Areas of Concentration

What will you put on your plate?

by: Monica Newton, DO

Every individual brings something to the table – residents and faculty alike. It’s a little like Thanksgiving dinner.

I have a huge family. There were 10 of us kids from one mom and dad. As we grew up, each of us – though similar in core values – had skills and interests that were different. We also had varying skill in the kitchen. As some folks are experts at bringing bread for Thanksgiving, others specialize in dessert, cranberry sauce or coleslaw.

We are the same way.

Each faculty member plays a part in the team. Without them, the meal would somehow feel incomplete. Likewise, this is a family medicine residency program, and your training can not be all or mostly any one of these areas. It would be like having a Thanksgiving where you were only served coleslaw!

Each year we invite new residents to the table, and we have the privilege of incorporating their passions into our culture. By doing so, we ever so slightly grow into a better version of our original program. Occasionally, we dial back in one area to make room for growth in another.

ACGME has codified this concept with new requirements by compelling residencies to tailor training and electives to their residents’ interests and future practice.

This is what we have always done. To clarify some pathways, we have gone through a process of establishing areas of concentration (AOC) that will help provide a template to get what they need. We also have mentor faculty members to help those with whatever AOC or new area we haven’t explored. These are not all, but a few pathways we could consider.

Point of care ultrasound

Point-of-care ultrasound (POCUS) is the new stethoscope. A safe and effective modality to diagnosis and treat, POCUS IS ultrasound delivered through a small handheld device and a small screen, which is a necessary too for you to take care of patients in the future. Utilizing both longitudinal and elective time, mastery of this skill is possible. Dr. Paul Klas is our faculty and resident mentor for growth in this area. All residents receive a two-day training during intern orientation and continued learning on their procedure month, as well as longitudinal experiences on clinical rotations.

Research

Quality work and scholarly activity are a requirement for all residents, but some residents have an interest, and we are here to foster that. Our faculty have received awards from the NGMC GME research team specifically for encouraging research within the program. We have a longitudinal AOC for folks who want to pursue this as well as elective rotations. Dedicated time is given away from rotations to pursue this longitudinally throughout your three years. Dr. Bailey is the faculty supervisor of this track

Obesity

Obesity is an epidemic and we have faculty (Drs. Singh, Dudas, C. Nguyen) who are certified in obesity medicine to help you in this journey. Electives are available with area clinicians. A longitudinal track is being developed that would enable residents to do obesity work throughout their three years and complete the necessary educational requirements to sit for the Obesity Medicine boards. We will also be adding unique opportunities for pediatric obesity treatment this upcoming academic year.

Addiction medicine

America is in an addiction crisis. Our faculty (Drs. Singh, Klas, Tembele, and Parker) seek to help meet that need and are piloting a Medical for Opioid Use Disorder clinic that will allow residents to see firsthand how to initiate treatment with suboxone and help patients with addiction. 

Global health/Rural health

This is a personal interest of mine. Most of the clinical reasoning skills you need to practice in a low resource area are taught in rural health and practiced when you travel abroad. Several faculty mentors (Drs. Newton, Nguyen, Tembele, and Michele Kelly) have worked oversees in the last few years. Resident interest in this AOC is high. We solidify it by making sure clinical exam and reasoning skills are at proficiency through enhanced rural experiences and allow residents to go on a case-by-case basis with a faculty mentor. There is additional training available to help you prepare online and with the AAFP Conference on Global Health.

As you can see, there are many things to choose from – just like Thanksgiving dinner!

Alas, your plate is only so large. Sometimes your eyes are bigger than your stomach and you can start to feel unwell with all the stuffing. So, choose wisely. Think about what you need to have to experience well rounded training. Add a little extra to your plate that will serve you well – but only if it will help with your future practice.