Madison Residency Curriculum

First Year

Partnership System

On entry into the residency, all residents are partnered with another entering resident from their clinic for many of our first-year inpatient rotations and the Community Health rotation. The residents in the partnership assist each other in managing their multiple responsibilities, and often are important sources of support for each other.

First-year residents rotate through curriculum blocks in:

• Family Medicine Inpatient Service at St. Mary’s Hospital
• Family Medicine Inpatient Service at UW Hospital and Clinics
• Medical Intensive Care Unit Service at St. Mary’s Hospital
• Pediatric Inpatient Services at St. Mary’s Hospital and American Family Children’s Hospital
• Inpatient Pediatric and Family Medicine Services Nights at St. Mary’s Hospital
• Obstetrics at St. Mary’s Hospital
• Rural Surgery Preceptorship
• Emergency Medicine at a community hospital and at St. Mary’s Hospital
• Community Health
• Family Medicine Obstetrics and Newborn Service at Meriter Hospital

Residents also attend a weekly family medicine seminar that provides a comprehensive orientation to family medicine and ambulatory care.

Outpatient Responsibilities

Residents begin building a continuity practice at one of our four family medicine clinics (FMCs) during their first year. Each center operates as a group practice, with emphasis placed on the resident partnership system and on a team structure to facilitate continuity of care, awareness of complex patients, and after-hours coverage. Working with physician faculty, nurse practitioners, physician assistants, and behavioral science faculty allows the residents to experience a multi-disciplinary approach to patient care. First-year residents average two half-days per week at the family medicine center.

Second and Third Year

Inpatient Responsibilities

The second- and third-year curriculum is well established and flexible. Residents spend fewer blocks on hospital rotations and have more opportunities to teach and supervise inpatient care.

Outpatient Responsibilities

While on inpatient rotations, second- and third-year residents are scheduled in the FMC two times per week. During outpatient and elective rotations, second- and third-year residents are generally scheduled to see patients in the FMC four half-days per week. Most subspecialty outpatient rotations are scheduled for five half-days per week. An example of a typical week is five half-days of outpatient rotation, four half-days in the FMC, and one half-day for Primary Care Conference and Family Medicine Seminars (Wednesdays).

There are a wide range of options available for fulfilling requirements during the second and third year, including:

• Dermatology
• ENT
• Gynecology
• Management of Health Systems (MHS)
• Nutrition
• Ophthalmology
• Orthopedics
• Orthopedics-Related (rheumatology, physical therapy, pain management, prolotherapy, podiatry, Spine Clinic, and work-hardening)
• Pediatric Selectives
• Sports Medicine

In addition, one 3-4 week block in a Wisconsin rural practice site is required. Site options include: Beaver Dam, Dodgeville, Lancaster, Menominee Tribal Clinic, Richland Center, Sauk, Viroqua, and Watertown.

Residents also complete longitudinal rotations in community health and management of health systems.

Call for Second- and Third-Year Residents

Night call for the FMC patients are shared by all second- and third-year residents and has been consolidated into four After Hours Care rotation weeks per year.

Electives

Residents have a minimum of 24 weeks of elective time. Established electives are listed below:

• Addiction Disorders
• Allergy
• Behavioral Health
• Cardiology
• Diabetes Management
• Endocrine
• ER
• Geriatrics
• Integrative Health
• International Health
• Medical Informatics
• Neurology
• OB
• Obesity Medicine
• Nutrition
• Palliative Care and Hospice
• Practice Styles
• Psychiatry
• Radiology
• Research
• Resident as Teacher
• Urgent Care
• Urology
• Vasectomies
• Wound Care

Based on their Individualized Learning Plan, residents may complete additional weeks of rotations that meet requirements. Residents may also develop their own electives, and longitudinal electives can be arranged to meet individual educational goals.

Additional Educational Opportunities

Additional educational opportunities include weekly Primary Care Conference, family medicine seminars with a broad curriculum inclusive of the full spectrum of family medicine, clustered didactics that focus on Gynecology and Management of Health Systems, and Men’s Health in the second year, and Musculoskeletal, Addiction Medicine and Nutrition (one week) in the third year. There are also weekly teaching rounds on Monday mornings where a senior resident generally presents clinical cases that are inpatient focused, as well as some that are outpatient. An EKG teaching series is also a longitudinal part of this morning didactic.

Behavioral Science Curriculum

The behavioral science curriculum has long been a strong foundation of our program. Our family physician, nurse practitioner, and physician assistant faculty actively integrate responsiveness to the emotional needs of patients and their families into their teaching and practices, including working closely with the behavioral science faculty located at each FMC. Behavioral health care and education are not relegated only to behavioral science faculty. Physician faculty recognize, value, practice, and teach the role of the biopsychosocial approach. Integrative health faculty provide expertise in mind-body-spirit wellness and the importance of a patient-guided approach to healing.

Community Health Curriculum

Our longitudinal community health rotation features programming designed to enhance understanding of how to practice community-based medicine and work with key community resources that are important to patients. During the first year, residents participate in creating partnerships with community agencies. Residents then individualize their experience in addressing health and wellness issues associated with their FMC’s patient population. During protected time in the second and third years, residents create a personal learning plan that may include design and implementation of a community health project with the assistance of the department’s Office of Community Health, FMC faculty, other residents, and community members.

The goals of the community health rotation include the following:

• To understand the community served by the FMC
• To familiarize residents with the local resources that address community health issues
• To integrate the use of local health and social resources into clinical care
• To learn the principles of community health care team management
• To understand the impact of socioeconomic conditions on the health and well being of patients
• To understand how public health policy at the local, state, and national levels interface with patient health

Global Health

The UW DFMCH has long been a Global Health leader at the UW School of Medicine and Public Health, and our faculty and residents are active on many continents. Residents with a special interest in Global Health are encouraged to augment their training by participating in the Global Health Pathway.

Pathways in Residency Education

The Madison program has created a mechanism for resident physicians interested in specific topic areas to pursue individualized, yet structured longitudinal curricular experiences through Educational Pathways. These Pathways provide experiences and learning above the usual residency curricular opportunities in an integrated approach. Each Pathway delineates learning goals, objectives, and educational opportunities for interested residents.

Resident Support

We care about the health and well being of our residents. As such, we have many activities that are supported by the residency program, including:

• The famous mid-winter “Fizzle” Dinner, where first-year residents and their significant others mark the half-way point in the year with food and drink at a local Madison restaurant. Each intern is presented with a special award from the chief residents, and this event is always a fun time!
• Chief resident rounds bring residents together every other Wednesday before didactics to discuss pertinent issues and enjoy each other’s company. 
• A yearly resident retreat takes place over a fall weekend at an outdoors-oriented site outside of Madison. Faculty cover patient care responsibilities during the retreat.
• Wellness-based group activities are scheduled regularly during protected didactic time, including Check-in groups, Resiliency Training and Balint Groups.

In addition, the program director and all faculty and residency staff are open and available to residents for any purpose. We truly care about our residents’ quality of life as well as promoting the best educational experience.