in the hospital
The NCFM team maintains a robust inpatient medicine service. We have a flexible cap to adjust to the time of year and the number of docs on the team. The day team gets sign out from the night team at 6AM and team rounds are usually at around 9AM with plenty of time after morning rounds to get notes done and patient care settled for the day before heading to continuity clinic once or twice per week. The day team signs out to the night team at 5PM. We recently moved to a 6AM-5PM and 5PM-6AM approach to provide the day team with more needed free time during a busy month of hospital service. #workingwell is a priority for NCFM.
The NCFM Obstetrics experience is very robust and is considered a fellowship-equivalent for the amount of time dedicated to OB as well as numbers of deliveries/procedures. Our OB experience prepares each of our graduates to be qualified and competent to practice OB, and it is simply up to them how much OB they pursue in their practice.
On average our residents graduate with a minimum of 100 vaginal deliveries. The Advanced Maternity Care track residents typically have more like 150 vaginal deliveries in addition to 100+ cesarean deliveries.
At least half of our residents go on to practice Obstetrics and many obtain privileges for cesarean delivery. The majority of resident supervision in Obstetrics is from Family Medicine faculty. As an unopposed program our residents deliver nearly every baby born at NCMC, including the patients of our OB/GYN colleagues and private Family Physicians.
NCFM residents admit all of the pediatric patients at NCMC. NCFM maintains its own pediatric service with an NCFM core faculty physician. In addition, NCFM residents admit and round on patients with the NCMC pediatric hospitalists and private pediatricians. One of the pediatric hospitalists, Dr. Brian Money, is a clinical adjunct member of the core NCFM faculty. NCFM residents have two months of inpatient pediatrics during the intern year and continue to have a longitudinal inpatient pediatric experience as senior residents. Dr. Money has a regular, monthly didactic session focused on inpatient pediatric topics.
NCFM residents rotate in the NCMC intensive care unit late in their first year or during their second year. The intensivists are welcoming and readily include residents in procedures. During the peak of COVID-19 in our community, NCFM residents were an integral part of the critical care team at NCMC. Residents learn intubations, central lines, and ventilator management--skills that are invaluable when working in rural emergency departments and intensive care units.
In addition, NCMC is the Western States burn center for Banner Health and the burn ICU provides additional opportunity for critical care training for interested residents.
NCFM residents have a NICU rotation during their 1st or 2nd year. In addition, senior residents admit babies to the NICU throughout their time covering the inpatient admitting services. Additional NICU experience is available to residents with a particular interested/career need. The neonatologists provide a longitudinal didactic series focused on neonatal care for family physicians.
NCFM residents have time dedicated to rotating through the NCMC emergency department during the pgy-1 and pgy-2 years. The ED attendings are great about including our residents in procedures and complicated cases. Since we are an unopposed program, there is no competition with other learners for procedures. NCMC is a level-2 trauma center, and there is additional opportunity to spend time with the trauma team.
The NCFM inpatient medicine team is the primary team for the NCMC inpatient hospice service. We work with the hospice team to provide supportive, patient and family centered end-of-life care.
NCFM residents who have a particular interest in Palliative care have the opportunity to use elective rotation time to work with the NCMC palliative care team.