The North Oakland Medical Centers Family Medicine Residency is a three-year program with six positions available each year. The program is a major affiliate of the Wayne State University School of Medicine. All required rotations are available at the main hospital campus.

Program Goals

The mission of the North Oakland Medical Centers' Family Medicine Residency program is to educate its graduates to be competent, caring, dedicated and effective family physicians. This goal has several dimensions:

• To provide comprehensive health maintenance and continuing medical care to entire family units.
• To acquire the scientific and humane concepts of family medicine as derived from other medical and non-medical sources, as well as the growing body of knowledge developed by family medicine research.
• To educate patients on the essentials of routine health maintenance and good health care practices.
• To assume an advocate's role with respect to problems of patients and families.
• To use appropriate consultation and referral, while coordinating the overall care of the patient.
• To assume a community orientation to one's practice, wherein patients are viewed as a part of the larger community's concerns and needs.

The Curriculum

In order to accomplish the program goals, the curriculum reflects the program's philosophical dimensions. There is a balance in the education of the resident reflecting the diversity required in actual practice. The curriculum accents all three facets of family medicine activities hospital-based, office-based, and community-based. The curriculum is updated as necessary to reflect the changing requirements of the accrediting boards.

First Year
4 months	Internal Medicine
2 months	Inpatient Pediatrics
2 months	Obstetrics
2 months	Surgery (inpatient & outpatient)
1 month	Emergency Medicine
1 month	ICU
	One-half day per week in the Family Medicine Center

Second Year
2 months	Family Medicine
1 month	Occupational Medicine
1 month	Emergency Medicine
1 month	GYN
4 months	Internal Medicine
1 month	Dermatology
1 month	Hospice & Palliative Medicine
1 month	Medicine Subspecialty Elective
	Two one-half days per week in the Family Medicine Center Continuity experiences during the second year include: Extended Care Facility, Community Medicine, Scholarly Activity and Management of Health Systems

Third Year
4 months	Electives
2 months	Internal Medicine (Chief Resident)
1 month	Inpatient Pediatrics
1 month	Cardiology
1 month	ENT/OPHT/URO/MHS
1 month	Orthopedics
1 month	Outpatient Pediatrics
1 month	Sports Medicine
	Three one-half days per week in the Family Medicine Center

A Closer Look

Internal Medicine

The Internal Medicine Service is coordinated by the family medicine residents. Each resident usually follows six to eight patients. During the residency, ten months are spent on general internal medicine. Family medicine residents fully manage these patients with the supervision of the program director, faculty, and attending internal medicine and family medicine staff. For two months in the third year, each resident serves as chief resident of the Internal Medicine Service.

A diverse group of medical patients will be seen, which offers excellent exposure to general as well as subspecialty internal medicine.

Daily morning report is conducted to discuss new admissions and any problems from the preceding 24 hours. Teaching rounds are conducted at least three times per week by faculty, internal medicine and family medicine attending staff. Radiology and EKG rounds alternate every other week. Other general internal medicine and subspecialty topics are covered during the noon conference series.

Obstetrics/Gynecology

First-year residents spend two months on the inpatient obstetric service. During this time residents are exposed to normal and high-risk labor, deliveries and post-partum care. Residents care for patients under the supervision of the ob/gyn faculty and staff.

Additionally, a large amount of obstetrics experience is obtained as residents see ob/gyn patients in the Family Medicine Center with family medicine and ob/gyn staff as advisors and consultants. Obstetric electives are available and encouraged for residents planning to practice obstetrics after graduation.

Second-year residents spend one month on outpatient gynecology. During this time the resident is exposed to outpatient gynecology in private gynecologists' offices and in the gynecology clinic. Appropriate procedures such as colposcopy and endometrial biopsy are taught.

Pediatrics
Residents spend two months in the first year and one month in the third year on the inpatient pediatric service. While on this service, residents are responsible for patient care under the supervision of pediatric faculty and attending staff.

General Surgery
Two months of general surgery experience are provided in the first year. Residents are exposed to inpatient and outpatient surgery with emphasis on preoperative and postoperative surgical care, major surgical procedures, and outpatient surgical skills useful in family medicine. Residents also learn to evaluate acute surgical problems under the supervision of the surgical faculty.

Emergency Medicine
Residents spend a total of two months, one month in the first year and one month in the second year, in the Emergency Center. Working shifts are scheduled to provide high patient volumes. Emphasis is placed on evaluation of acute problems in an emergency room setting and procedural skills. Supervision is provided by full-time emergency medicine staff physicians.

Orthopedics
One month in the third year is spent on orthopedics. During this time residents are exposed to inpatient and outpatient care of orthopedic problems, with an emphasis on evaluation and treatment of problems commonly encountered in the outpatient setting. Residents are assigned to a staff orthopedist who acts as preceptor.

Critical Care
First-year residents spend one month in the hospital critical care area where 16 beds are available for medical education. Residents are assigned patients to follow under the supervision of full-time staff intensive care specialist. Teaching rounds are made daily along with interactive discussions of a group of critical care topics.

Behavioral Science/Psychiatry
Behavioral science/psychiatry is integrated throughout the curriculum. Residents are exposed to community mental health resources during the integrated Family Medicine rotation.

As part of their family medicine training, residents see patients with mental health problems in the Family Medicine Center. A faculty behavioral scientist is available for individual and group consultation and therapy along with the resident physician.

A bi-monthly Medical Ethics conference addresses the complicated diversity of the doctor/patient relationship, and potential ethical/behavioral dilemmas in providing medical care. Additionally, a monthly Well-Being seminar focuses on assisting residents in developing a repertoire of coping behaviors and stress management techniques to balance relational, professional, and leisure pursuits. Supervision is provided by a faculty psychologist, family physicians, and staff psychiatrists.

Family Medicine
Patient care in the Family Medicine Center is an important part of training in family medicine. Residents assume primary responsibility for the care of Center patients, under the supervision of the family medicine faculty (which has no other patient care or administrative duties while precepting residents.) Emphasis is placed on: preventative care and health maintenance, diagnosis and treatment of medical and psycho-social complaints of all ages, and appropriate procedures (such as sigmoidoscopy, colposcopy, minor surgery, etc.)

First year residents are assigned to the Family Medicine Center one-half day per week. In the second year, two one-half days per week are spent in the Family Medicine Center on all rotations except for the Family Medicine rotation where residents spend five half days per week in the Family Medicine Center. Third-year residents spend three one-half days per week seeing patients in the Family Medicine Center.

Electives
There are four months of electives available in the third year and one month in second year. Electives may be used to add to training in required rotations or enhance areas of special interest. Residents may choose one month electives in the following areas: allergy, anesthesia, cardiology, community medicine, emergency medicine, endocrinology, gastroenterology, geriatrics, gynecology, hematology/oncology, infectious disease, laboratory medicine, obstetrics (including high risk), pediatric developmental assessment, physical medicine and rehabilitation, proctology, pulmonology, radiology, radiation oncology, sports medicine, and family medicine preceptorships. Other electives may be arranged on an individual basis to fit special needs.

Scholarly Activity Residents are required to participate in a scholarly activities project as a graduation requirement. This involves the design and completion of a simple research project or submitting for publication a review article or case study. A yearly research workshop and regularly scheduled lectures are available to help residents with research topics, design, and presentation. Funding is available for resident research through North Oakland Medical Centers' medical staff, and through other funding organizations. University affiliations allow for use of faculty and consulting staff that may be necessary for certain projects, along with facilities such as animal labs. A yearly Research Day presents a forum for discussion of research results along with prize awards and regional representation for the best project.

Technology Resource technology has become an integral part of the practice of medicine. Residents are given the opportunity to become proficient in the use of computers. Appropriate equipment and resources are available in the hospital and Family Medicine Center for resident education and use. An E-mail address and Internet access is provided for all residents. A stipend to purchase an electronic handheld palm devices are provided to each resident for scheduling, phone directories, documentation of procedures and access to medical databases, and other valuable information.

Faculty
There is a full-time program director and four full-time faculty physician positions. All faculty members see patients in the medical center and Family Medicine Center to keep their clinical skills current. The faculty have varied interests including computers, geriatrics, research and sports medicine. Additionally, there is a full-time behavioral science faculty member.

Each resident is assigned to a physician faculty advisor when beginning the program. The faculty advisor meets routinely with each resident to assess performance, completion of graduation requirements, and for career planning.

Resident Organization/Peer Review
The family medicine residents have a resident organization to discuss and present subjects of mutual interest and governance. An administrative chief resident is elected annually by the residents. The administrative chief is in charge of the resident organization and acts as liaison with the faculty and staff. Residents also conduct peer review which exposes them to the review process of medicine, and improves patient care.

Moonlighting
Moonlighting is allowed on a individual basis with the approval of the program director. Opportunities are available locally and within the organization.

Conferences
Conferences and other group learning activities are held every day for one hour from Monday through Friday. The conference curriculum is developed to ensure meeting the requirements for Family Medicine education, and to prepare the residents to pass their boards.

The topics from the curriculum are repeated approximately every two years. The conference list is reviewed by the faculty, with resident input, yearly to meet the changing educational needs.

Specialty Conferences are offered by other medical center departments (e.g. medicine, surgery, obstetrics). Additionally, SEMCME (a medical education consortium with which NOMC is affiliated) conducts a yearly research forum and Family Medicine Review that residents are encouraged to attend.

APPLICATION PROCEDURE

We have six first year positions per year.

The application deadline is December 31st.

General application requirements:

1. All applicants to our program must be registered with the Match.
2. Applications must be submitted through ERAS (Electronic Residency Application System) and should include all of the following:
   • Completed ERAS application and personal statement
   • Medical School Dean's Letter
   • Official transcripts from all medical schools attended
   • An official USMLE transcript with results of Step I and Step II, (no minimum score requirement)
   • Three letters of recommendations from physicians
3. Applicants to our program must be either a U. S. Citizen, permanent resident, or be eligible for a J-1, or H-1 visa. We will assist in completing paperwork required to obtain a H-1 visa, but are unable to provide the attorney fees and other fees involved in the process.