Internal Medicine
Internal medicine training at FMRI is broad-based, and designed to facilitate independence in thinking. Interns begin their training at the Boise VA in a traditional "university" teaching team setting. During their 3 VA months interns work closely with general medicine attendings, University of Washington second-year internal medicine residents, as well as medical students. The service is busy, with opportunities to follow patients into and out of the ICU. This VA experience serves as excellent preparation for the interns' first month at Saint Al's. Here, residents take call independently and staff their patients directly with the attending family practice physician. Patients are admitted both to the floors and to the ICU. Didactics are held daily during the lunch hour at Saint Alphonsus. An additional month is spent in the ICU during the second year. Throughout their 3 years residents spend 9 months on inpatient medicine.
Pediatrics
Two months are spent on pediatrics in the first year and one month in the second year, at St. Luke's hospital, doing both inpatient and outpatient work. Residents round in the hospital in the morning, and see their own exclusively pediatric clinic in the afternoon. The inpatient service is busy, with a large volume of newborns as well as sick children on the wards. There are several pediatricians on staff who function as attendings both in the hospital and in the clinic. Didactics are held daily and are excellent, involving many of the pediatric subspecialists in the community. An additional 2 weeks in the first year is spent in the NICU, and 3rd-year residents finish out their pediatric training with a final month of inpatient and a month of mixed inpatient and outpatient/subspecialty peds. Because of the large inpatient and outpatient volume, our incredible pediatric didactic curriculum, and the willingness of Boise's private pediatricians to teach us, many residents find the pediatric curriculum one of the strong points of the program.
Obstetrics
Six total months are dedicated to obstetric training at FMRI. All rotations are spent at St. Lukes, working both with our own family medicine attendings, as well as with community OB/Gyn attendings. Similar to the pediatrics rotations, the obstetrics experience is made more diverse with an obstetrics clinic. In addition to the patients delivered while on the obstetrics rotations, residents typically follow 5-10 of their own private obstetric clinic patients as well. Residents average 100-130 vaginal deliveries during their 6 months, as well as 40-50 C-section assists. Additionally, the residents average 20-40 continuity deliveries on their own patients over the 3 year residency period. We are also fortunate to have our own OB/Gyn attending at the residency program, Dr. Marietta Thompson.
Surgery
Two total months are spent on inpatient surgery. Principles of pre and post-op care are emphasized, as well as surgical skills. We have two surgeons on faculty, one who specializes in teaching the residents endoscopy, and a second who staffs a weekly plastics clinic. In addition to inpatient surgery, there is ample opportunity to learn many procedures throughout the three years. We have recently added a surgical rotation in rural Twin Falls, Idaho which is an excellent surgical experience for our residents.
Emergency Medicine
Two months are dedicated to emergency medicine in the R2 and R3 years. Residents spend one month during the second year in the St. Luke's ED, learning to handle typical medical emergencies as well as triage. Addtionally, residents spend an additional month at Saint Alphonsus's ED, the region's largest trauma center, during their third year. Residents also get additional experience in the ED during their rural months in the second and third years of training.
Rural Medicine
During the first, second, and third year, residents have a required community rotation in rural Idaho. During this time the resident spends time with a family physician in rural practice in Idaho so that he/she may learn first hand the unique challenges and rewards of practice in a smaller community. The experience will help the resident determine his/her own areas of need to help tailor the remainder of the curriculum and choose electives as appropriate. As part of its rural curriculum, FMRI also offers special educational opportunities in the area of wilderness medicine. A series of seminars, some with "hands on" experience, as well as outdoor activities are coordinated by the residency program to enhance the understanding of the principles of wilderness medicine as they apply to rural practice.
Behavioral Medicine
Behavioral medicine plays a significant role in many family physicians' practices. Because of this, FMRI emphasizes the biopsychosocial approach to clinical medicine from the beginning of the resident's training. As interns and R2s, two months are spent working closely with the clinic's own staff psychologist and psychiatrist, reviewing both clinical psychiatry as well as interviewing skills. Additional time is spent working in our own psychiatry focus clinic. Throughout the three years, regular didactics are held which cover a wide variety of behavioral medicine topics.
Specialty Clinics
A number of specialty rotations are required and are part of the curriculum. These include geriatrics, dermatology, cardiology, ENT, neurology, orthopedics, urology, and ophthalmology. In addition to these required rotations, residents also participate in regular clinics in orthopedics, sports medicine, gynecology, vasectomy, procedures, and treadmills within the FMRI clinic itself.