NH Dartmouth Family Medicine Residency

As the leading division of the Concord Hospital Medical Group (CHMG), a group of nearly 200 primary and specialty care physicians, the NH Dartmouth Family Residency program has led CHMG in the patient centered medical home (PCMH) evolution and, more recently, into becoming an Accountable Care Organization. The use of multidisciplinary teams, medical informatics, group visits, and care plans for both urgent care and for complex patients are all examples of innovation currently in use in the clinics. The residency program is an 8-8-8 program with a multidisciplinary faculty that includes family physicians, obstetricians/gynecologists, pediatricians, behavioral health specialists, geriatrics, nursing leaders, and social workers.  A rural continuity clinic experience for two residents from each class is offered by the program as well as a combined family medicine/preventive medicine residency that focuses on quality improvement within the clinical microsystem.

Based on a “systems” module, concepts are introduced on systems thinking, teamwork, and collaboration to family medicine residents.  This module encompasses two weeks during the post graduate year 1 (PGY1) and one week during the PGY2 and PGY3 years. Throughout the program, reflective exercises, didactics and shadowing are all utilized in combination with organizational development curricula such as “Positive Power and Influence”, “Situational Leadership”, and “Crucial Conversations.”  Each day of the program features a different topic. Examples from the PGY1 curriculum include: 1) Approaching Complexity in Health Care; 2) Healers Art and Hero Myth; 3) Motivational Interviewing; 4) Healers Art and Motivational Interviewing; 5) Simulation Lab and Learning; 6) Retreat, 7-8) Situational Leadership; 9) Learning Conversations and Relationship Based Care; and 10) Relationship Based Care and Wrap Up.

The program has achieved Level 3 PCMH recognition from the National Committee of Quality Assurance.