Alaska Family Medicine Residency
Alaska Family Medicine Residency

 

3-Year Curriculum

Curriculum Overview
Our curriculum was designed to meet the needs of family physicians that practice in remote and isolated Alaskan communities. Alaskan bush communities differ greatly from many rural communities of the lower 48 states and our areas of emphasis reflect this. We encourage our residents to think freely so they will feel comfortable managing patients without rapid specialist access other than by telephone. Our faculty, who all have longstanding experience with the Alaskan rural and urban needs, continually revise and improve the curriculum based on the needs and input of the residents. The close faculty resident relationship has helped to maximize resident learning while minimizing those parts of the curriculum that are ineffective in meeting their goals. To read more about each area, click on a link to the left.

R-1 Year
Transcultural Medicine (4 weeks)
OB (6 weeks)
OB Night Float (2 weeks)
Surgery (4 weeks)
ER (4 weeks)
NICU (2 weeks)
Ambulatory Med (2 weeks)
Med Service (16 weeks)
Med Service Night Float (4 weeks)
Peds Night Float (2 weeks)
Inpatient Peds (4 weeks)
Outpatient Peds (2 weeks)
R-2 Year
Gynecology (4 weeks)
OB (6 weeks)
OB Night Float (2 weeks)
ICU (4 weeks)
Ortho (4 weeks)
Med Service (2 weeks)
Ambulatory Med (2 weeks)
Rural (6 weeks in Bethel or Dillingham)
Outpatient Peds (2 weeks)
Inpatient Peds (4 weeks)
Peds Night Float (2 weeks)
Practice Mgmt (2 weeks)
Electives (4 weeks)
Psychiatry (4 weeks)
Specialty Clinics (4 weeks)
R-3 Year
Transcultural Med (4 weeks)
Cardiology (2 weeks)
ER (4 weeks)
Rural (8 weeks)
Inpatient Chief (8 weeks)
Ambulatory Med (4 weeks)
Ortho (4 weeks)
Surgery (4 weeks)
Senior Night Float (4 weeks)
Elective (8 weeks)
Dermatology (2 weeks)

Night Float/Call
Night Float is utilized during the week and weekends are covered by a traditional call system.

R-1 Year
4 weeks total during Medicine,
2 weeks of OB night float,
2 weeks of Pediatrics night float
R-2 Year
2 weeks of OB night float,
2 weeks of Pediatrics night float
R-3 Year
4 weeks total as Medicine Senior

General Surgery
We complete surgery training with competence in surgical decision-making and assisting through both OR experience and surgical clinics. Residents are paired with community surgeons for this one-on-one training. The residency also requires all residents to successfully complete the Advanced Trauma Life Support course prior to graduation.

Adult Medicine
The family medicine service at Providence provides a comprehensive general internal medicine experience throughout the three years. We work closely with hospitalists, community attendings and program faculty. We manage patient care throughout their hospitalization, including in the ICU. In the R1 year we develop a solid base of understanding the management of the hospitalized patient. During the second year we solidify skills in advanced medical management, critical care and enhanced procedural skills. During the R3 year each resident serves as the team leader on the inpatient service. This helps develop a broader and more sophisticated understanding of patient care while teaching interns.

Obstetrics-Gynecology
Obstetrical experience is gained primarily at Providence Alaska Medical Center. The Maternity Center averages 230 deliveries per month and on-deck residents are involved in all aspects of low and high-risk OB care, including surgical obstetrics. Residents interested in cesarean delivery competency have arranged for additional experiences through other institutions. The gynecology curriculum is taught in a variety of care settings. These include the Family Medicine Center, private physician offices, rural rotation locations and other organizations that partner with the residency.

Orthopedics/Sports Medicine
Orthopedics and sports medicine are integral parts of our residency training due to the community’s active lifestyle. We work with two large orthopedics groups, as well as Alaska Native Medical Center, to provide residents with comprehensive training. Residents learn detailed exam skills, casting techniques, X-ray interpretation and surgical management. Sports Medicine is integrated throughout the three year curriculum.

Pediatrics
A strength of the curriculum, pediatrics is taught in multiple venues throughout the three years. Training consists of treating pediatric patients in both inpatient (this includes the PICU) and outpatient settings throughout all three years. Residents work with family physicians, pediatricians and pediatric intensivists. We get extensive experience caring for newborns as part of the obstetrics and NICU rotations as well. Pediatric patients are also a significant part of the population served at the Family Medicine Center and on rural rotations.

Rural Experience
There is no substitute for direct rural experience. The residency encourages as much rural experience as is allowed by the Graduate Medical Education guidelines. A six-week block in the R2 year is spent in either Bethel at the Yukon-Kuskokwim Delta Regional Hospital, or in Dillingham at Kanakanak Hospital. The experience includes heavy patient volumes, pathology rarely seen elsewhere, frequent patient transport (often in adverse weather conditions), obstetrics, village site visits and the challenging task of evaluating patients by phone through discussions with community health aides. R3’s spend eight weeks in rural rotations elsewhere in Alaska, often being one of only a few physicians, hours from the nearest major medical facility. These rotations help residents to understand the uniqueness of delivering health care in bush and rural Alaska.

Specialty Clinics
A unique, integrated rotation during the second year allows each resident to participate in a variety of specialties. ENT, ophthalmology, and urology are all represented on a weekly schedule. The design allows residents to follow individuals seen in specialty clinics over time so that responses to therapy, complications, and outcomes are experienced with continuity. Training occurs in both private offices and public clinic settings providing residents with multiple perspectives on the delivery of health care. A two week rotation during the third year in Dermatology provides residents with comprehensive experience identifying and treating common skin conditions, as well as the opportunity to gain experience with dermatological procedures.

Trans-Cultural Medicine
Trans-cultural medicine is a curriculum unique to the Alaska Family Medicine Residency held during December/January for all R1 and R3’s. It integrates Alaskan geographic, ethnic, environmental and political issues into components of cultural competency, wilderness and survival medicine, rural and remote medical skills, and complimentary/alternative medicine practices. The faculty tailors each course to the needs of the individual year. During this time, R2’s take all in-patient hospital call so as to promote teambuilding and protect R1 and R3’s from burnout. Wilderness Medicine Training with snow-cave building and winter camping occurs during this rotation.

Electives
AKFMR elective policy states that a resident may do any medical elective they desire in the state of Alaska with an MD/DO overseeing them, as long as it fits within RRC guidelines. This flexibility in establishing rotations allows residents to personalize and tailor their training to fit personal interests or particular needs. If a resident desires to receive training in a field or subject that is not adequately taught in the state of Alaska, they may go “outside” (the lower 48) after special consideration.

Behavioral Sciences
The behavioral science curriculum is integrated throughout all three years of residency. It includes didactic sessions on common behavioral issues and experience with an on-site behavioral scientist at the Family Medicine Center for consultation and other educational activities. Each resident is also required to successfully complete a psychiatry rotation. The behavioral and social aspects of health and disease are emphasized in all areas of training, whether a subspecialty elective or core rotation.

Emergency Medicine
Our emergency medicine rotations take place at Alaska Native Medical Center or one of three locations outside of Anchorage, and Providence Alaska Medical Center. Airlift transport via fixed wing plane and helicopter are common activities at all sites. All residents become certified in ACLS, ATLS, ALSO and NRP.

Osteopathic Education
The Alaska Family Medicine Residency is a dually accredited program – we are accredited by both the ACGME and the AOA. Osteopathic residents have the opportunity to utilize and develop their OMT skills in all patient care settings. Our osteopathic residents are expected to integrate osteopathic concepts and OMT skills into the medical care and management of their own panel of patients at the Providence Family Medical Center. The center also hosts an OMT clinic twice a month where appropriately referred patients can receive OMT, and our osteopathic faculty and residents can share, compare and develop their OMT skills.

Patient Centered Medical Home
The Family Medicine Center is an NCQA Accredited Level 3 Patient Centered Medical Home (PCMH). This model helps ensure that our residents learn ambulatory care in a supportive, challenging and pertinent environment. Residents have been and continue to be involved in all aspects of developing the PCMH – increasing practice management skills which will be essential to success in their future practices.