Family Medicine Curriculum

The NSU KPCOM – Evara Health Family Medicine Residency is dedicated to the training, education, and development of caring, mature, professionally competent, and family medicine board-eligible physicians. We strive to deliver the highest quality comprehensive, evidence-based, compassionate, patient-centered care to the community while remaining sensitive to the community's health care problems and resources. Our mission is to innovate beyond the barriers that limit access to quality healthcare, ensuring everyone can receive industry-leading services from professional teams that care as much as family.

This three-year educational program aims to provide a curriculum to produce competent, independent physicians for a career in family medicine with board certification. The following description of the educational program outlines the expected acquisition of knowledge and skills by residents. The faculty endorses a team approach to patient care. The effectiveness of the residency depends upon shared responsibility by both the residents and the attending staff. The program recognizes that residents must have opportunities for learning and practicing critical decision-making and endorses meaningful patient responsibility as defined by the Accreditation Council for Graduate Medical Education (ACGME).

Program graduates will demonstrate the knowledge, skills, and attitudes necessary to provide independent, patient-centered care in the specialty of Family Medicine. We aim to train physicians to gain expertise in the roles and responsibilities of Federally Qualified Health Centers and the treatment and care of the medically underserved. Competence is demonstrated in the domains described by the Program Requirements of the ACGME: Patient Care, Medical Knowledge, Practice-based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-based Practice.

Our graduates will have the knowledge and training to become local and national leaders in the areas of advocacy, public health, and academic medicine. The program provides flexibility in curriculum to accommodate each trainee’s individual learning needs and maximize achievement. The curriculum will encompass the following family medicine care settings to give a diverse educational experience and improve patient quality of care by training well-rounded physicians.

Rotation Schedule:

PGY-1 Rotations

Gynecology - 4 weeks
Family Medicine Clinic - 12 weeks
- Longitudinal experiences in Radiology, Behavioral Health, Community medicine and Pain management
Outpatient Pediatrics & Nursery - 4 weeks
Obstetrics - 4 weeks
Inpatient Adult Family Medicine - 12 weeks
Adult Emergency Medicine - 4 weeks
General Surgery - 4 weeks
Pediatric Emergency Medicine - 4 weeks
Inpatient Pediatrics - 4 weeks

PGY-2 Rotations

Outpatient Pediatrics - 4 weeks
Family Medicine Clinic - 8 weeks
- Longitudinal experiences in Radiology, Behavioral Health, Community Medicine, Pain management and Health Systems Management
Obstetrics - 4 weeks
Inpatient Adult Family Medicine - 12 weeks
Cardiology - 4 weeks
Ophthalmology & ENT - 4 weeks
Orthopedics & Sports Medicine - 4 weeks
Family Medicine Procedures - 8 weeks
Elective - 8 weeks

PGY-3 Rotations

Outpatient Pediatrics - 4 weeks
Nephrology - 4 weeks
Geriatrics - 4 weeks
Family Medicine Clinic - 12 weeks
Inpatient Adult Family Medicine - 12 weeks
- Longitudinal experiences in Behavioral Health, Community Medicine, Practice and Health Systems Management
Elective - 16 weeks

Example Rotation Schedule

Required Family Medicine Rotations:

Outpatient Pediatrics and Nursery: Residents will complete a four-week rotation during each residency training year under the supervision of our Pediatric faculty at Evara Health. This PGY-1 rotation also includes time in the Nursery at Orlando Health Bayfront Hospital Center for Women and Babies (St. Petersburg) evaluating healthy, term newborns. During this rotation residents will evaluate a diverse population of children with acute and chronic medical conditions as well as perform well-child checks. This rotation is also supplemented by lectures on topics relevant to the care of the pediatric patient.

Orthopedics and Sports Medicine: The primary care sports medicine and orthopedics rotation is a four-week rotation in the PGY-2 year. Under the supervision of Evara Health’s physicians certified in the specialty of Primary Care Sports Medicine, residents will learn the concepts of the sports medicine approach and the methods by which patients are diagnosed, managed, and rehabilitated. The resident is instructed in the examination, diagnosis and nonsurgical management of patients with injuries, overuse and degenerative musculoskeletal conditions in an outpatient clinic. Conditions treated in this clinic are primarily related to the knee, shoulder, elbow, hip, foot and ankle. Residents will also have exposure to the evaluation of sport-related concussion in the youth and high school population. Diagnostic and interventional ultrasound are a significant component of this clinic, as are regenerative medicine and orthobiologics. Residents will also learn how to discern nonsurgical sports injuries from those that would benefit from surgical referrals. The rotation also provides the residents with the skills and knowledge expected of family physicians in the field of Orthopedic Surgery. The residents will work under the supervision of board-certified orthopedists at Florida Orthopedic Institute/All Florida Orthopedics. Residents will not only spend time with orthopedists specializing in Sports Medicine, Hand Surgery, Foot and Ankle Surgery but also with athletic trainers, physical therapists, and casting/splinting technicians.

Nephrology: The nephrology rotation is a four-week rotation during the PGY-3 training year. The rotation occurs at BayCare Medical Group Nephrology, and includes experience in the office, at the dialysis center, and in other locations included in the nephrologist’s usual practice. The nephrology rotation will provide the resident with an opportunity to evaluate and manage patients across the spectrum of renal disorders in the outpatient setting. The goal is to familiarize them with the basic mechanisms, clinical manifestations, diagnostic strategies, and management of acute and chronic kidney disease. At the completion of this rotation, the resident will develop competency in the prevention of renal disease, indications for procedures, management of common disease, and appropriate indications for referral pertinent to the practice of family medicine.

Geriatrics: Residents will complete a four-week rotation in their third year of training across a variety of settings. Settings include outpatient practices, nursing homes, and assisted living facilities and home visits with a community-based Family Physician specializing in Geriatric care. Residents will have a longitudinal experience in their continuity outpatient clinic at Evara Health and will gain knowledge in the inpatient treatment of the geriatric population during their inpatient medicine rotations. This is also supplemented by lectures in various topics relevant to the care of the geriatric patient. The goal of all these experiences is to prepare graduates to provide high-quality, evidence-based, patient-centered health care to older adults.

Family Medicine Clinic: This rotation is designed to enhance the longitudinal patient care experience in Family Medicine and is a four-week block in each of the three training years. This rotation provides the resident with the opportunity to become the primary care provider for patients in the Family Medicine Center at Evara Health. Residents will evaluate patients with a variety of common chronic and acute complaints in a wide range of age groups and make an initial management plan in conjunction with their supervising physician. Patients will be seen for initial evaluation or continuity of care. Residents will learn about the community in which they serve patients and how that community and the individual’s social determinants of health may affect health care outcomes.

Community Medicine Experience: This experience is designed to explore social and economic determinants of health and to develop skills for community-level interventions. The experience is embedded in the Family Medicine Clinic rotation. This experience will allow the resident to have a broader understanding of the role played by community agencies in health promotion and disease prevention, and how the Family Medicine physician can further the health of their patient population by working hand in hand with these agencies. The rotation will increase the resident’s awareness of the community’s resources.
Radiology Experience: This is a longitudinal experience during PGY-1 and PGY-2 years. At the completion of this experience, the resident will have the knowledge and skills in the areas of radiology pertinent to the practice of Family Medicine. During the experience, the radiologist will provide experiential learning, role-modeling, and one-on-one teaching to the resident. The resident will learn the appropriate use of imaging as well as the technical aspects, strengths, and weaknesses of different imaging modalities: CT, US, MR, Radiography, Nuclear medicine, and Interventional Radiology. The teaching of radiology in the program is not limited to this, as residents will also have experiences in the Family Health Center, inpatient medicine rotation, didactics, and other rotations such as orthopedics/sports medicine.
Behavioral Health Experience: This is a longitudinal experience during all three years of training. During this experience, residents will work primarily with our behavioral health team at Evara Health. Residents will spend time with our clinical psychiatrist, clinical psychologist, as well as our licensed social clinical workers. During the rotation residents will participate in individual patient evaluations as well as group sessions. Residents will also receive several excellent lectures on common psychiatric problems and the medications used to treat them done by our faculty psychiatrist and pharmacist.

Inpatient Adult Medicine: Inpatient Adult medicine rotations consist of three four-week blocks in each of the three residency training years. The residents will work with our Family Medicine faculty, staff, and hospitalists at Morton Plant Hospital during this rotation. This rotation exposes the residents to a variety of acute and chronic medical conditions in the inpatient hospital setting. Patients on this service have a wide and representative array of inpatient medical problems and are drawn from a socioeconomically and ethnically diverse population. Residents will have critical care experience embedded within this rotation. Residents will work 8- hour shifts 6 days of the week under the supervision of the attending staff. There is no overnight call.

Obstetrics: This experience in obstetrics occurs in two four-week blocks in the PGY-1 and PGY-2 years of training. Family physician practices vary considerably in the extent to which they provide obstetrical care. This rotation is designed to provide residents with the skills and expertise expected of family physicians in this area. The residents will work under the direct supervision of our Evara Health faculty obstetricians providing comprehensive inpatient obstetrical care at Orlando Health Bayfront Hospital Center for Women and Babies (St. Petersburg) and outpatient obstetrical care at the Evara Health Highpoint office. This experience includes prenatal, intra-partum, and post-partum care. In addition to this rotation, residents are assigned patients to be followed through their maternity experience in a continuity care relationship.

Gynecology: The gynecology rotation is a four-week rotation occurring during the PGY-1 training year. During this rotation residents will work under the direct supervision of our Women’s Health faculty at the Evara Health Highpoint office. This rotation will provide an experience in the care of women with gynecologic complaints and disorders. It will complement the longitudinal gynecology experience in the Family Medicine Center as well as the gynecology that is learned during the obstetrics experiences throughout residency. The resident will be expected to perform gynecologic procedures commonly performed by family physicians.

Adult Emergency Medicine: The Adult Emergency Medicine rotation consists of two four-week blocks, one in the PGY-1 and one in the PGY-2 training years. The residents will work at the Bay Pines VA Hospital under the direct supervision of our site faculty. This rotation focuses on acute care management and critical care, improving differential diagnosis insight and skills, and coordinating inpatient and outpatient healthcare with primary care providers and other services. Residents will develop and implement, in coordination with the attending staff, case specific patient management plans including proper patient disposition. Residents will also complete an oral airway didactic session during this rotation. Residents will have four 12-hour shifts each week of the rotation.

Cardiology: This rotation is a four-week block during the PGY-2 training year. This rotation is designed to provide the resident with the skills and knowledge necessary to provide care to patients with cardiac disease at the level that is expected of family physicians. The residents will achieve competency in the management of cardiac disorders commonly cared for by family physicians, including disease prevention, early detection of disease and management of the patient with disease. The residents will also attain proficiency in the interpretation of EKGs. The residents will work under the direct supervision of board-certified cardiologists at the HCA Florida Heart Institute.

Ophthalmology: This rotation is spent with a board-certified Ophthalmologist at The Eye Institute of West Florida. The residents will become familiar with the evaluation and treatment options for ophthalmic disorders commonly seen by family physicians including conjunctivitis, hordeolum, chalazion, corneal abrasion, uveitis, strabismus, and visual impairment. Residents will also have the opportunity to learn ophthalmic procedures commonly performed by family physicians including slit lamp examination, fluorescein staining, visual acuity testing, visual field testing, removal of foreign body, and application of eye shield.

ENT: During this rotation the residents will work with board-certified site faculty at ENT Associates. This rotation provides the residents with the experience and exposure in the outpatient evaluation and management of patients with common illnesses, pathology, and complaints presenting to otolaryngology specialists. Residents will become familiar with the guidelines for elective tonsillectomy, adenoidectomy, and placement of pneumonostomy tubes. Residents will also be able to observe and learn appropriate physical exam tactics on the nasopharynx, oropharynx, and sinuses.

General Surgery: This rotation is a four-week block in the PGY-1 training year. Residents will work with a team of surgeons at the Bay Pines Veterans Administration Hospital. The residents will be supervised at all times by the faculty surgeon at the hospital. The residents will be responsible for the comprehensive care of all patients assigned to them. This rotation is designed to provide residents with the skills and expertise expected of family physicians involved in the care of patients with surgical disorders.

Pediatric Emergency Medicine: The Pediatric Emergency Medicine rotation consists of one four-week block in the PGY-1 training year. The residents will work at the Johns Hopkins All Children’s Hospital under the direct supervision of our board-certified site faculty. This rotation focuses on the evaluation and management of pediatric emergencies, acute care, improving differential diagnosis insight and skills, and coordinating inpatient and outpatient healthcare with pediatric services. Residents will develop and implement, in coordination with the attending staff, case-specific patient management plans including proper patient disposition. On Tuesday mornings, residents will participate in didactics as well as prepare a 15–20 minute presentation. Residents will have four 10-hour shifts each week of the rotation.

Inpatient Pediatrics: This is a four-week rotation in the PGY-1 year of training. The residents in this rotation will work alongside other pediatric residents at the hospital under the direct supervision of our pediatric hospitalist faculty at Johns Hopkins All Children’s Hospital. This rotation is designed to provide residents with the skills and expertise expected of family physicians involved in the care of inpatient pediatric patients. With the support of the residents and faculty physician, the resident will be responsible for the comprehensive care of all patients assigned to them. The care of these patients can occur in the emergency department or the pediatric inpatient ward.

ABFM Core Outcomes

In addition to the above required rotations, residents will also be expected to be competent in the following ABFM Core Outcomes upon graduation:

Practice as personal physicians, providing first contact, comprehensive and continuity care, to include excellent doctor-patient relationships, excellent care of chronic disease and routine preventive care and effective practice management.
Diagnose and manage acute illness and injury for people of all ages in the emergency room or hospital.
Provide comprehensive care of children, including diagnosis and management of the acutely ill child and routine preventive care.
Develop effective communication and constructive relationships with patients, clinical teams, and consultants
Model Professionalism and be trustworthy for patients, peers, and communities."
"Practice as personal physicians, to include care of women, the elderly, and patients at the end of life, with excellent rate of continuity and appropriate referrals.
Provide care for low-risk patients who are pregnant, to include management of early pregnancy, medical problems during pregnancy, prenatal care, postpartum care and breastfeeding, with or without competence in labor and delivery.
Diagnose and manage of common mental health problems in people of all ages.
Perform the procedures most frequently needed by patients in continuity and hospital practices.
Model lifelong learning and engage in self-reflection."
"Practice as personal physicians, to include musculoskeletal health, appropriate medication use and coordination of care by helping patients navigate a complex health system.
Provide preventive care that improves wellness, modifies risk factors for illness and injury, and detects illness in early, treatable, stages for people of all ages while supporting patients’ values and preferences.
Assess priorities of care for individual patients across the continuum of care—in-office visits, emergency, hospital, and other settings, balancing the preferences of patients and medical priorities.
Evaluate, diagnose, and manage patients with undifferentiated symptoms, chronic medical conditions, and multiple comorbidities.
Effectively lead, manage, and participate in teams that provide care and improve outcomes for the diverse populations and communities they serve."¹