Family Medicine Residency - Forbes: Curriculum

Our program's primary goal is to help you develop professionally and personally during your training with tools you will use throughout your career.

As a Forbes Family Medicine resident, you will learn to provide top-quality, comprehensive patient care, both by treating illness and by promoting ongoing health maintenance for families. You will use principles of population management and community outreach to improve the health of our community. Our integrated curricula for medical and behavioral health, evidence-based medicine and leadership development ensure that all residents learn and practice skills that are needed to succeed and lead in the evolving environment of American health care.

The curriculum's range and flexibility also allow you to pursue additional experience in areas of particular interest such as our special tracks in women's health and sports medicine, and added exposure in LGBTQ health and correctional medicine. Because we value your ability to tailor your education, we offer 8 electives over the course of residency.

Forbes Family Medicine Center
AHN Forbes Hospital
Clinical Rotations

Special tracks:

Women's Health Track
Sports and Exercise Medicine Track
Primary Care Sports Medicine Fellowship Partnership
Didactic Learning Experiences (Conferences)

Forbes Family Medicine Center

Forbes Family Medicine is our group practice and is the hub of your outpatient experience as a resident. In addition to building your own patient panel here, you will work elbow-to-elbow with your faculty as they see patients. The Center is just off the hospital campus, allowing easy access to both sites. The office was renovated recently, and its 8,000 square feet includes 15 patient exam rooms, including dedicated rooms for OMT, counseling, and procedures.

Patient care

Residents spend increasing time in the Family Medicine Center throughout residency. First-year residents initially spend one half-day per week, advancing to 2 half-day sessions by the end of internship. On average, second-year residents spend 3 half-days in the office and third-years will have an average of 5 half-days. The number of patients per session also increases with increasing experience, in order to maximize your proficiency with a wide variety of patient ages and conditions.

Procedures

You will get experience with a range of office procedures. We provide gynecologic procedures including insertion and removal of long-acting reversible contraception (LARC), such as Nexplanon and IUDs, and other gynecologic procedures including colposcopy and endometrial biopsies. You will also learn joint injections, skin biopsy techniques, incision and drainage of abscesses, cyst excisions, toenail removal and newborn circumcision.

OMT clinic

Osteopathic residents (and interested allopathic residents) are encouraged to utilize osteopathic techniques in the course of patient care, but we also support a dedicated OMT clinic 1 sessions per week. Family medicine faculty with OMT expertise supervise this clinic and provide additional scheduled instruction.

Integrated behavioral health

As effective assessment and treatment of patients’ mental and emotional health is crucial to maximizing total health and wellbeing, we have several avenues to integrate behavioral health services in the office. Our full-time behavioral health faculty sees patients with residents and is available for acute needs. All rooms are equipped with video cameras for additional opportunities for patient interactions to be observed. 

Patient services

The office offers full laboratory services with several point-of-care tests available to maximize efficiency as well as audiometry, spirometry and similar evaluations.

Residency services

In addition to the patient care areas, the Family Medicine Center houses faculty offices and residency administration staff, a large resident work area and a small exercise room with equipment. We also have a large conference room with a kitchen which we use for community outreach events.

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Forbes Hospital

Forbes Hospital has a rich tradition of serving the community of Monroeville and Pittsburgh’s eastern region. The hospital has always offered obstetrics, inpatient pediatrics and inpatient psychiatry services. With the addition of a level 2 trauma center, cardiothoracic and neurosurgery programs, a cancer center, rehabilitative services and increasingly busy emergency department, Forbes Hospital provides comprehensive care in a community hospital atmosphere. Forbes Family Medicine residents are active and visible in every unit of the hospital; in addition to our inpatient family medicine service, our residents provide integral care on the pediatrics and nursery units, labor and delivery, the ICU and in the ED. They also respond to and manage codes for unstable patients throughout the hospital.

AHN surgery, emergency medicine, anesthesia, psychiatry, and podiatry residents rotate through their respective services at Forbes. Interactions among residents enhance the learning opportunities without competing for experiences – there is enough to go around. However, as family medicine is a constant presence in the hospital and our residents provides “eyes and ears” about hospital operations, especially after hours, the FM residents are welcome contributors to hospital committees, initiatives and community outreach programs. These opportunities enhance our leadership curriculum.

Clinical rotations

Our rotations are organized in 3-week blocks. The curriculum for each year of the Family Medicine Residency Program is as follows:

First year

First-year rotations are designed to reinforce and expand the knowledge and skills acquired in medical school with inpatient experience in adult medicine, pediatrics, obstetrics, and emergency medicine. The care of families is introduced at the Forbes Family Medicine Center with one and then two half-day sessions per week.

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Second year

In the second year, the program emphasizes expanding your knowledge in core family medicine topics including inpatient pediatrics, adult medicine, and obstetrics while increasing your responsibility as a senior resident. Additional ED time, and 2 months of electives round out this year. During this year, you will begin to serve as a supervising physician and teacher for first-year residents and medical students. You will receive specific training in teaching techniques to prepare you for this role. Throughout the year you will spend an average of 3 half-days per week in the Family Medicine Center.

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Third year

The program's third year gives you advanced clinical practice experience and more time in the Forbes Family Medicine Center. In addition to the required medical and surgical subspecialty rotations, you will choose or design electives to expand your knowledge in previously introduced areas or integrate new ones of special interest.

The third-year curriculum includes an average of five half-days per week in the Family Medicine Center and the following rotations:

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Electives:

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Maternity care / Women's health track

Forbes Family Medicine Center has a long and rich history of teaching women's health. Back in 1994 we received a U.S. Health and Human Services grant to develop a comprehensive curriculum in women's health for the residency. We now offer a Women’s Health Track, where rotation electives are used in concert with readings and community experiences to allow enhanced, resident-directed learning about obstetrics, gynecology, or overall women’s health.

1. If interested in possibly going on to OB fellowship, it is suggested that you gain more experience in OB/Gyne procedures such as vacuum extractions, perineal laceration repairs, cesarean sections, tubal ligations, D&Cs, office ablations, etc.
2. A High Volume OB Elective at West Penn, Forbes, or Jefferson, OR a Gyne Elective in a private OB/Gyne doctor’s office (ESOB, Clark, Logan) can each include other experiences such as: The Midwife Center (TMC, a freestanding birth center), Allegheny County Jail, infertility clinic, the adolescent unit at Children’s Hospital, or an abortion provider (Allegheny Reproductive, Planned Parenthood, or AHN Family Planning Clinic). 
3. Women’s Health includes issues beyond reproductive health, including: rheumatology, hematology – oncology, uro-gynecology, breast health, sports medicine, preventive care, sexual medicine, behavioral medicine (eating disorder, IPV, sexual abuse, sexual dysfunction, PTSD, and addiction). Elective time can include these topics and/or PAAR (Pgh Action Against Rape), Women’s Shelter, food bank, homeless shelter, etc.

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Sports and Exercise Medicine track

Musculoskeletal complaints are one of the top reasons patients choose to see a physician. Musculoskeletal medicine is an extremely important, but often overlooked, rotation in family medicine residencies. We offer a Sports & Exercise Medicine Track for residents interested in pursuing sports medicine fellowship or who want to learn advanced MSK and sports medicine care.

Residents are exposed to a wide range of sports medicine opportunities through collaboration with AHN’s primary care sport medicine fellowship. As the school district physicians for Gateway (Monroeville, PA) and Franklin Regional (Murrysville, PA) School Districts, the residency performs their pre-participation physicals. Our residents aid in sideline coverage for Gateway and Franklin Regional High Schools. Additional opportunities for sports track residents include: Westmoreland County Wrestling Tournament, the Great Race, Pittsburgh Marathon, and pre-participation exams for other AHN schools. Training room sessions are held, when needed, once weekly and sports medicine track residents help with these evaluations. Sports track residents have an additional rotations where they gain further experience and resume-building for fellowship applications.

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Primary Care Sports Medicine partnership

In partnership with Allegheny Health Network’s Primary Care Sports Medicine Fellowship, Forbes Family Medicine hosts one PCSM fellow each year. The fellow sees their continuity patients in our office. The fellow works with sports medicine-interested residents, mentoring them and working on scholarly activity. Osteopathic fellows help teach OMT clinics within the residency. Game and training room coverage for the fellow occurs at a high school in close proximity to the residency. This partnership provides a unique opportunity, for the residents and fellow alike, to work with both a cutting-edge sports medicine fellowship AND a well-recognized family medicine residency program.

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Family Medicine conferences

All residents and faculty are excused from clinical responsibilities on Tuesday afternoons to participate in our core curriculum conferences. This 12-5 pm session provides important learning time as well as an opportunity for collegial support. The following broad categories are presented:

1. Core clinical topics: residents, faculty (including our clinical pharmacist and behavioral scientist), and outside speakers augment clinical learning with case reviews, hands-on procedure workshops, and interactive Q&A.
2. Evidence-based medicine: We hold monthly Journal Clubs that each focus on a particular type of article or EBM principle. M&M is held at least quarterly.
3. Leadership development: This curriculum introduces core skills needed for family physician leaders, including difficult conversations, emotional intelligence, conflict management, community interactions, and local and statewide advocacy opportunities.
4. Practice management meetings occur monthly and include all office staff in addition to residents and faculty. Practice quality statistics are reviewed and group PDSA cycles are instituted and reviewed.
5. “Res-Fac” is our monthly problem-solving meeting where the chief residents present issues collected from and discussed with all residents to share with the faculty.
6. Curriculum review meetings occur every other month and enable close to real-time evaluation of rotations in order to institute changes more quickly.

Additional conferences and didactic learning opportunities occur throughout the week, such as Balint (resident support), Forbes Hospital Grand Rounds, Art of Medicine, and OMT workshops.

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