Longitudinal experiences throughout the three years (e.g. Family Medicine Center; nursing homes, didactic presentations) are essential components of the curriculum in all areas, including those with block rotations described elsewhere. However, several elements of the curriculum are provided entirely in a longitudinal manner without time specifically devoted to block rotations. The lack of block rotations in these content areas is a reflection of our belief that they are best addressed progressively throughout the three years rather in short intensive blocks. For residents with special interests in these areas, elective block rotations can also be scheduled.
Behavioral Medicine - Beginning early in the first year, residents work closely with physician and behavioral science faculty to enhance their ability to meet their patient's psychosocial needs. Through the use of direct observation, videotape reviews, and OSCE's (objective structured clinical evaluations), residents are assisted in developing more effective communication skills. Assigned readings and didactic presentations provide a framework for increasing cognitive knowledge in the behavioral sciences. Specific clinical activities that allow residents to become more proficient in addressing mental health needs of patients include experience in psychiatric office settings and collaborative work with a variety of mental health professionals in the family medicine center.
Evidence Based Medicine/Medical Informatics - Residents are expected to become proficient in using the latest evidence based information in their approach to caring for patients. Lectures and hands-on workshops focused on these skills are held on a regular basis. The Family Medicine Center is well equipped with computers and high-speed Internet connection that allows access to the many resources of the College of Medicine Library. These resources include online evidence-based databases such as Cochrane, TRIP, and InfoRetriever, as well as full-text online access to most major medical journals.
Medical Ethics - The teaching of ethics takes place through continuing, longitudinal discussions of the ethical significance of patient-physician relations and interactions. These discussions occur on a regular basis in the following settings: office precepting, teaching rounds in the hospital, formal didactic sessions involving case presentations and interactive discussions and clinical teaching on specialty rotations with other faculty. Additional opportunities exist for residents wishing to explore these issues further. An elective is available in end of life care, stressing rural concerns for the dying. In addition some of our residents have the opportunity to serve on hospital ethics committees.
Practice Management - Throughout the three years, didactic presentations cover a wide variety of practice management topics. During the PGY 2 Family Medicine Skills rotation, residents attend a two-day seminar on practice management. Residents are strongly encouraged to use some of their elective time to schedule practice management rotations. The nature of these rotations varies widely, and depends on the specific practice plans and needs of each individual resident. As part of their practice management curriculum, residents are allowed up to five days during PGY 3 to visit and evaluate potential future practices. To maximize the value of these visits, residents are required to prepare written objectives prior to the visits, and written evaluative reports following the visits.
Sports Medicine - In addition to the PGY 3 orthopedics rotation (which includes experience working with a sports medicine physician) didactic presentations frequently cover sports medicine topics. For those who are interested in more hands-on experience, several additional opportunities are available. These include serving as team physician for local high schools, assisting with community-wide pre-participation physical exam events, working with the athletic department of King College here in Bristol, and participating with team physicians at East Tennessee State University.