Family Medicine Residency

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Organization Type: 
Program Type: 
Education Level: 
Postgraduate (e.g., residency, fellowship)
Educational Elements: 
Independent Study
Self Reflection Activities
Experiential including clinical contact with patients
Program Description: 

The Crozer-Keystone Family Medicine Residency program offers multidisciplinary training in a residency-based patient-centered medial home (PCMH) environment. The program is designed to combine traditional inpatient training experience at a larger urban teaching hospital with an innovative final two years of training that emphasize the outpatient experience. The Crozer-Keystone Health System provides the residency program with access to several resources, including tertiary and community hospitals, a primary care physician network, and comprehensive community outreach and wellness health programs. This program is dedicated to excellence in clinical and didactic training, with major emphasis on ambulatory family medicine, sports medicine, women’s health, family-centered obstetrics, community medicine and behavioral science.

This program’s primary outpatient office utilizes a fully functional electronic medical record system to provide real-time access to patient charts and medical information at the point of care.  The urban office, recently designated as a federally qualified health center (FQHC), provides residents with training on how to manage the patient’s healthcare needs using a culturally sensitive approach and encourages opportunities to participate in community service projects.  The program includes a Medical Informatics longitudinal curriculum, which builds on each resident’s computer knowledge base, with the goal of bringing computer technology into the examination room to improve efficiency and quality of care.

First-year residents gain a firm foundation in medical knowledge primarily through their hospital rotations in medicine, surgery, critical care, pediatrics and obstetrics/gynecology. Family medicine interns are completely integrated into all the teaching services and are given the same responsibility and recognition as other specialty residents.  In addition to Crozer’s hospital experience, postgraduate year one (PGY1) residents see their own patients at least a half-day per week at the Center for Family Health. They also spend one month on the family medicine inpatient service providing care for hospitalized patients, and one month on community medicine learning about the broad resources and ancillary services in the community.

Second and third year residents develop diagnostic and therapeutic proficiency in ambulatory medicine, in addition to the inpatient setting. In order to maximize continuity of care, and to develop the skills, knowledge and abilities needed to become a family physician, half of each week is spent seeing patients at the Center for Family Health and the other half is spent primarily in ambulatory-based specialty offices.

During the inpatient experience, residents act as “co-attendants” with the faculty and have complete responsibility in managing the family medicine service. Residents spend two months in a Geriatric rotation providing care to the elderly in the nursing home, assisted living facility, office, and home, with experience in palliative care in all settings. This is in addition to the longitudinal care they provide to their own nursing home and home visit patients. 

During the third year, residents are provided with four rotations of elective time, to utilize in areas of personal interest or to obtain further specialized training.

In 2009, the Center for Family Health, which is the main clinical site for outpatient teaching, was awarded Level 3 designation as a PCMH by the National Committee for Quality Assurance (NCQA).  This quality award was based upon the residency program’s work with patient registries, chronic disease management, patient self-management support, and multi-cultural patient education activities.  It also was a participant in the Pennsylvania Multi-Payer Chronic Care Initiative (PA CCI) from 2008-2011 and is currently participating in the Centers for Medicare and Medicaid Services (CMS) Multi-Payer Advance Primary Care Practice (MAPCP) Demonstration Project (2012-2015).

Program Results: 

This program is currently being evaluated through several external programs.  RAND is conducting an evaluation on the Pennsylvania Multi-Payer Chronic Care Initiative program with results expected to be released in mid-2013; Centers for Medicare and Medicaid Services (CMS) is conducting an ongoing study of the Multi-Payer Advance Primary Care Practice demonstration project; and population data from CMS and multi-payers is being examined including data on shared savings.

Targeted Professions
Family Medicine
Nurse Practitioners
Registered Nurses
Ambulatory Care
Social Work: 
Medical social work
Medical Assistants
Patient Educators
Self-Reported Competencies
PCPCC’s Education and Training Task Force identified 16 interprofessional training competencies critical for preparing health professionals for practicing in team-based, coordinated care models such as patient-centered medical homes. Listed below are the self-reported competencies that this program has achieved, which have been organized by the five core features of a medical home as defined by the Agency for Healthcare Research and Quality
Patient-Centered Care Competencies: 
Advocacy for patient-centered integrated care
Cultural sensitivity and competence in culturally appropriate practice
Development of effective, caring relationships with patients
Patient-centered care planning, including collaborative decision-making and patient self-management
Comprehensive Care Competencies: 
Assessment of biopsychosocial needs across the lifespan
Population-based approaches to health care delivery
Risk identification
Coordinated Care Competencies: 
Care coordination for comprehensive care of patient & family in the community
Health information technology, including e-communications with patients & other providers
Interprofessionalism & interdisciplinary team collaboration
Team leadership
Quality Care & Safety Competencies: 
Assessment of patient outcomes
Business models for patient-centered integrated care
Evidence-based practice
Quality improvement methods, including assessment of patient-experience for use in practice-based improvement efforts
Accessible Care Competencies: 
Promotion of appropriate access to care (e.g., group appointments, open scheduling)
Last updated November 15, 2013

* Please note: Information contained in this database is self-reported by representatives from each program. It does not represent an exhaustive list of education and training programs and inclusion does not constitute an endorsement from the PCPCC.


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