Section 9: LONGITUDINAL EDUCATIONAL EXPERIENCES IN THE COMMUNITY

In addition to hospital experience and experience in the Family Practice Center, there are community activities in which residents participate.  These longitudinal activities include nursing home visits, Family Planning, Recovery Resources, visits to homebound patients, and pre-participation sports physicals.

 

1. Nursing Home Visits 
   During the second and third year of the residency program, residents are assigned nursing home patients.  These nursing home patients may reside at any of the five nursing homes.  Each resident, under faculty supervision, is responsible for the care of approximately 10-15 nursing home patients.  Nursing home patients should be discussed with faculty.  Routine nursing home visits are required every two months or more frequently if acute problems arise.  When a patient is admitted or readmitted to the nursing home, monthly visits are required for the first 90 days.  Occasionally, other residents who have patients in that nursing home may be responsible for these monthly visits if a patient’s assigned resident is not available.  Routine 2-month visits are then started.  At the nursing home, the resident is to write a progress note.  Bring a copy to Lois Schlueter in the Billing Office if not done by the faculty supervisor.  It is mandatory that this copy be brought to the Family Practice Center so that the proper records can be kept in our charts, and so that proper billing can be done.  Each nursing home has a designated area for progress notes and that institution’s policy should be followed.
2. Family Planning  
   Family Planning of Quincy provides contraceptive counseling for women of limited finances.  This clinic provides extensive experience with pelvic examinations and public health.  The first time a resident works there, they need to be “checked off” by an attending physician or resident physician who has previously seen Family Planning patients.  Each male resident will be required to perform no less than 12 clinics while female residents staff 6.
3. Recovery Resources 
   Required educational experience and community service occurs at Recovery Resources for second year residents.  This facility is a treatment house for patients with substance abuse problems.  Family practice residents are assigned on a block basis to visit Recovery Resources one-half day morning per week (Fridays usually).  Residents are expected to perform brief admission physicals, renew prescription orders, and care for minor ailments.   Further educational experience in substance abuse will also occur at Recovery Resources.
4. Home-Bound Patient Visits 
   Second and third year resident will be assigned patients for home visits.  The resident will usually be assigned less than five such patients.  The resident should make the appropriate visit, consulting the attending physician prior to and after the visit.  The resident should dictate a note for the chart and fill out a card so that appropriate charges can be made.  The resident is encouraged to notify faculty beforehand so they can jointly make these visits.  The resident is encouraged to identify patients from their own practice who may be better cared for by home visits.  Residents will be required to do a minimum of two home visits.
5. Pre-Participation Sports Physicals 
   As part of the required sports medicine curriculum, all residents will participate in pre-participation physical examinations.  At present, we perform these physical examinations for the YMCA and for five or six schools here in Quincy.  This activity is coordinated by an attending that will notify you when your presence is required.  Residents will be required to perform no less than two sessions per year.  These will be assigned.  Residents will be responsible to find a back-up resident if unable to attend.

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