Program Overview
Learn more about the Family Medicine Residency Program in Vancouver, WA.
Curriculum
Family Medicine of Southwest Washington (FMSW) is an unopposed community-based family medicine program committed to providing its residents with a broad based curriculum in a rich learning environment with an emphasis on fostering individual ownership and responsibility for patient care decisions through guided mentorship. The core inpatient rotations at PeaceHealth Southwest occur during FMSW inpatient teaching services, which are managed by senior residents and supervised by residency program core faculty. While attending for the inpatient services, faculty’s sole responsibility is teaching and oversight of the service. This provides a high level of interaction and collaboration to encourage resident learning. The remainder of inpatient education is conducted by community attendings on specialty rotations such as Cardiology, GI, OB and Critical Care/ICU.
Location
The Family Medicine Residency program is a community-based residency program located in Vancouver, Washington. It is part of the University of Washington Affiliated Family Practice Residency Network and sponsored by PeaceHealth Southwest Medical Center.
Evaluations
Residents will be continuously evaluated for their knowledge, skills and attitudes in both the inpatient and out-patient settings. Evaluations are done at the end of each rotation and longitudinally. Evaluations are both competency and milestone based, as defined by the ACGME.
On-site Specialty Clinics
In addition to continuity clinics, the Family Medicine of Southwest Washington (FMSW) residency program includes numerous on-site specialty clinics. Specialty clinics allow residents to gain hands-on experience through responsibility combined with active mentorship.
Areas of Concentration
Our program provides several areas of concentration for residents to focus in a particular area of interest during their second and third year of residency.
Musculoskeletal (MSK) and Sports and Exercise Medicine (MSK/SEM)
This AOC is designed to provide additional knowledge and skills to FMSW residents that can be integrated into a traditional primary care practice. It is also meant to prepare residents for submitting a competitive Fellowship application packet at the end of R2 year, should they intend to do that.
Required experiences:
- 4 weeks of elective time over 2 years on approved MSK/SEM rotations.
- Serve as Team Physician for a local sports team during at least one season, attending at least all home games. Minimum of 5 games is required.
- Assist with PPEs at least once, and training room clinics on occasion, at local high schools, Clark College or University of Portland.
- Complete a Sports Ultrasound skills curriculum
- Complete assigned readings
- Present one Journal Club article and two lectures or worships on MSK/SEM topics
- Complete one scholarly writing project (e.g., GEM, review article, book chapter)
Maternal Child Health (MCH)
This AOC is designed to acquire advanced skills in obstetrics and neonatal care to prepare residents interested in rural practice or in other settings where advanced skills might be warranted.
Required experiences:
- 4 weeks of inpatient Hi Risk OB at a tertiary care center, or 2 weeks of outpatient maternal fetal medicine combined with alternative inpatient OB experience
- 2 weeks of NICU/Special Care Nursery
- Perform a minimum 80 vaginal deliveries
- Perform a minimum of 20 C-section assists
- Participate in 15 continuity deliveries
- Participate in the care of patient with high-risk problems including substance abuse issues. This should include both prenatal and intrapartum care.
- Participate in at least one water birth.
- Attend at least 3 breastfeeding support group meetings
- Acquire experience in basic OB Ultrasound.
Integrative Medicine
Integrative Medicine at FMSW is done in conjunction with the University of Arizona Weil Center for Integrative Medicine. Residents who choose this AOC start in their second year. To graduate with a certificate, they will complete 180 hours of online course work and another 20 hours+ of live education. Residents will finish with a solid knowledge base of nutrition, lifestyle medicine and botanicals/supplements. Residents who complete the program are eligible to sit for the Integrative Medicine board exam.
Required experiences:
- Spend one half-day per academic year during elective time, outside of FMSW, in a clinical setting where Integrative Medicine is practiced. Examples include but are not limited to: Integrative Medicine Family Medicine, Naturopath, Acupuncturist/Chinese Medicine, Massage Therapist, Osteopathic physician practicing OMT, Chiropractor. - Resident will work with faculty liaison to arrange with Program Core Team.
- Spend a minimum of 2 half-days per year in FMSW Integrative Medicine clinic as scheduled by program scheduler.
HIV
This AOC is designed to provide participating residents with an enhanced degree of knowledge of various HIV-related topics to adequately and efficiently identify, resolve, and prevent clinical problems in patients with HIV and at high risk for HIV infection.
It is a longitudinal experience beginning in the R-2 year. By the end of the AOC, residents will be well prepared to do primary care and general HIV care for HIV infected patients in a primary care setting.
Required patient care experiences:
- HIV clinic w/ faculty liaison with the goal of at least once per 4 weeks of elective/outpatient centered rotations as scheduling permits.
- Manage HIV patients as part of residents’ own panel beginning late first year/early second year.
- Care for at least 20 HIV continuity patients prior to graduation.
- 4 weeks of additional elective time to be spent in HIV related patient care activities.
- Optional: Residents are encouraged to spend 2 or more weeks of elective time in HIV or related areas such as LGTBQ care, addiction, Hep C, STIs, etc. International opportunities may
Mission & Objectives
The primary mission of the residency program is to train family physicians for the future while enhancing the health and well-being of our community. In addition, the program is intended to provide a service to the community by meeting the medical and health care needs of the medically underserved in the Vancouver area.
Frequently Asked Questions
Family Medicine of Southwest Washington is an 8/8/8 program. It is a three-year training program. Having completed the 36-month curriculum, residents are eligible to sit for the American Board of Family Medicine board exam. They then become board certified family physicians, and fully employable. Our program opened its doors for establishment of a clinic in 1995, and we graduated our first residents in 1997. The program is sponsored by PeaceHealth Southwest Medical Center, supported by PeaceHealth Medical Group, and is academically affiliated with the University of Washington School of Medicine.
As of June 30, 2020, we have 167 graduates:
- 92 practice in the Vancouver/Portland metropolitan area:
- 38 are in Clark County
- 22 work for PeaceHealth Medical Group
- 8 at FMSW (residency), Vancouver
- 8 at Fisher’s Landing, Vancouver
- 1 at PeaceHealth Woodland
- 1 Memorial Campus Urgent Care, Vancouver
- 1 at PHSW Wound Care Clinic
- 1 in Florence, Oregon
- 1 in Bellingham, Washington
- 1 in Friday Harbor
The rest of our graduates are located mostly in the Pacific Northwest, with smaller numbers serving communities in Hawaii, Alaska, California, Utah, Arizona, New Mexico, Illinois, Missouri, Arkansas, Mississippi, New Hampshire, New York, North Carolina, and Florida. Globally, FMSW graduates have a presence in Kenya, Malawi, and Zimbabwe.
Yes. The program has an accredited Sports Medicine fellowship, fully funded by the program, training one fellow per year.
Yes, specialty clinics and curriculum offered by core residency faculty incudes:
- Endocrinology consultation
- Women’s Health Consultation and Procedures
- General Procedures/ Vasectomy
- Musculoskeletal and Sports Medicine
- Integrated Mental Health Program with comprehensive counseling and prescribing
- Mental Health Medication Consultation
- HIV, Hepatitis C, and Transgender Care
- OMT (Osteopathic Manipulation Therapy)
- Integrative Medicine Consultation
- Suboxone Clinics for MAT (Medication Assisted Treatment) of opioid addiction and for chronic pain.
- “Bloom” Clinic, a collaboration with Lifeline Connections Women’s Recovery Center, to provide Maternity, Newborn, Pediatric care for women in residential substance abuse treatment.
- “Eat, Sleep, and Console Model” leadership/chair, faculty Heidi Radlinski, MD. Babies born after intrauterine exposure to opioids have both short- term and long-term effects. Historically, Neonatal Opioid Withdrawal Syndrome (NOWS) with significant withdrawal symptoms is treated with opiates, requiring NICU admission and intensive nursing involvement and extended length of stay. In 2010, Dr. Grossman at Yale School of medicine implemented a new method called Eat, Sleep, Console (ESC) keeping infants in a low-stimulation environment focused on keeping mother and child together. Breastfeeding is encouraged and skin to skin used as a treatment method. An integral part of the Eat, Sleep and Console model involves increased caregiver/parent involvement and normalizing the at-risk infant’s environment. A multidisciplinary workgroup at our hospital, led by Family Medicine of Southwest Washington has been developed to transition to the ESC Model at the Family Birth Center at PHSW.
- Pharmacy consultative services for patients with complex medication profiles.
- Dedicated anticoagulation clinic for warfarin (coumadin) management
Family Medicine of Southwest Washington sponsors interdisciplinary training in healthcare professions critical to the Patient Centered Medical Home. This includes:
- 6 Masters level graduate students in Marriage and Family Therapy through an educational collaboration with Lewis and Clark College
- 2 Masters level Medical Social Worker (MSW) interns
- 2 PGY-1 (post-doctoral first year) Pharmacy Residents
- 1 PGY-2 (post-doctoral second year) Pharmacy Residents
FMSW serves diverse ethnic groups in Vancouver, which includes a large Latino and Russian population. FMSW focuses on other “high-needs” vulnerable populations, such as those with substance use disorder, mental illness, and homelessness. FMSW and PeaceHealth sponsor the programs below, providing residents with additional opportunities for contribution to the local community:
- Community Free Clinic
- Grant-supported Cervical and Breast Health Screening program
- Procedure Clinic for the Uninsured
- New Heights Free Clinic
- Annual Sports Physical Clinics for the Vancouver School District
- Medical staffing at local high school football games, wrestling tournaments, mixed martial arts matches, and high school lacrosse games.
- Medical staffing for the Vancouver Marathon other community sporting events throughout the year
- Primary Care medical services and Medical Directorship for Adolescent residential substance abuse treatment center, Daybreak Youth Services
Since 2004, FMSW has been a leader in the Patient-Centered Medical Home environment, teaching and living in a quality improvement, advanced/open access care model. FMSW has team care pods that are protocol-driven for standardized processes. Our clinic incorporates systems-based disease management and chronic care model programs, including anticoagulation management, diabetes, medical management of chronic pain, COPD, and childhood ADHD.
FMSW’s newest PCMH enhancement is a robust model of integrated mental healthcare. Led by marriage and family therapist Layne Prest, PhD, the team consists of an inter-professional group of two MFT PhDs, six master’s level graduate student therapists, a social worker, pharmacist, care coordinator, a part time psychiatrist, and the patient’s PCP. This model optimizes bi-directional clinical integration of mental and physical health activities on site, within the context of an individual’s Family Medicine health home.
We are currently a NCQA-Recognized Level III PCMH.
Summary of Quality Improvement Efforts at FMSW since launching Advanced Access (second generation Open Access) care environment in 2004:
- 2004 - Advanced Access care environment. “Today’s work Today”. Taken from Clinicalmicrosystem.org. Adapted from IHI Practice Redesign Project.
- 2004 - Team Care/ standardized processes and care pods/ mini practices. LPN- managed
- 2006 - Group Visits for Diabetes
- 2006 - Initiation of LPN team leaders for station (care pod)-based teams, including complex care management outreach. Creation of Non-RN team leadership environment
- 2007 - 2009 - Washington St. DOH/Qualis Diabetes Learning Collaborative.
- 2009 - 2011- Washington St. DOH/Qualis Learning Collaborative for PCMH model development
- 2010 - 2011 Team-based LPN- led InBasket management for HAC (McKesson)-EMR
- 2011 - Chronic Disease Management program for Childhood ADHD utilizing IHI Chronic Care Model
- 2012 - Group Visits for Childhood Obesity
- 2012 to the Present -Development of Interdisciplinary Integrated Mental Health program as part of PCMH
- 2013 - Group Visits for Childhood Obesity in Spanish
- 2013 - NCQA PCMH recognition, Level II
- 2013 - Development of standardized Clinician/MA huddle
- 2013 - Group Visits for Chronic Pain
- 2014 - Group Visits for Eating Disorders
- 2014 - Development of the standardized rooming checklist, adopted by PeaceHealth’s PCT (primary care transformation) team
- 2015 - Registry Development and structured Care Coordination for HIV patients, leading to reduction in viral loads/CD4 counts
- 2016 - 2018 - Participant in WPRN (WWAMI Practice-based Research Network) Grant project, Health Hearts Northwest. Participating with UWSOM, OHSU Medical School, multiple residencies and community practices in the 5 state WWAMI (Washington/Wyoming/Alaska/Montana/Idaho) region, with aim of cardiovascular morbidity and mortality reduction.
- 2016 - 2018 - Participant in PeaceHealth Medical Group ACT (ambulatory care transformation) Advisory Committee. This group created the system level practice changes required for CPC Plus in Oregon, and PCMH (Patient Centered Medical home) development, for which PeaceHealth received a multimillion-dollar TCPI grant from CMS
- 2017 - 2020 - NCQA PCMH recognition, Level III
- 2018 - Present - PeaceHealth System Primary Care Collaborative, Pediatric Care Collaborative, Opioid Collaborative
**Disease Management / Chronic Care Model programs, including Anticoagulation Management, Diabetes, Medical Management of Chronic Pain. All are Interdisciplinary, LPN-managed. Ongoing since their development and launch.