Family Medicine Residency

The Community Health Network Family Medicine Residency Program in Indianapolis was awarded a $1.3 million Health Resources and Services Administration (HRSA) grant in 2010 to achieve three major patient-centered medical home (PCMH) goals: 1) to transform its residency curriculum to meet the needs of PCMH training, 2) to transform its Family Medicine Center into a PCMH with National Committee for Quality Assurance (NCQA) certification and 3) to change the culture of its organization to lend itself to these transformations.

In 2012 the program implemented a new three-year residency curriculum focused on training residents for care delivery in a PCMH.  Key components of the new curriculum included the following:  1) increased resident presence in the family medical center comprising of up to 50 percent throughout all three years of residency, 2) elimination of traditional organ-based block rotations, 3) longitudinal team-based "modules" in acute care, chronic care, and preventive care that include the highest yield learning experiences from specialists and other providers; these experiences recur in all three years of residency.  Quality metrics, process improvement, and physician leadership roles in multidisciplinary teams are key components of small group "team time" that occur during each year of training.  When possible, the program integrates "specialty clinics" in the family medical center with a specialist preceptor, enabling residents to learn from that specialist in a focused experience with the center’s patient population.

The Acute Care Module includes 12 weeks in each year of training of the following: 18 weeks of inpatient adult, six weeks if inpatient pediatrics, nine weeks of emergency department, and three weeks in either urgent care or the intensive care unit (ICU).  The Chronic Care Module incudes 12 weeks each year of training on the following: endocrinology clinics; congestive heart failure and cardiology clinics; renal, chronic obstructive pulmonary disease (COPD), allergy, and asthma clinics; longitudinal behavioral health curriculum;  team time with process improvement, quality metrics; and interdisciplinary team staffing.  The Preventative Module incudes 12 weeks each year of training on the following: ambulatory pediatrics; gynecology; sports medicine (in and out of the family medical center), orthopedics, and spine center; podiatry at the family medical center; geriatrics; community medicine; and team time with small group learning, procedure training, and process improvement.  The Individual Module incudes 12 weeks each year of training on the following:  six weeks of obstetrics and another six weeks of surgery in the first year with electives and scholarly activity occurring in years two and three.  Nursing home and centering pregnancy group visits are longitudinal experiences that span multiple modules.