Goals & Objectives

The Kaiser Permanente Fontana Family Medicine Residency has a simple goal to train the outstanding family physicians of tomorrow.

Besides exceptional clinical experience, the resident will have access to daily lunchtime lectures, weekly grand rounds, all Kaiser Permanente Symposium, and lectures in behavioral health during the resident counseling clinic experience.

Residents are taught lecture skills and provide many of the lectures with the help of faculty. All residents do a written case presentation, research project or poster presentation.

Resident and faculty offices are interspersed, so a resident is not more than a few feet from having a question answered. There are dedicated “mentors” in the clinic whose only responsibility is to aid the resident in their education. Resident will never be left without adequate backup to care for patients.

The most frequent call is every fourth night. We are dedicated to follow not only the letter but also the spirit of the rules regarding resident work hours.

Clinical Experiences

Pillar One: Ambulatory Care

  • High volume patient exposure
  • Cultural, age and, socio-economic diversity
  • Unmatched exposure to common and rare pathology
  • Residents have their own panel which they actively manage
  • Family Medicine Center entrance point for all minor injuries
  • Excellent exposure to sprains, strains, fractures and lacerations
  • Outstanding training in population management of chronic disease
  • Team-based care for diabetes, hypertension and lipid management
  • Clinic teaching from core faculty and a myriad of other family physicians with years of experience
  • Comprehensive Electronic Medical Record (EMR) across all levels of care.
  • Teaching of time management, in-box management
  • Teaching of telephone and E mail communication with patients
  • Sports Medicine fellowship in same site, with immediate “curbside” consultation available
  • Excellent exposure to pediatrics, gynecology, orthopedics, adult medicine in your primary clinic

Pillar Two: Academics

  • Noon teaching conferences 4 days per week of diverse family medicine topics
  • Medical Subspecialty on inpatient medicine case conference
  • Daily teaching conference on in-patient pediatrics
  • Longitudinal behavioral science program with weekly teaching conference
  • One-on-one teaching from various sub-specialty physicians
  • Board Review during noon teaching conferences
  • Outstanding hands-on teaching in all clinical settings
  • Faculty development provided for teaching faculty
  • Research opportunities
  • Grants available through regional research
  • Research subcommittee through Graduate Medical Education committee to support research

Pillar Three: Procedures

  • Focus on office-based procedures
  • Lump and bump clinic with one-to-one teaching in the FMC over all 3 years
  • Training in minor procedures in General Surgery and Plastic Surgery clinics during first year
  • Flexible sigmoidoscopy training; further elective time if full competency desired
  • Family Medicine does all vasectomies; observation with further training to full competency if desired
  • Dermatology clinics with minor procedures included in FMC
  • IUD clinics in FMC
  • Teaching in endometrial biopsies.
  • Training for Nexplanon placement
  • Sports medicine rotation with joint ultrasound as part of experience
  • Training in joint injections typically done in Family Medicine clinic
  • OB Ultrasound

Pillar Four: Family

  • Biopsychosocial model of family care
  • Patient centered care in a family context
  • Integrated into all rotations
  • Family Circles and genograms as tools to understand family systems
  • Basic family skills covered during orientation
  • Year long, weekly, longitudinal behavioral rotation
    • Didatics covering all major behavioral and psychiatric topics
    • Basic primary care counseling techniques
    • Taught by family doctor, psychiatrist and various behaviorists
    • Perform primary care counseling, with observation and feedback
    • Learn to do basic counseling with the time constraints of a family physician

Rotations

Adult Medicine

  • 3 blocks in the first year, 3 blocks in the second year, 6 weeks in the third year
  • 2 week ICU rotation
  • 4 week in-patient cardiology in the 3rd year, working directly with Cardiologist doing hospital consults
  • Various IM subspecialty rotations such as endocrinology, rheumatology, and other electives
  • 3 teams-2 with Family Medicine attendings; one with Internal Medicine and/or hospitalist attendings
  • 5 patients per resident
  • Follow patients into and out of ICU/CCU while on Adult Medicine rotation
  • Broad clinical experience with varied pathology, socio-economic and racial diversity
  • Full responsibility for patient care with excellent back up and teaching
  • Admitting short calls during the first year
  • Admitting short and overnight calls in the second year
  • Medical officer on duty (MOD) overnight call in the second year with responsibility for in-house coverage
  • Excellent in-house back up for all calls
  • Third year experience as Jr. attending/teaching responsibility
  • Didactic conferences- morning report with subspecialty teaching

Child Care

  • 2 blocks of in-patient child care, one in first year, one in second year
  • PICU-provides night coverage for sicker children
  • Didactic teaching every morning on in-patient service
  • Hospitalist pediatricians provide bulk of attending and teaching
  • Several short calls per block.
  • Cover floor and Emergency Room during call
  • 2 blocks outpatient child care rotation with routine pediatrics, exposure to subspecialty care and learning disability clinic.
  • Pediatric Urgent Care in 2nd and 3rd year for exposure to sick ambulatory children
  • 2 week rotation on NICU which includes new born care, NALS training, and neonatal resuscitation in the Delivery Room.
  • Exposure to newborns in post partum area, Great Starts Newborn clinic and your own continuity clinics
  • Breastfeeding problems/consults in Great Starts Clinic
  • Pediatric ED experience working with Pediatric ED attending.

Women’s Health and Maternal Child Health

  • One Obstetric block and one Gynecology block in each of the first and second year
  • High volume of deliveries
  • Exposure to high risk pregnancies with emphasis on normal risk
  • Advance Life Support in Obstetrics course
  • Prenatal care in Family Medicine Clinic with OB and Family Medicine input and supervision
  • Early obstetric ultrasound training
  • Teaching and clinical experience with most routine gynecologic care
  • IUD insertion, endometrial biopsies taught in Family Medicine Center as well as GYN rotations
  • Nexplanon insertion training is available
  • Exposure to subspecialty gynecology such as colposcopy, infertility, endocrinology, etc
  • Breast feeding training in Great Starts clinic
  • Call is short call and some night call in both first and second year OB rotations.
  • Occasional OB night call on second year GYN rotation.

Surgery

  • 1 block inpatient surgery, one block outpatient surgery in the first 2 years
  • Focus of in-patient surgery is minor procedures with exposure to OR
  • Pre operative optimization and post op care is covered
  • Consults for evaluation of potential surgical issues
  • Occasional short calls
  • Extensive training in outpatient surgery and other rotations on lump and bump, office procedures.
  • Exposure in Urgent Care of acute minor trauma including laceration repairs

Musculoskeletal/Sports Medicine

  • One block in Year 1 and Year 2
  • Extensive sports medicine exposure in Sports Medicine clinic with our fellowship
  • Sideline and event Sport Medicine Coverage
  • Fracture management
  • Work with Physical Medicine and Rehab, orthopedics, cast room
  • Excellent exposure to acute injuries in Urgent Care

Emergency Room

  • 6 week rotation in the 3rd year in our high volume Emergency Department
  • Outstanding teaching from our emergentologists
  • Opportunity to perform various procedures, including suturing, intubations, CPR, etc.

Community Medicine

  • Community work in all three years, including school based health clinic, community clinics, etc
  • Block community medicine rotation in 3rd year
    • School based health clinic
    • County health department
    • Community clinics
    • Elementary school health education programs
    • Child protective services
  • 2 week rotation in Chemical Dependency
  • Home visit and homebound patient curriculum with community medicine fellow support and supervision

Practice Management

  • Longitudinal curriculum with exposure to all practice options, office management, financial planning, interview skills, etc.
  • Ongoing feedback on utilization of resources: radiology, consults, lab, medications, etc
  • One block preceptorship in the 3rd year to explore practice options and understand practice management in an outside office setting.
  • Coding and Billing

Geriatrics

  • Exposure to geriatrics and nursing home care in all three years
  • Didactic lectures during noon conferences and during block rotation
  • Longitudinal care of 2 nursing home patients during 2nd & 3rd Year.
  • Four week block rotation in the 3rd year
    • Geriatric assessment clinic
    • Skilled nursing facilities
    • Hospice
    • Palliative
    • Home care

Behavioral Medicine

  • Family systems and behavioral training integrated in outpatient and inpatient rotations
  • Longitudinal behavioral training
    • Year long half day a week training
    • Didactic lectures covering all major behavioral science topics, including medication management, counseling skills, etc
    • Experience in primary care counseling of basic family medicine issues, such as depression, anxiety, grief, life cycle issues, etc.
    • Experience training in medication management when appropriate
    • Taught by family physicians, psychiatrist and various behaviorists

Specialty Clinics/ Curriculum

  • Pain management- Family medicine resident patients seen along with pain specialist
  • Dermatology-Family medicine patients seen in FMC with supervision of dermatologist. Weekly didactic training in dermatology
  • Home care curriculum, including care of home-bound patients, home visits and palliative/hospice (done in Geriatric block)
  • Women’s Health Curriculum
  • Professionalism Curriculum
  • Family Medicine OB Clinic

Electives
A total of 4 months elective time is available to tailor your training to your future needs.
Your faculty advisor will work with you to optimize your training.