The following describes BMC's Family Medicine program highlights:
- Off Service
- Patient-Centered Primary Care
- Reproductive Health
- Addiction Medicine
- Inpatient Adult Medicine
- Global Health
This video will help the viewer understand the experiences that our Family Medicine Residents have when rotating through non-Family Medicine services and the relationships that our Faculty and Residents have with Residents and Faculty in other Departments within the hospital.
BMC is a founding partner of Boston HealthNet, a network of 15 community health centers through Boston serving more than a quarter-million people annually. Family medicine residents have the privilege of delivering primary care at one of four state-of-the-art Patient-Centered Medical Homes: Codman Square Health Center, East Boston Neighborhood Health Center, South Boston Community Health Center, and Greater Roslindale Medical and Dental Center. While each health center is uniquely reflective of the community where it is located, they all feature a breadth of on-site resources such as behavioral health and psychiatry, radiology, vision and dental services, sub-specialty care, and wellness programs, in order to provide a comprehensive, patient-centered primary care that empowers individuals to lead healthy lives.
From the first day of training, residents are assigned a panel of patients distributed by age, gender, and diagnosis so that over three years residents are exposed to a broad patient base. This experience is at the core of the residency program. All community health centers are located minutes away from the medical center and offer diverse patient populations, teaching opportunities and learning experiences for residents. First-year residents will care for their panel of patients at least two half-days per week; second-year residents care for their panel of patients 2-4 sessions per week, and third-year residents 3-5 times per week. Residents are responsible for patients in whatever setting they present, whether office, home, nursing home, or tertiary care center. This orientation also extends to addressing unmet health care needs in our community, including coordination with schools, churches, and industry, and conducting innovative outreach to vulnerable populations. A strong emphasis is placed on the active management of patients within integrated service systems, especially as they apply to the needs of the undeserved.
Check out this news piece involving PGY-3 Julian Gonzalez, MD at Greater Roslindale Medical and Dental Center https://vimeo.com/444253098
Maternal/child health and maternity care are vital pieces of the work that we do in Family Medicine. Our department is strongly committed to training family doctors who are well-prepared to continue this work upon graduation.
All of our Family Medicine residents participate in continuity deliveries, providing a special opportunity to connect with patients and families. Each of our residency training sites offers prenatal care. Centering Pregnancy group prenatal care is offered at both Codman Square Health Center and Boston Medical Center, and Codman Square also offers Centering Parenting group visits.
At Boston Medical Center, we have a unique collaborative model of care on Labor and Delivery that is rooted in close teamwork with our OB/Gyn and Midwifery colleagues. As a resident trainee, you are integrated into a Labor and Delivery team that also includes OB residents and ED residents. The team is supervised 24 hours/day by a collaborative group of Family Medicine, OB/Gyn and Midwife attendings.
You will gain experience both in low-risk labor management and births, as well as high-risk maternity/obstetrics care and management of common complications. We have a total of 18 Family Medicine attending providers working on Labor & Delivery, 7 of whom are fellowship-trained operative providers who perform cesarean deliveries and tubal ligations. We have a high volume of deliveries and plenty of opportunities for learning, with a total of 2,841 deliveries in AY20. The expectation is for residents who are seeking OB competency to participate in at least 80 vaginal deliveries, and at least 20 vaginal deliveries for residents seeking OB-exposure.
We have a busy Family Medicine Mother/Baby Service that focuses on postpartum care of mother and infant dyads. We care for a number of patients with complex social and medical challenges, including opioid use disorder. You will gain expertise in caring for infants with neonatal abstinence syndrome. Boston Medical Center is proud to be a Baby-Friendly hospital (with re-designation confirmed in 2019), and there is a strong focus on supporting breastfeeding.
All residents gain experience in providing women's health and contraception in their continuity clinics and have exposure to the full spectrum of reproductive health care during their 2nd-year Gynecology rotation. Residents interested in gaining advanced experience in reproductive health can opt to participate in a structured reproductive health elective as well as additional sessions with a Family Medicine provider in the gynecologic procedures unit. Some residents have also opted to arrange away electives to further advance their reproductive health skills.
With support from the Massachusetts League of Community Health Centers, the BMC Family Medicine Residency program is working to expand training in addiction medicine for its FM residents. During their time at BMC, FM residents will learn to care for patients with a range of substance use disorders (SUD) including but not limited to opioids, alcohol, tobacco, and cocaine, in both the inpatient and outpatient/ambulatory settings. They will have opportunities to rotate and spend elective time on various BMC related addiction services, including the addiction consult services, Faster Paths (urgent care for SUD), Project Respect (prenatal clinic for patients with SUD), and Catalyst and SOFAR clinics (for adolescents with SUD). All residents are required to take the SCOPE of pain lecture by Dan Alford, which specifically addresses diagnosis and management of chronic pain. Residents at South Boston Community Health Center will provide pain and addiction management to their primary care patients. We are also working to incorporate resident involvement in office based addiction treatment at Codman Square Health Center.
As a program, we recognize that the three years of residency are always stressful. We have implemented teaching and programs to try and ease that stress with overseen by Associate Program Director and Wellness Director, Avra Goldman MD and Associate Director of Psychosocial Training Carol Mostow LICSW. These include support groups for each class, regular Balint groups, facilitated sessions to support communication and support on our in-patient team, mindfulness training and other modalities, an advisor and mentoring system, and frequent behavioral health teaching and support. In addition, each resident is encouraged to set up appointments with a primary care physician and the program helps interested residents adjust their schedules to access individual counseling. We , your advisors and other faculty collaborate to assist each resident's professional and personal growth and development; together we commit to help each resident's journey to become well-rounded, happy and healthy family doctors.
In this video you will hear about the structure of our Family Medicine-run Inpatient Medicine Service at Boston Medical Center, the patient population that our teams care for, the learning that takes place due to inter-disciplinary team support as well as the progressive model of supervision and teaching that our inpatient structure provides.