Family Medicine

Curriculum

Our curriculum prepares residents to provide full-spectrum care for underserved patients in various settings.

Longitudinal Rotations

Pawtucket residents have their outpatient continuity clinics at The Family Care Center (FCC) in Pawtucket. Residents spend one to two half-days there per week in the first year, two to three half-days per week in the second year, and three to five half-days per week in third year. Residents also staff a variety of specialty clinics at the FCC during their specialty-specific rotations, where they might also see their own continuity patients. 

Warwick residents have their outpatient continuity clinics at Thundermist Health Center. Residents spend one half-day there per week in the first year, three half-days per week in the second year, and four half-days per week in third year.

Pawtucket and Warwick residents work in the emergency department at Kent Hospital for one month each in first and second year. Residents work alongside EM residents in both high and low acuity sections of the emergency department, allowing them to see a variety of patient presentations and perform a variety of procedures. Residents also spend time in OB triage and the pediatric emergency department.

Pawtucket residents staff their own family medicine service at The Miriam Hospital in Providence, supervised by both family medicine attendings and hospitalists. The inpatient team is made up of two interns and one senior during the day, and one intern and one senior at night. Residents spend a total of 4 months doing inpatient medicine in first year, and approximately 1 month in second and third years respectively.

Warwick residents staff their own family medicine service at Kent Hospital that all Thundermist patients get admitted to, supervised by family medicine attendings. The inpatient team is made up of two interns and one senior. Residents spend a total of 3 months doing inpatient medicine in PGY1, and 2 months in PGY2 and PGY3.

Pawtucket residents staff their own family medicine MCH service at Women & Infants Hospital in Providence, supervised by family medicine attendings. As a part of the family medicine MCH service, we manage the OB care for our own continuity patients and the patients of other community physicians. We also manage the care of newborns on our service. The team is made up of one intern and one senior, both during the day and at night. Interns and second years spend two months on the MCH service, and third years spend 1 month. During the MCH rotation, residents also spend time in OB triage, supervised by OB/Gyns and teaching midwives, where they learn to manage obstetric and gynecologic emergencies. 

Warwick residents staff their own family medicine MCH service at Kent Hospital, supervised by Family Medicine attendings and private OB/GYNs. This service is unopposed, meaning there are no other residency programs on this unit. As a part of the family medicine MCH service, we manage the OB care for our Thundermist patients and the patients of private OB/GYNs. We also manage the care of newborns who will receive their pediatric care at Thundermist. Typically, one resident is on service at a time. Interns spend 2 months on the MCH service and second years spend 1 month. Residents interested in including MCH into their future career, including pursuing an OB fellowship, will  spend additional time on the MCH service as part of the MCH track.

Pawtucket residents complete two months of orthopedics, one in second year and one in third year. This experience includes staffing the FCC Primary Care Sports Medicine Clinic as well as several sessions per week with office-based orthopedists. The sports medicine component includes working with the physician and trainers at Providence College and the University of Rhode Island. Elective experiences are available working with the sports medicine group at these NCAA Division I schools. 

Warwick residents complete two months of orthopedics and sports medicine during residency training. The sports medicine rotation is with a fellowship trained family doctor, who also gives residents the opportunity to attend sporting events with him. Residents do a lot of orthopedic injections during their primary care clinic, including musculoskeletal ultrasound. Residents have the opportunity to join the FCC sports medicine clinic as well

Pawtucket residents participate in the PCMH rotation for one month during all three years of residency. The PCMH team is made up of one first year, one second year and one third year resident. During the PCMH rotation residents learn about different outpatient healthcare delivery models and the business of medicine. Every PCMH team also carries out a quality improvement project that improves efficiency and quality of patient care at the FCC. The other part of the PCMH rotation is clinical in nature. The PCMH team, based at the FCC, functions as a clinical safety net for our patients, ensuring vital continuity of care. As such, the team works closely with faculty to address patient care needs that arise on short notice, with a focus on patients that are discharged from the hospital, those who live in nursing homes and develop acute care needs, and those who contact the on-call physician overnight or on weekends.

Warwick residents participate in the Practice Management rotation for one month during all three years of residency. During this rotation, residents learn about different outpatient healthcare delivery models and the business of medicine, and work on a quality improvement project. Additionally, every resident spends their first month of PGY-2 in the Community Medicine rotation, where they engage with the community and learn about resources in West Warwick.

Residents receive extensive and varied pediatric training throughout their three years of residency.During their hospital-based pediatric rotations, residents work closely with the Brown pediatrics residents. Residents also see pediatric patients of all ages in their continuity clinics.

Pawtucket  residents have have one month of outpatient pediatrics with community pediatricians, one month of inpatient pediatrics at Hasbro Children’s Hospital, and one month of newborn care at Women & Infants Hospital during their first yearl. During third year, residents spend one month in the pediatric urgent care and one month in the pediatric emergency room at Hasbro Children’s Hospital. 

Warwick interns spend 3 months on pediatric rotations - outpatient at a local office, inpatient at the Kent Hospital nursery, and inpatient at Hasbro Children's Hospital. During PGY2 and PGY3, residents spend 1 month in the Hasbro pediatric ER and in the Hasbro urgent care clinic.

First-Year Rotations

Pawtucket: During their Emergency Medicine month, first year residents also spend several half-days per week with outpatient cardiologists in the community learning key concepts of the assessment and management of common cardiac conditions. Residents frequently see FCC continuity patients that are referred to these clinics. 

Warwick residents complete a month-long Cardiology rotation at Kent Hospital. During this inpatient rotation, residents learn key concepts of the assessment and management of common cardiac conditions.

Pawtucket and Warwick first-year residents complete their surgery rotation at Kent Hospital, where they work alongside other off-service residents on the surgery consult team. Residents are primarily responsible for managing admissions and patients on the floor, but they also have the freedom to participate as first-assists in surgeries, and perform minor bedside procedures.

Second-Year Rotations

Pawtucket and Warwick second-year residents spend one month working as part of an interdisciplinary team caring primarily for older patients at Kent Hospital. Residents receive hands-on experience in the assessment and management of common geriatric and rehabilitation problems and conduct a comprehensive geriatric assessment for one of their continuity patients. Experiential learning is supplemented by nursing home and home visits supervised by Family Medicine faculty and a geriatric nurse practitioner.

Pawtucket and Warwick second-year residents spend one month on their gynecology rotation, working with community-based specialists to learn core concepts and procedures in urogynecology, abortion care, general gynecology and colposcopy. Pawtucket residents staff a number of specialty clinics at the FCC, including: colposcopy clinic, family planning clinic, high-risk OB clinic and gender clinic, and spend a half-day at Planned Parenthood focused primarily on abortion care.

Pawtucket and Warwick residents spend one month in second year in the ICU at their site’s FMIS hospital, managing high acuity patients as a part of an interdisciplinary team with internal medicine and other off-service residents.

Third-Year Rotations

While residents gain a lot of exposure to behavioral health in their continuity clinics and various inpatient rotations, third-year residents in both tracks spend one month focused exclusively on behavioral health. During this month they work with community mental health providers. Pawtucket residents also spend time every week in suboxone clinic and the free open access behavioral health clinic at the FCC.

Pawtucket and Warwick third-year residents spend one month learning the core concepts of dermatology under the supervision of community dermatologists, where they also have the opportunity to perform dermatologic procedures. Residents gain additional experience in dermatologic procedures in their continuity clinics and in their site specific specialty procedure clinics

Pawtucket and Warwick third-year residents spend one month each learning outpatient ophthalmology, rheumatology, ENT and Urology by working one-on-one with private specialists in the community.

Elective Rotations

Every year, residents pursue abortion care electives through either Planned Parenthood in Schenectady, NY, or through the Midwest Access Project, at various sites throughout the Midwest. These are four week rotations, where residents learn to perform manual vacuum aspirations, electric vacuum aspirations and dilation and evacuations, under the supervision of both FM and OB attendings. By the end of the rotation most residents will be signed off to perform MVAs and EVAs up to 13’6 wga. The rotation also includes thoughtful training about the psychosocial demands of being an abortion care provider and advocacy around abortion care.

The Block Island elective is available for 2-4 weeks in summer months. It is a combination of primary care, urgent care and emergency medicine, in the low resource setting that is Block Island. This is a hands-on rotation that tests a broad range of skills and includes a lot of procedural medicine. One resident writes:

We get to do everything from diabetes management to laceration repairs to fracture management, which also means that we often have to do our own labs and x-rays. We also see many emergencies, including traumas, strokes, and MI's, so we have to decide how to best get the patient off the island and to a trauma center- this can happen by boat, helicopter, or airplane, and sometimes the weather doesn't always cooperate!” 

On days off there are lots of opportunities to explore the beautiful bluffs and beaches of Block Island. Housing is provided.

 

All residents gain exposure to gender affirming care through the gender clinic at the FCC. However, for residents who are interested in spending more time working with transgender and gender diverse patients, this can be done through either an adolescent medicine elective, or a specific gender care elective. In both cases, residents work closely with Dr. Michelle Forcier, director of the Gender and Sexual Health Program at Lifespan, to gain confidence initiating and managing gender affirming therapies. Residents also gain exposure to the broad network of healthcare providers in Rhode Island who participate in different aspects of gender affirming care.

Each year, residents have the opportunity to participate in the medical exchange program between Brown University and Moi University in Eldoret, Kenya. This robust and longitudinal partnership has been in place since 1998. Our residents work collaboratively with Kenyan family medicine residents while rotating on services like inpatient medicine, obstetrics, pediatrics, and outpatient clinics at Webuye County Hospital in rural Kenya. This four-week elective emphasizes a thoughtful approach to global health that highlights the importance of partnership, exchange of ideas, and elevation of local voices and knowledge. On the weekends residents have the opportunity to explore Kenya, including the potential for trips to birdwatching in Kakamega rainforest, hiking nearby Mount Elgon, or safaris in any of Kenya's beautiful national parks.

While residents have several opportunities locally to increase their OB numbers, the high volume OB elective at the Pomona Valley Hospital Medical Center in Pomona, CA, has been a draw for Brown FM residents for a long time. The elective is sponsored by the Pomona Valley Hospital Family Medicine Residency and allows residents to work with both FM and OB providers to gain broad exposure to routine and emergent obstetrical care. During the rotation residents spend 1 week working day shifts as a part of the FM team, and then 3 weeks covering the labor floor at night. One recent resident reported:

“During my month in Pomona I was able to participate in a large number of deliveries, including high-risk, complicated deliveries, requiring vacuums, c-section and laceration repairs. There was an excellent balance of supervision and autonomy, which allowed me to really grow as an obstetric care provider.”

 

This elective is based at the Indian Health Service hospital on the Zuni Reservation in New Mexico. It offers residents an opportunity to experience rural, full-spectrum family medicine in a vibrant community with an incredible history. While there, residents participate in routine outpatient visits, including prenatal and urgent care visits. There are also opportunities to work inpatient, providing adult and pediatric care, as well as obstetric and other emergency and critical care. Because the hospital has no specialists, patients often need to be transported to larger institutions, which residents help to coordinate. Opportunities for exploration on days off abound, there are multiple national parks within easy driving distance and many people go for walks or runs in the nearby hills each evening.

During this elective rotation, residents work at the SAGE Healing Collaborative with Dr. John McGonigle, who uses an artful blend of traditional and holistic methods in his approach to care. This rotation allows residents to develop a broader array of tools for addressing complicated and commonplace health problems, and affords residents the opportunity to explore new and helpful resources for integrative medicine.

Learn how to diagnose and treat medical complications of pregnancy with the Division of Obstetric & Consultative Medicine at Women and Infants Hospital. During this elective residents primarily work on the inpatient OB-Medicine consultation service, where they  work with the OB-Medicine fellows and attendings to treat a wide range of diseases in pregnancy, such as thromboembolisms, infections, seizures, and more. Residents also spend some time in their outpatient specialty clinics (e.g., cardiology, hematology, rheum, etc.), and participate in their journal clubs and didactics.

The Palliative Care Elective affords residents the opportunity to explore palliative medicine in both the inpatient and outpatient setting. Working with Dr. Christine Nevins-Herbert, a graduate of the Brown University Family Medicine Program, residents gain more experience facilitating end-of-life conversations and important family meetings, as well as managing chronic pain and other complications that arise at the end of life. Residents also play a vital role in coordinating with other specialists and services that are involved in patient care.

If residents want more exposure to ultrasound procedures, they have the opportunity to spend a full month working with Dr. Medhani in the Kent emergency department to hone their ultrasound skills. During this elective, residents practice different ultrasound techniques using their “sono sim” training equipment and then have the opportunity to perform these different ultrasound techniques on the patients in the emergency department. Common ultrasounds performed are: abdominal, renal, MSK, and occasional cardiac and lung.