Family Med Hendersonville - Curriculum

Internal Medicine

Intern year: four weeks of inpatient medicine with a hospitalist group at Mission Hospital in Asheville, as well as eight weeks on the inpatient family practice service in Hendersonville.

Second and third year: 12 weeks of inpatient medicine each year, as well as core rotations in cardiology and critical care. All residents complete ACLS course.

Residents also see patients in a local nursing home and often make home visits.

OB/GYN

Intern year: four weeks of labor and delivery at a Women’s Hospital in Greensboro, as well as four weeks of outpatient antenatal care and L&D in Hendersonville.

Second and third year: four weeks of gynecology at the Health Department and a local OB/GYN clinic.

Extensive experience managing labor and delivery as our inpatient service covers obstetrics. There is approximately one birth per call over three years. Deliveries are done with midwives, family physicians, and obstetricians. Residents participate in vaginal deliveries, vacuums, forceps, and C-sections. Continuity prenatal care is done at the Family Health Center and at the Health Department beginning the second half of intern year.

Additional opportunities exist to rotate through high-risk clinic and to learn ultrasound. All residents complete ALSO course.

Pediatrics

Intern year: three months of inpatient pediatrics at Mission Hospital in Asheville. Excellent teaching by pediatric hospitalists, intensivists, and sub-specialists. Residents become very comfortable with newborn care, management of routine and complicated sick children, and coordination of care with specialists.

Second and third year: ongoing inpatient peds experience on the inpatient service in Hendersonville. Thriving OB practice means that many children are recruited by residents into clinic after participating in deliveries. Additional outpatient experiences at the local Health Department and a month long rotation at a private pediatrics practice. Opportunities exist to learn neonatal resuscitation and attend C-section deliveries. All residents complete PALS and NRP course.

Behavioral Medicine

Three behavioral health faculty currently see patients in the Family Health Center and are available for consults on clinic patients. Residents often schedule joint visits with behavioral health faculty for complicated patients. A psychiatrist is available weekly in clinic for consults and questions. Residents also lead group visits for behavioral health issues. Two months of community medicine and behavioral health provides experiences in counseling patients and teaches residents about available community resources.

Emergency Medicine

One month during intern year and another during second year in the second busiest ER in western NC. Active management of routine and critically ill patients, as well as lots of procedural experience. Residents often do additional procedures in the ER while on call for the inpatient service.

Surgery

Intern year: two months learning colonoscopy and endoscopy, as well as learning inpatient and outpatient management of surgical problems.

Residents participate in surgery and have the opportunity to learn basic anesthesia and intubation in the OR.

Third year: core rotations in urology, ophthalmology, and otolaryngology.

Orthopedics

Two months in the second year learning outpatient management of orthopedic problems. Residents also participate in surgery, and rotate through sports medicine clinics and physical therapy.

Practice Management

Low-overhead patient centered model. Residents become adept at coding, billing, personnel management, patient flow and satisfaction. Program participation in P4 initiative where residents work to integrate EMR and low-overhead model in local small rural practices. One month rotation during third year focuses on skills necessary to run a practice.

Community Medicine

Residents see patients in a variety of locations throughout the three years, including the Family Health Center, Henderson County Health Department, the Homeless Shelter, and the local Free Clinic. Continuity often exists at all of these locations. There are multiple other opportunities to be involved in the community on a volunteer basis, including the local Community Health Center and Migrant Clinic. These experiences may involve office medicine, or often extend into field clinics and home visits.

A two month rotation in second year provides focused experience in learning about community programs and resources.

International Medicine

Residents can travel to rural Honduras through Shoulder to Shoulder as early as the intern year. Didactics include monthly lectures on international medicine topics. Most faculty have experience practicing abroad. There is a large local population of native Spanish speakers with ample opportunity to learn medical Spanish. Relationships exist with physicians in Central America and Africa for possible away electives.

Wilderness Medicine

Monthly didactics as well as periodic workshops and outings. Opportunity to teach lectures for a wilderness EMT course. Close relationship with local outdoor education center for both teaching and learning. Close proximity to State Parks and Forest, National Park and Forest, and multiple wilderness areas.

New residents do one four-week block of internal medicine and two six-week blocks of inpatient pediatrics at Mission Hospital, a 500-bed tertiary care hospital in Asheville. Eight weeks of inpatient medicine is done in Hendersonville at Pardee Hospital, a busy 200-bed community hospital. Teaching is done on a one-on-one basis by attending physicians, both family practitioners and specialists, as well as family medicine residents. Family Medicine and OB/GYN are the only training programs at Mission Hospitals; therefore residents have access to a wide range of in-house medical cases and experiences. Other rotations in the first year include integrated blocks of surgery and OB/GYN, and inpatient neurology. Residents spend one or two half-days a week seeing patients at the Hendersonville Family Health Center throughout the first year of the program.

The next two years of training are entirely based in Hendersonville, where the emphasis switches from the hospital to an outpatient and community setting. Some rotations in the second year are structured over a two-month time period. Learning becomes an integrated process, with different approaches and techniques for solving a clinical problem considered as the patients and circumstances vary. Community attendings have great flexibility to cluster illustrative teaching cases over a three-month period. The PGY-2 year includes a rotation in the ICU for training in critical care medicine to give you the confidence and experience in stabilizing critically ill patients, especially since specialists may not be available in more rural settings.

The final year of residency training at the Hendersonville Family Medicine Residency Program is designed with two principal goals. First, all of the in-town rotations are structured with a 'rounds-clinic/office-call' type of schedule to prepare you for the expected routine of practice after graduation. Secondly, the third year also has ample flexible elective time (four months) to allow you to fill any perceived knowledge gaps and strengthen areas of interest.