The curriculum is designed to broadly prepare the physician for Family Medicine in a rural or underserved setting. Therefore, it includes a strong emphasis in medicine, obstetrics, pediatrics, emergency medicine, and surgical procedures and assisting that is not found in many other programs. During their three years the residents have increasing responsibilities in patient care, management of their own continuing education, and participation in the management of the Family Medicine Health Center. They also participate in organized medicine and various committee functions within the hospitals, the communities, the state, and the nation. The Residency strives to help our physicians develop a sustainable medical lifestyle that will provide them with long term satisfaction and deep meaning and inspiration in the practice of Family Medicine.
Internal Medicine | Family Medicine Service (FMS): Internal medicine training at FMRI is broad-based, and designed to facilitate independence in thinking. Interns begin their training at the Boise Veterans Affairs (VA) medical center in a traditional “university” teaching team setting. During their two VA months, interns work closely with general medicine attendings, University of Washington internal medicine residents, as well as medical students. The service is busy, with opportunities to follow patients into and out of the ICU. This experience serves as excellent preparation for the interns’ first month at Saint Alphonsus where residents work as an integrated team and staff their patients directly with the attending family medicine physician on the family medicine service. This service is primarily comprised of medicine patients but also consists of pediatric and obstetric patients. Patients are admitted both to the medicine, obstetrics, and pediatric wards and to the ICU. Didactics are held daily at Saint Alphonsus. An additional month is spent in the ICU during the second year. Throughout their three years, residents spend 9 months on inpatient medicine.
Pediatrics: Eight weeks are spent on pediatrics in the first year, four weeks in the second year, and four weeks in the third year, at St. Luke’s hospital, doing both inpatient and outpatient work. Residents round in the hospital in the morning, and see outpatients in the 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 multiple 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 two weeks in the first year is spent in the NICU. There is also a four week pediatric subspecialty rotation during the third year, which is outpatient-based and offers experience in GI, cardiology, neurology, behavior and development, pulmonology, and numerous other subspecialty areas. Because of the large inpatient and outpatient volume, our incredible pediatric didactic curriculum, and the willingness of Boise’s private pediatricians and pediatric subspecialists to teach us, many residents find the pediatric curriculum one of the strong points of the program.
Obstetrics: Five total months are dedicated to obstetric training at FMRI. All formal 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 10-30 of their own private obstetric clinic patients as well. Residents average 100-130 deliveries during their five months and many c-section assists. Additionally, the residents average 12-30 continuity deliveries on their own patients over the three year residency period.
Surgery: Two total months are spent on inpatient surgery. Principles of pre and post-op care are emphasized, as well as intra-operative surgical skills. We have one surgeon on faculty who staffs a weekly plastics clinic. In addition to inpatient surgery, there is ample opportunity to learn many procedures throughout the three years. A rural surgical rotation in rural Twin Falls, Idaho provides surgical experience for our residents. FMRI also teaches upper GI endoscopy, colonoscopy, vasectomy, treadmills, colposcopy, womens health care, and multiple dermatologic procedures.
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 three rural rotations.
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 integrated 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 psychiatrists, reviewing both clinical psychiatry as well as interviewing skills. Throughout the three years, regular didactics are held which cover a wide variety of behavioral medicine topics. FMRI believes strongly in the integration of behavioral and family medicine through the patient centered medical home concept.
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.
FMRI Clinics | Patient Centered Medical Home (PCMH): FMRI believes strongly in the PCMH. The integration of continuous, comprehensive patient centered care is paramount to future primary care based health care for our nation. The use of EMR registries, advanced access scheduling, e-prescription, group visits, e-mail visits are all important at FMRI. FMRI is a designated PCMH as recognized by the National Committee for Quality Assurance.
Electives: FMRI allows four electives to help further polish the resident’s superb skills. These can be done internationally in one of several countries or right here in our communities in one of many types of specialties. Residents are free to create their own electives as well with the guidance of their advisor and the oversight of the program director.