgent Care Center*

1 month

Family Medicine Center/ Community Medicine*

1.5 months

Ambulatory Pediatrics*

1 month

Newborn Care*

2 weeks

Community Health Center (FQHC)

2 weeks

 

Family Medicine Continuity Clinic: At least one half day per week 
* = Outpatient Rotations

Year 2 - Highlights and Rotation Blocks

Year-2-Highlights-and-Rotation-Blocks

During your second year, emphasis is placed on increasing your knowledge, skills, and responsibility in inpatient family medicine, obstetrics, orthopedics, and office-based procedures. The PGY2 year also includes emergency medicine, gynecology, and rural medicine rotations. In addition, there is one month of elective time and one month practicing full time at the Family Medicine Center (Milton Family Practice). Continuity of care expands and strengthens through 3-4 clinic sessions a week, home visits, nursing home rounds, and continued inpatient service.

Highlights for PGY2s unique to our program (UVM) include:

  • Back to Bedside (BTB) Clinic

    • Originally funded by ACGME grant, written by our residents!

    • One of only 3 Family Medicine programs to receive the grant, now fully sustainable

  • Our hospital-to-home discharge clinic

    • As PGY2 or PGY3 on our FM inpatient service, you will come to clinic for BTB and see patients on their transition of care visit after hospital discharge

    • Team includes social work, pharmacy, and a dedicated 1:1 faculty preceptor

    • Great opportunity to provide in-depth care with complex patients

    • Quality improvement at work- with reduced re-admission rate for patients

  • Palliative Care

    • Division of palliative care within Family Medicine

    • Inpatient consult service and outpatient/eHealth components

    • Opportunity to round at new inpatient hospice facility (Vermont Respite House)

    • Faculty nationally known for NIH-funded research on end of life conversations

    • Didactic curriculum for our residents - includes "Talk Vermont," workshops with standardized patients on serious illness conversations, and symptom management:

PGY2- Rotation Block Schedule

Obstetrics

1 month

Emergency Medicine

1 month

Family Medicine Hospital Service

3 months

Family Medicine Center/Dermatology*

1 month

Orthopedics/Sports Medicine*

1 month

Elective*

1 month

Rural*

1 month

Gynecology*

1 month

Family Medicine Procedures/ Weekend Nights

1 month

Surgery (Inpatient)

2 weeks

Palliative care

2 weeks

Family Medicine Center: One to six half days per week 
* = Outpatient Rotations

Year 3 - Highlights and Rotation Blocks

Year-3-Highlights-and-Rotation-Blocks

As a third-year resident, you will have the opportunity for advanced practice in the Family Medicine Center. Residents spend four to five half-days per week in the Center to continue to develop their clinical skills. In addition, you will have two months to choose electives that match your educational needs and future career plans. Two Chief Residents are elected from the third year class.

PGY3- Rotation Block Schedule

Family Medicine Center/Endocrinology*

1 month

Orthopedics*

1 month

Family Medicine Hospital Service

3 months

Family Medicine Procedures/ Weekend Nights

1 month

Specialty Clinics (includes Urology, ENT, Ophthalmology, and Geriatric home visits)*

1 month

Outpatient Pediatrics*

1 month

Pediatric Urgent Care/Pediatric Emergency Medicine

1 month

Addiction Medicine/ Health Systems Management*

1 month

Elective*

2 months

Family Medicine Center: One to six half days per week 
* = Outpatient Rotations

Elective Opportunities

What sort of elective opportunities will I have?

There is one elective month in the second year and two in the third year in which you may create your own schedule to pursue your medical interests. Electives are available in any subspecialty area of medicine in addition to research, integrative medicine, sports medicine, palliative care, outpatient procedures, global-environmental health, addiction medicine and international medicine. Schedules are flexible and resident-directed based on educational needs.

Are there opportunities for international health rotations?

The residency program has partnered with The Western Connecticut Health Network in Danbury, Connecticut to provide funded global health experiences in the Dominican Republic, Russia, Uganda, Vietnam, and Zimbabwe.  These locations have fully developed rotations with sponsoring physicians.  These experiences are extremely enriching to the residency training but can be both emotionally and physically demanding. Rotations include preparatory work, support on site, and dedicated Family Medicine GH faculty.  Unfortunately, due to the COVID pandemic, international rotations are currently on hold. Funding for the international health rotation is also uncertain at this time due to the COVID crisis.

Where do University of Vermont Family Medicine Residents go?

Residents have most recently visited the following locations for away rotations: Alaska, Uganda, Vietnam, Zimbabwe, Indian Health Service in Zuni, New Mexico, Thomas Jefferson University and Christiana Care Health Services for Sports Medicine, and OHSU for Clinical Informatics. Unfortunately, domestic away elective rotations are also on hold due to the COVID pandemic.

Do I have to apply?

All away electives require program director approval and an application approved by the GMEC, the Graduate Medical Education Committee at UVMMC.  Rotations need to further residents training in knowledge and skill areas and in settings unavailable at UVM Medical Center.

How has UVM Family Medicine responded to the COVID crisis in terms of limited travel and elective opportunities?

We developed several virtual didactics to help supplement resident learning and experience during these unprecedented times. Virtual didactics may include online content or modules, articles, pre and post-tests or relevant board review questions, and a set of deliverables to help residents best understand and assimilate the content.

List of virtual electives now available:

  • Virtual Dermatology
  • Virtual Diabetes
  • Virtual eHealth
  • Virtual Preventative Care
  • Virtual Community Medicine
  • Virtual Reproductive Justice

Virtual electives in development:

  • Virtual radiology
  • Virtual tick borne illness

Didactics and Longitudinal Curriculum

One full morning each week (Wednesday morning) is dedicated to real-time didactic education on family medicine educational topics. During the COVID pandemic, we transitioned to zoom-based didactics to ensure safety, ability to social distance, and to avoid group settings. Faculty regularly incorporate case-based education, active learning, and interactive styles of teaching (i.e. poll everywhere) to keep didactics fun and engaging. Didactic attendance is required and protected on most rotations. All didactics are also now recorded and available for asynchronous viewing (i.e. for those on night float). Residents also have access to national online didactic content through our subscription to the residency curricular resource (RCR) in additional to a large cadre of online content to supplement learning. 

UVM residency leadership is working hard to adjust to these unusual times and will incorporate in-person didactics and simulation as soon as safely possible. During typical times, in-person procedural training, simulation training, and workshops occur approximately every 5 weeks.

Selected longitudinal curriculums throughout all three years provide extensive training in:

  • addiction medicine
  • behavioral science
  • community medicine
  • quality improvement
  • international health
  • geriatric and palliative care
  • maternal-child health
  • pharmacy
  • sports medicine
  • evidence-based medicine, including journal club and clinical question

Addiction Medicine

Family Medicine at UVM has been an integral part of the State of Vermont’s response to the Opiate Crisis.  As a department we participate in a Hub and Spoke model providing office-based substance abuse care through medication assisted therapy with Suboxone.  Residents participate in Suboxone waiver training and spend time in the Hub (induction and stabilization clinic) as well as in the Spoke (office-based maintenance therapy).  Residents also have their own MAT clinic, and follow their own MAT patients longitudinally with a dedicated supervising faculty.

The longitudinal curriculum spans all three years to ensure residents are comfortable treating substance abuse, addiction, and chronic pain as chronic diseases.  Residents are trained to treat chronic pain with alternative therapies as well as with non-narcotic and limited narcotic pharmaceuticals.  Using functional assessments, risk prediction tools, and controlled-substance informed consent and contracts, and the Vermont Prescription Drug Monitoring System (VPMS) residents strive to provide medically appropriate care while closely monitoring for signs of misuse, addiction, and diversion.

Behavioral Science

The Behavioral Science/Primary Care Psychiatry portion of the Family Medicine Residency Program provides both didactic and hands-on experience with psychiatric aspects of family medicine.

Behavioral health educational sessions focus on:

  • evaluation and treatment of psychiatric symptoms and illness
  • evaluation of suicide risk
  • substance abuse
  • psychiatric emergencies in inpatient medicine
  • psychopharmacology
  • participation in Balint Groups twice monthly for reflection on the emotional aspects of the practice of Family Medicine

Additional behavioral health resources are available at Milton Family Practice:

  • pediatric mental health case manager
  • 2 master's level therapists specializing in CBT and substance abuse therapy
  • on-site psychiatrist for primary care consultations
  • weekly behavioral health lunchtime brown bag case conference at the resident clinic, Milton Family Practice

Community Medicine

Outpatient rotations include dedicated community medicine time for experiences and assignments that educate residents about the Milton, Burlington, and surrounding communities and teach them to understand and advocate for the needs of the underserved.

We learn how to work with partners serving our continuity clinic population to promote education and healthy living:

  • Milton Elementary School

  • Milton Community Garden

  • Milton Independent Newspaper

  • Safe Harbor Homeless Health Clinic

  • Pearl Street Youth Clinic

  • Participate in Farm Worker visits with the mobile Farm Health Connection

  • Participate in the Open Door Clinic, a free clinic serving an uninsured population

Quality Improvement

Residents participate in a longitudinal quality improvement project over the course of their residency with a faculty supervisor expert in population health and quality improvement. Dedicated time is given during most outpatient rotations where the resident focuses on a group quality improvement project in the Patient Center Medical Home that incorporate:

  • resident- selected annual quality improvement project relevant to Milton Family Practice

  • health outcomes improvement through PDSA cycles

  • population management through registry management

  • residents come away with life-long skills in quality improvement that they can apply to their own clinical practice after graduation.

International Health Curriculum

The International Health Curriculum includes a longitudinal series of educational sessions and Grand Rounds utilizing multidisciplinary faculty and community resources with expertise in such areas as malnutrition, immunizations and infectious diseases, maternal-child health. Elective international health rotations are currently on hold due to the COVID pandemic.

Maternal Child Health

The Maternal-Child Health curriculum provides the knowledge and skill to care for families from preconception counseling through pregnancy and childbirth, to well child-care:

  • didactic sessions from family physicians with a commitment to maternal child health

  • resident performed chart reviews of Family Medicine OB patients (OB audit)

  • 10 family medicine obstetric faculty- FM-OB providers at CHC (FQHC) and UVMMC FM Practices

  • dedicated weekly prenatal clinics during specific rotations

  • dedicated outpatient pediatric experiences with UVM Pediatrics and FM faculty

  • resident ownership of prenatal and well-child care throughout continuity clinic schedules

Sports Medicine Curriculum

The sports medicine curriculum at the University of Vermont Family Medicine Residency is directed by Dr. David Lisle, partnered with Dr. Kim Sikule. Both are family physicians who are fellowship trained in sports medicine. The curriculum involves didactic, procedural, and clinical experience in a wide variety of orthopedic and sports medicine topics:

  • monthly lecture series on a wide variety of musculoskeletal and athletic injuries

  • hands-on patient care in the Sports Medicine Clinic

  • procedure workshops in injections, and splinting and casting

  • game coverage at the high school, college, and professional levels

  • dedicated sports medicine-related procedure clinics that include ultrasound

  • training in ultrasound-guided injections

Resident Evaluation

Residents receive both formative (on-the-fly and mid-rotation) feedback as well as summative (end-of rotation) feedback.  Evaluations are milestone-based with the expectation that residents will build upon their knowledge and skills throughout residency.  Milestones were developed by the ACGME around the six core competencies: patient care, medical knowledge, practice-based learning, systems-based practice, communication, and professionalism.

At the Family Medicine Center, the family medicine teaching attendings review all charts and supervise the residents' patient care.

Residents meet bi-annually for individual evaluation meetings with core faculty (PD or APD). Residents also have the opportunity to perform self-evaluation and are paired with faculty advisors for academic support. If needed, core faculty will assist with an individualized plan for enhanced educational support in growth areas.

At regular intervals, the residents meet with their faculty advisors to discuss physician wellness, residency progress, areas of interest/elective goals, and career planning.

Residents evaluate the teaching, rotations, and other learning experiences that comprise the program. They also work on committees with faculty members to plan and implement changes.

Resident Wellness

Supporting resident wellness is a priority for the administrative team. Residents are encouraged to identify and make wellness goals to preserve wellness and resiliency and prevent physician burnout. Weekly noon lunches consist of Balint, resident support lunch (RSL), and resident director’s lunch (RDL). Throughout the year wellness activities include: the welcome picnic, bi-annual resident retreats, and interview dinners.

curriculum-didactics-02
Family Medicine sites:
 
Larner College of Medicine at UVM
 
UVM Medical Center

Interested in applying?

Program number for ERAS Applications:
1205021316