Our Curriculum

NEW IN 2016! We have an exciting new Longitudinal Integrated Curriculum starting in July 2016. This innovative structure will improve the quality of learning and allow for more continuity of care.

FAMILY MEDICINE

INPATIENT

On the Family Practice Service at Mission Hospital, residents:

  • Work one-on-one with our family medicine faculty and pharmacotherapists
  • Work with the patient’s assigned doctor or specialist to provide comprehensive care and continuity
  • Gain procedural skills (Ex: placement of central lines, intubations, thoracentesis, paracentesis, lumbar puncture, and circumcisions)

 

OUTPATIENT

At the Family Health Center, residents:

  • See their own patients and work-ins
  • Are precepted in person and via video by faculty or their peers
  • Learn about coding and billing, practice management models
  • Access a variety of community resources
  • See patients in variety of specialty-clinics such as diabetes, metabolic, osteoporosis, colposcopy, pharmacotherapy, pain, OMT, sports medicine, geriatric assessment, suboxone, and dermatology
  • See patients in innovative group visits
  • Receive professional, timely feedback on their performance and progress
  • Gain procedural skills (Ex: skin biopsies, toe nail removal, vasectomy, joint injections, casting, laceration repair, and sphenopalatine blocks)
  • Attend weekly didactics. Topics include gout, bronchitis, diabetes, URI, hypertension, step throat,  incontinence, obesity, dementia, chronic pain, hematuria , jaundice, GI bleeding, kidney stones, and more

The payer mix for the Division of Family Medicine includes:

Private/Commericial – 15.61%
Medicaid – 28.33%
Medicare – 34.46%
Other Gov’t – 1.67%
Self – 19.93%

The following are age demographics of our Family Medicine patients:

Age 0-17   14%
Age 18-35  30%
Age 36-53  27%
Age 54-71  18%
Age 72+    11%
 

DIDACTICS

  • Weekly protected time for dynamic classroom instruction and resident support at our Family Health Center
  • Use of innovative and interactive "flipped classroom model” of teaching which includes problem-based learning, case presentations, procedure rodeos, role-play, and audience respons.
  • Supplementary DAILY morning teaching by our faculty or local specialists
  • Other Didactics activities include OSCEs, journal club, M&M, Cardiology and Peds Master clinician presentations, bi-monthly Spanish club, practice management lectures


Our Didactics curriculum is structured into 12 themed months , below:

Month Theme
July Renal-Electrolytes
August Cardiology
September Endocrine-Diabetes
October Respiratory
November GI
December Rheum-Heme-Onc
January Cardiology
February Neuro-Psych
March MSK
April GU/GYN
May Derm-ID-Allergy
June ENT-Opth

 

 

 

 

 

 

 

 

 

 

 

 

 

ADULT MEDICINE

On the adult medicine service at Mission Hospital, residents:

  • Work closely with attending physicians of the Asheville Hospitalist Group
  • Manage “unassigned” patients on the Adult Medicine Unit, cardiac and pulmonary step-down units, Med-Surg ICU, Cardiac ICU, and Neurotrauma ICU. 
  • Teams include three to four interns, a senior resident, a pharmacist, and the attending physician
  • Gain procedural skills (paracentesis, thoracentesis, intubation, central line placement, lumbar puncture, interpretation of EKGs/ABGs and more)
  • Attend daily teaching rounds and Internal Medicine conferences. Topics include: ACS, CHF, COPD, Pnuemonia, DKA, sepsis, Afib, DM, meningitis, chest pain, GIB, cirrhosis, and more.

 

PEDIATRICS

On the Pediatrics service at Mission Hospital, residents:

  • Manage normal growth and development, anticipatory guidance, and ambulatory or hospitalized children
  • Experience daily case-based instruction and supervision by the "Mission Kids" hospitalist group
  • Gain procedural skills (circumcisions, lumbar punctures, and more)
  • Attend weekly community-wide pediatric conferences, weekly neonatology seminars, and participate in online pediatric modules. Topics include: acute respiratory infection, diarrhea, murmurs, gastroenteritis, meningitis, and more
  • Participate in neonatal abstinence service for newborns

In the outpatient setting:

  • Work in pediatric practices in our community and at the Family Health Center
  • Explore Pediatric specialties in cardiology, orthopedics, obesity, hypertension, asthma, sleep, oncology, dermatology, endocrinology, neurology, allergy and asthma, developmental issues, and genetic disorders

 

OBSTETRICS & GYNECOLOGY

  • Collaborate on patient care and deliveries with our sister MAHEC OB/GYN residency program
  • Visit family planning clinics and STD clinics at the health department
  • Receive extensive experience in high and low risk obstetrics
  • Participate in the longitudinal care of prenatal patients in the Family Health Center and on Labor & Delivery
  • Gain procedural skills, including colposcopy, IUD and contraceptive implant insertion, endometrial biopsies, miscarriage management, ultrasound, vaginal repair, pessary fittings.
  • Attend monthly didactics lectures. Topics include preconception care, breast and cervical cancer screening, contraception, vulvar disease, abnormal uterine bleeding, sexual dysfunction, menopause, natural childbirth, and management of pregnancy complications and chronic disease in pregnant patients.

NOTE: Our maternity care curriculum is designed to accommodate the needs of those who are committed to practicing obstetrics, those who are sure they do not wish to practice obstetrics, and to stimulate those who are still undecided. Those residents who wish to go on to an “OB emphasis” track have the opportunity to follow additional patients at the Family Health Center as well as participate in an additional one to two months of higher risk, higher volume obstetric experience. 

 

BEHAVIORAL HEALTH

  • Practice within a national model of Integrated Care, collaborating with psychologists and psychiatrists
  • Learn fundamental skills in anticipatory guidance, supportive counseling, and caring for patients throughout individual and family life cycles.
  • Spend time in mental health clinics, addictions clinics
  • Attend Support Group, and weekly didactics lectures. Topics include ADHD, substance abuse, parenting, Anxiety, Myers-Briggs, Genogram, Depression, Bipolar Disorder, Finding Meaning in Medicine, Ethics and Motivational Interviewing.
  • Coming soon! The addition of a Psychiatry residency in 2018 will further enhance our residents behavioral health curriculum

 

SURGERY

  • Spend time with general surgeons, both in the hospital and the outpatient setting
  • Assist with surgeries, referrals, pre- and post-operative management
  • Gain procedural skills (Ex: Intubations, skin biopsy, colonospcopy, anoscopy, Vaginal Repair, Suturing, Simulation Lab)
  • Attend quarterly Procedure Rodeos in Didactics and practice procedures in Simulation lab setting

Coming Soon! The addition of a surgery residency in 2018 will further enhance our resident’s surgery experience.

 

 

ELECTIVES & SCHOLARLY ACTIVITY

  • Examples of resident elective time include: additional experience in medical or surgical subspecialities, seeing patients in a practice they might consider working for in the future, going on an international medical mission, or assisting in community-based care
  • All electives must be approved by the resident’s faculty advisor and program director as well as GME Office, Risk Management, and Fiscal Departments
  • Residents are required to complete a community, QI, or research project prior to graduation. Click here to learn more about the Clinical Research and Scholarly Activity of our residents and faculty!
  • CQI is the fabric of how we practice medicine. All residents will participate in team-based quality improvement projects and initiatives in collaboration with nurses and other clinical staff

 

EMERGENCY MEDICINE

  • Supervision by ER-trained physicians in the 3rd busiest ED in North Carolina (one of the busiest in the nation)
  • Improve procedural skills  with the “Fast-track team” including EKG interpretation, incision and drainage, laceration repair, fracture reduction and splinting
  • Spend time in rural ED settings of McDowell County
  • Attend ER Safety meetings and Didactics lectures. Topics include chest pain, trauma, overdose, syncope, fever/sepsis, wound management, asthma/COPD and more

 

GERIATRICS

  • Longitudinal care for elderly patients at the Family Health Center, at a skilled nursing facility and through home visits.
  • Acute care for geriatric patients in the hospital.
  • Attend didactics lectures on medications in the elderly, failure to thrive, wound care, delirium/dementia, advanced directives, physiology of aging, and Parkinson's Disease.

 

ORTHOPEDICS & SPORTS MEDICINE

  • Work with general orthopedists, hand surgeons, spine specialists, physical therapists, chiropractors and podiatrists
  • Administer sports physicals and provide side-line care at local sporting events and races.
  •  Diagnose and stabilize common musculoskeletal trauma and sports injuries, and inject soft tissues and joints.  
  • Gain procedural skills (shoulder and knee injections, aspirations, splinting, casting)
  • Attend Didactics lectures. Topics include Sciatica, Sprain, osteoarthritis, plantar fasciitis, carpal tunnel syndrome,  Knee Injuries, Geriatric Trauma and Fractures, Shoulder Pain, Hip/Back Pain and more.

 

COMMUNITY & GLOBAL HEALTH

  • Provide primary care for Project Access (volunteer based health care for the underserved and underinsured) patients in our office, at Mission Hospital, and at the ABCCM free medical clinic
  • Collaborate with local schools under the School Healthy Lifestyle Collaborative
  • Visit at least 5 rural hospitals and clinics under a national Teaching Health Center grant. Housing exists at many of these sites
  • Option to attend a medical Spanish course followed by a two week trip to rural Honduras with the not-for-profit, NGO  called Shoulder to Shoulder
  • Attend monthly Spanish club meetings
  • Assist Hispanic and underserved populations with navigating the medical system
  • Attend lectures on Biostatistics, Tuberculosis, Maternal Health in the Developing World, the Burden of Poverty, Infectious Diseases of the Developing World, and Skin Disorders of the Tropics

 

SUB-SPECIALTIES

  • The primary care curriculum is accentuated by additional specialty rotations in cardiology, pharmacotherapy, ENT, nephrology, ophthalmology, dermatology, rheumatology, neurology, and urology.

 

ACGME PROGRAM REQUIREMENTS