Family Medicine Residency Greenville - Curriculum Overview

Educational experiences

The Family Medicine Residency curriculum is designed to provide residents with the opportunity to expand their knowledge, develop necessary skills and move forward in their career as competent and caring family physicians. The bulk of educational programming comes during patient care experiences through our block rotations and longitudinal continuity clinics, but the Prisma Health Family Medicine Greenville Residency Program also offers some unique curricular experiences that make our program stand out from others.

Patient care

Outpatient care delivery

With that, our diverse and engaged faculty strive to create a foundation for residents to practice in any setting after graduation. We model our clinical experience after the 10+3 AAMC model of “High Functioning Primary Care Residency Clinics” and actively strive to enhance the patient and educational experiences through a process of continuous improvement.

We hold ourselves to the highest standards for quality and are committed to achieving health equity by working to identify and address social determinants of health within the healthcare system.

From the first day of residency, each resident will be assigned a patient panel, serving as their primary care provider. While working within their assigned team, they will coordinate and oversee the delivery of high-quality and high-value care to their patients. As a resident progresses through residency, they will build to a clinic volume that mirrors most community outpatient practices.

Each resident is also assigned to one of three clinical teams upon starting residency and works with a designated team nurse throughout. As residents advance through the curriculum, they will build to a clinic volume that mirrors most community outpatient practices.

The Center for Family Medicine has several ongoing projects that align with our dual missions of clinical and educational excellence. These include:

A grant from the American Cancer Society to improve colorectal cancer screening rates.
Partnership with Choose Well SC to provide contraception counseling services to patients in need.
Partnership with The Best Chance Network to provide breast and cervical cancer screening for at risk women.
Selected by the Association of Family Medicine Residency Directors “Clinic First” Collaborative.

The Center for Family Medicine – Greenville strives to be a high-performing clinic that offers improved access and continuity of care, population management, data-driven improvement and coordination of care within the medical system. Clinical leadership looks to the resident as agents of change, and we support resident engagement in quality improvement and community outreach. Our residents not only graduate into successful practice settings but become leaders within the healthcare system and advocates for change.

Inpatient care delivery

The Family Medicine Teaching Service is a full-scope family medicine inpatient service that operates at Prisma Health Greenville Memorial Hospital. The service is comprised of a two- to-three resident team that cares for adult, obstetric, pediatric, and newborn patients.

Residents will also rotate through Greenville Memorial Hospital for rotation experience with other inpatient services.

Photos: Family medicine curriculum

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Curriculum overview

Behavioral science

Behavioral science is a unique aspect of the field of family medicine. Specialized training in this area prepares providers to care for the whole person within their unique biopsychosocial environment. It also promotes provider wellness through self-reflection and mindful work. Our behavioral science curriculum is based on the Family Medicine Behavioral Science principles outlined by Baird and colleagues.

Residents receive communication skills training through video reviews of patient encounters, as well as communication-focused simulation center sessions which include practice with standardized patients. Provider self-awareness and reflective practice are taught and strengthened through narrative medicine and Balint Group sessions in weekly didactics.

Sessions focusing on provider wellness skills are also included in the PGY-1 core skills curriculum and the Lifestyle Medicine curriculum.

Our behavioral faculty member, clinical psychologist Dr. Taylor, provides clinic co-precepting and leads psychosocial rounds on the inpatient Family Medicine Teaching Service to teach core behavioral health topics and skills and biopsychosocial contextual care. She also leads sessions on these topics in weekly didactics.

Core rotations

Rotations are broken into 13 blocks annually which allows for 4 weeks on each rotation experience. During each block rotation, residents will be pulled to see patients at the Center for Family Medicine in increasing frequency as they progress through the training program. Certain rotations will also contain additional experiences such as the mobile health clinic and detention center.

Didactics

Our didactic sessions take place weekly on Wednesday afternoons, and all residents are pulled from clinical duties to attend these sessions.

The didactic curriculum is theme-based and covers common diseases managed by a primary care provider in both the inpatient and outpatient settings.

The curriculum follows an 18-month cycle so that all information will be reviewed twice during a resident’s three years of residency. The didactic curriculum is taught by our core faculty, clinical pharmacists, behavioral science specialists, and residents. Collaboration between the Greer and Seneca Family Medicine Residency Programs allows for shared lectures between our three groups.

Monthly we gather at the University of South Carolina School of Medicine Greenville simulation lab for hands on simulations sessions including:

Point of Care Ultrasound (MSK, Skin and Soft Tissue, OB, Chest, Abdomen)
Behavioral Science (Delivering Difficult News, Communication and Chronic Pain, Motivational Interviewing, Agenda Setting)
Procedural Skills (Paracentesis, Thoracentesis, Skin and Soft Tissue Biopsy, Vaginal Delivery and Vaginal Laceration Repairs)

Focus tracks

Family medicine is an incredible specialty for a lot of reasons, one of which is the breadth of scope that family physicians are capable of practicing. Our residency program offers a large selection of elective opportunities for residents in their PGY2 and PGY3 years which allows additional training in everything from wound care to inpatient nephrology. However, some residents decide early on that they would like to focus on specific areas as they work towards solidifying a career choice. For those students, having a dedicated “focus track” can be helpful.

Tracks of focus were introduced during the AY19-20 at the Prisma-Health FMR Greenville and are currently available in 5 areas.

Sports Medicine
Lifestyle Medicine
Inpatient Medicine
Women’s Health and Obstetrics
Academic Development

The goal of these tracks is to provide mentorship and guidance to residents hoping to focus their training in a specific area, coordinate and organize extra-curricular and scholarly activities that align with areas of focus, and provide priority placement in elective experiences to assure residents can get the experiences they desire. The requirements for an individual track will vary, but generally include some type of scholarly contribution, community service project, and participation in targeted elective experiences.

Completion of the focus track will be documented in your graduation portfolio and a summary of your work will be communicated to future employers.

Sample Focus Track Curriculum/Timeline

Global health

Providing care to patients in a variety of settings is one of the best ways to enrich the understanding of both systemic, political, and cultural aspects of health. As a residency program, we realize that there are limits to what we can show you within the walls of our institution and we want to support any resident that has a desire to provide care in another country or community where they feel the need to serve.

Residents can participate in global health experiences either as an elective experience that counts towards graduation requirements or as an extra-curricular experience that falls outside of the residency programming.

Residents have traveled to various locations across the globe over the past 50 years, but most recently our residents have had a consistent presence through an annual trip to Fortaleza Brazil in conjunction with the Med/Peds and Pediatric departments. Faculty, residents, and medical students provide primary care in clinics throughout the city and in multiple sites of the Davis Lar orphanage.

Lifestyle medicine

Our Lifestyle Medicine program is one of the most innovative aspects of our curriculum. We are a pilot site for a novel residency-based curriculum which integrates Lifestyle Medicine into clinical and didactic learning. Through this curriculum, interested residents have the option of completing all requirements to sit for Lifestyle Medicine board certification after graduation. Three of our faculty members, Dr. Carek, Dr. Emerson, and Dr. MacGilvray are board certified in Lifestyle Medicine. We also collaborate with the USC School of Medicine Greenville to offer Lifestyle Medicine training to medical students.

The Lifestyle medicine curriculum is broken into three components:

Clinical delivery

Residents are encouraged to use evidenced lifestyle medicine counseling and treatment options for the patients they care for at the center for family medicine. Residents track and monitor the use of these clinical experiences.

Independent application

The best proponents of making therapeutic lifestyle changes are those that practice what they preach. Residents are provided a menu of independent application activities that they can complete throughout the education training. These include fun activities such as cooking a healthy meal with friends, learning about stress reduction techniques through mindfulness, or tracking physical activity with a goal of monitoring and improving.

Lifestyle Focused Didactics

Throughout our didactic series and core skills block rotations, residents receive evidenced reviews on key topics within the field of lifestyle medicine to begin to build the knowledge base to provide lifestyle focused care. These are 30-60 minutes in length and delivered by both residents and faculty.

About Lifestyle Medicine

6 Ways to Take Control of Your Health

PGY1 Core Skills

Core Skills is a longitudinal curriculum spanning intern year that is broken up into three. This curriculum builds on prior material and ensures interns are developing the knowledge base and skills needed for progression to the PGY2 year. The rotations provide educational sessions on high yield topics that are foundational for a family physician. All of the clinical experiences are within the family medicine department and are predominantly outpatient allowing residents a chance to hone their skills seeing patients in the primary teaching site.

Along with clinical care, the interns have blocked time where they have simulation experiences, group learning activities, and more traditional didactics.

Point of care ultrasound

Point of care ultrasound (POCUS) is one of the most exciting developments in the field of medicine over the past decade. The physician of the future will continue to utilize advanced imaging to improve diagnostic accuracy at the bedside and within the clinic. We are proud to have a longitudinal experience in POCUS that allows our residents the opportunity to learn fundamental skills needed to utilize ultrasound in the clinical setting while caring for patients. Our POCUS education is collaborative and utilizes faculty in the departments of internal medicine, emergency medicine, and family medicine.

Quality improvement

Improving quality and value in healthcare is a common goal for healthcare systems around the country. Primary care physicians are key to driving quality improvements efforts and are often looked to as leaders not only in their practices, but in the health systems where many will work.

The Prisma Health Family Medicine Residency Greenville has a longitudinal curriculum in quality improvement that begins during the first month with the program. Residents are introduced to key principles of QI and then mentored through personal improvement QI projects to solidify the principles of developing AIM statements and running PDSA (plan, do, study, act) cycles.

Residents are then mentored through larger group projects in their PGY2 and PGY3 years, many of which become scholarly work worthy of presentation and publication.

Residents as teachers

Our residency acknowledges the value of residents as teachers and nurtures these skills through continuous teaching opportunities to medical students, peers, and the community. We offer electives that are focused on the development of skills needed to be an effective teacher such as Residents as Teachers Elective and Family Medicine Teaching Service Upper Level Teaching Resident Elective. We encourage participation at regional and national conferences and have each resident present during didactics.

Service learning

Opportunities to serve our community outside the walls of the Center for Family Medicine clinic and Greenville Memorial are also important for enriching the learning environment for our residents. Beginning in the PGY1 year, residents are permitted to work at the Greenville Free Clinic providing care to some of the most underserved patients in our community. Along with additional patient care opportunities, residents have also participated in CPR training, education on exercise, community talks on lifestyle medicine’s application for a variety of chronic issues.