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Combined Family Medicine and Preventive Medicine Residency Training Option

​​​Sponsored by: UCSD FM, Scripps FM and UCSD Preventive Medicine

The UCSD Department of Family Medicine and Public Health sponsors a combined training program that will lead to preparation for Board Certification in both Family Medicine and Preventive Medicine. Work by the Robert Graham Center on Policy Studies in Family Medicine and Primary Care highlights studies that show that access to primary care makes a substantial difference in health status. Many adult chronic diseases such as Diabetes, CAD, COPD, and arthritis have roots in preventable conditions such as obesity, smoking and lack of adequate nutrition and exercise. With a long history of accredited residency education in both Family Medicine and Preventive, UCSD and Scripps are well-poised to operate a Combined Training program.

Originally accredited in 1974, the UCSD FMRP graduated its first class of residents in 1977. The residency received five years of full accreditation by the Accreditation Council for Graduate Medical Education (ACGME) in 2009. Originally a 6-6-6 program, the residency expanded in 1996 to an 8-8-8 program. In 1998 the program expanded further through the development of the UCSD Combined Family Medicine/Psychiatry Residency Program (UCSD CFMPRP). In 2010 the UCSD FMRP expanded again with the assistance of federal residency expansion grant dollars. Currently there are 27 traditional Family Medicine Residents (9-9-9) and 10 Combined Family Medicine/Psychiatry Residents (2-2-2-2-2) for a total of 37 residents in the UCSD FMRP. Diversity is the hallmark of the UCSD FMRP. Residents are exposed to a training experience that includes 7 major hospitals and health care systems including UCSD Healthcare, Veteran's Administration, San Diego Children's Hospital and Health Center, Scripps Health, Sharp Healthcare, San Diego Kaiser Permanente and Navy Medical Center San Diego. In addition, residents have more then 6 months of exposure to specific underserved populations in community health settings including Escondido Neighborhood Healthcare, St. Vincent DePaul Village for the Homeless, University of California San Diego School of Medicine (UCSD SOM) Free Clinic Project, rural clinic in El Centro California, Inpatient Adult Medicine at the San Diego community hospital Palomar Medical Center with faculty from Escondido Neighborhood Healthcare. In addition, the current 10 combined Family Medicine/Psychiatry residents also have their continuity clinic at St. Vincent DePaul Village for the Homeless seeing an average total of 1682 continuity visits for Family Medicine alone during the 5 years of residency training.

The UCSD-affiliated Scripps FMRP is a community-based training program developed through a partnership between the UCSD SOM, Scripps Mercy Hospital Chula Vista, and the San Ysidro Health Center, Inc (SYHC). The Scripps FMRP was established with the support of the San Diego Border Area Health Education Center (AHEC) with a goal to increase access to quality healthcare for the medically underserved communities along the California and Baja California border region. In January 1998 the Scripps FMRP received accreditation as a new program from the ACGME and matched its first PGY I class in July, 1999. In November 2004 and 2009, the ACGME granted the program full accreditation for five years. In 2010 the Scripps FMRP expanded from 7-7-7 to 8-8-8 with the assistance of federal residency expansion grant funds. The core ambulatory-care training sites and the Family Medicine Center are located within the SYHC and its satellite clinics. SYHC is a federally-qualified health center (FQHC). The majority of the inpatient training takes place at Scripps Mercy Hospital Chula Vista, the institutional base for the San Diego/Border AHEC. The family medicine residency collaborates with the Community Benefits Department at Scripps Mercy Chula Vista and the San Diego Border AHEC to build and support a culturally diverse, culturally competent primary health care workforce in San Diego’s medically underserved communities. More than six months of core resident rotation experiences take place in community-based settings including the Southwest and Palomar High School Clinics, Imperial Beach Family Health Center, and Operation Samahan Family Medical Clinic. Rotations in Pediatrics, Women’s Health, Behavioral Medicine, HIV care, Sports Medicine, and Geriatrics all include clinical activities in community sites and with community service agencies.

The UCSD-SDSU jointly sponsored General Preventive Medicine residency (PMR) is a 2 year PGY2/PGY3 program. Founded in 1983, the PMR trains physicians in preventive medicine and public health. Co-sponsored by the Department of Family Medicine and Public Health at the University of California, San Diego (UCSD) and the Graduate School of Public Health at San Diego State University (SDSU), residents obtain a Masters in Public Health during their training, concurrent with the development of competencies in clinical PM, population medicine, and research. The PMR has been fully accredited by the American College of Graduate Medical Education since its inception and its most recent accreditation extends through 2012. All residents obtain competency in three areas: population medicine including public health, research and clinical preventive medicine. In addition to these required components, the program recognizes the breadth of career opportunities in preventive medicine, and the specific skills and competencies required for each career path. Therefore, we encourage residents to concentrate their practicum rotation efforts in one of the following four tracks, each of which has specific learning objectives, each of which enhances the skills of residents beyond the basic training described above: Community-Oriented Preventive Medicine (COPM): This track provides extensive training of residents in medically underserved communities, including community health centers (CHC), Indian Health Services, homeless shelters, and public health agency centers. Skills are developed in a combination of quality assurance, health care administration, community outreach, needs assessment and research and residents are encouraged to maintain—and even strengthen--their skills in patient care. Dr. Hill, who has worked in the CHCs since 1980, coordinates resident placement in this track.
Border and International Health Track: This track trains residents in health issues related to immigration, migration, and refugee status issues, as well as the public health and policy issues of border and international health care. Residents develop clinical skills in infectious and chronic disease, mental health, screening, family planning and health promotion for these populations. Public health and policy training provides skills in outreach, surveillance, research, community needs assessments, epidemiology, and public outreach. Training sites include refugee health clinic, public health clinics, international rotations, CHCs, international research experiences, travel clinics and others. Public Health Track: This track emphasizes training in the local public health department. Because of the “safety net” role the San Diego County Public Health Department plays in providing services to the underserved, this rotation also helps us meet our goal of training physicians to support underserved populations. Clinical services are provided for tuberculosis, and sexually transmitted diseases. Community health promotion programs, border health programs, communicable diseases and epidemiology are other areas of emphasis. Academic and Research-related Preventive Medicine: This track focuses on developing and enhancing the research and evaluation skills of residents who are interested in full-time careers in academic preventive medicine or as researchers in private or public settings. In addition to the required research, residents in this track participate in more extensive research projects with mentors at UCSD or SDSU where internationally known experts in fields such as epidemiology, health behavior, infectious disease, and health outcomes research have labs. A specialization on our Academic track is our Cancer Prevention and Control Research and Practice track. This is the track for residents with a specific interest in cancer-related preventive medicine. Residents in this track receive support from the American Cancer Society.

The combined curriculum meets the needs of the family medicine (FM) RRC and the preventive medicine (PM) RRC in a 48-month training program. The first 12 months, PGY1, are entirely the family medicine internship. The next 36 months include three types of rotations: 12 blocks of straight FM; 12 straight PM; and 12 combined. Residents participate in FM continuity clinic through all three types of rotations. The MPH is done with an epidemiology emphasis, for both ease of scheduling and usefulness for the combined resident. The PM ‘track’ is the “Community Oriented Preventive Medicine” track, which already includes clinical community rotations. The MPH classes have been batched during rotations that don’t involve ‘call’, to avoid residents having scheduling conflicts.

UCSD/Scripps Combined Family Medicine and Preventive Medicine Program Proposed Rotation Grid