Second Year

The goal of our residency is to train confident physicians skilled in providing continuing and comprehensive personal care to patients and their families. During their second year, residents continue their education in all areas of family medicine including adult medicine, maternal and child health, behavioral science, community medicine and surgical specialties. The emphasis on the value of wellness and preventive medicine with chronic disease management and curative medicine provides an opportunity for residents to work with other members of the health care team in the management of their patients.

It is during their second year that residents are encouraged to develop electives that meet their unique educational needs. The University of Iowa and the Iowa City community offer resources residents can utilize for their education. The residency supports individualized rotations, but asks that residents clearly identify their goals and objectives.  

Family Medicine Clinic
The purpose of this rotation is to provide senior residents the opportunity to function as a busy family physician in the outpatient setting on a daily basis. The senior resident will provide ambulatory care in the Family Medicine Clinic one month in second and third years of training. They will spend time in their continuity clinic, procedure clinic and in our same-day-access clinic, which are all located within the Family Care Center.
Cardiology
During this rotation, residents work with faculty and fellows in the Division of Cardiology. Two weeks are spent on the inpatient Cardiology Consult Service where a wide variety of inpatient cardiac conditions are managed, including coronary artery disease, heart failure, dysrhythmias, and cardiomyopathies. Two weeks are devoted to outpatient care in the Heart and Vascular Center where residents care for patients with chronic cardiac conditions and assess patients with new complaints. The rotation includes opportunities to perform stress testing and interpret imaging and other cardiac studies.
Geriatric Medicine
Under the supervision of family medicine trained geriatricians, residents evaluate and treat patients in the multi-disciplinary Geriatric Assessment Clinic. Patients presenting to this clinic are often complex and may have multiple medical problems as well as cognitive loss and socioeconomic challenges. Common presenting complaints include memory loss, functional decline, falls, and polypharmacy. Other aspects of this rotation include nursing home rounds, geriatric journal club, and multi-disciplinary case presentations.
Newborn and Maternal Medicine
This resident works one-on-one with one of our Family Medicine OB faculty providing care to Family Medicine newborn, infants (<3 months) and obstetric patients in the hospital setting. Residents will have experience triaging OB patients, resuscitating and evaluating newborns, first-assisting for Family Medicine cesarean sections and performing procedures for newborn infants.
Pediatric Inpatient
The Blue Team service is an inpatient ward service that is made up of different Pediatric division inpatient services. Included in Blue Team are: Cardiology, Neurology, General Pediatrics, and Pulmonology divisions. Family medicine residents work with pediatric residents and medical students providing care to hospitalized pediatric population.
Surgery
Training is provided in general and surgical subspecialties with special emphasis on the diagnosis and management of surgical disorders, emergencies and the appropriate and timely referral for specialized care. Residents rotate through the Surgery Consult Service under the supervision of surgery faculty to achieve competency in the diagnosis and management of a wide variety of surgical problems typically encountered by family physicians. This experience includes both the ambulatory and operating room experience.
Family Medicine Inpatient Service – Night Float
Residents in this position will assume care of all Family Medicine inpatients, including newborns, post-partum women, and any children, for the evening and overnight hours during the week, and after the inpatient team has rounded on the weekends. Residents work in pairs with a junior and senior resident for this 2-week rotation.
Community Medicine
Residents participate in a Community Medicine rotation to assess and understand the health needs of the community in which they work. The residents visit community health agencies so they may gain appreciation of the resources available to their patients and patient families, including school health services and public health services. Disease prevention and health promotion is covered during the community medicine rotation in addition to care of their patients in the Family Medicine Clinic.
Family Medicine Inpatient Service
While the junior residents are responsible for the clinical care of service patients, the senior resident is responsible for coordinating all clinical, educational, and administrative responsibilities of the service. This includes ensuring that the service runs smoothly, and that all clinical and educational activities happen on time and in the correct place. It includes advising and supervising the junior residents and students in the provision of clinical care to patients, and ensuring that the care delivered is of the highest quality. It includes participation in the education of junior residents and other learners in cooperation with the attending faculty physician. It is probably the most complex and challenging job in the residency-- and it can be one of the most rewarding and fulfilling!
Orthopedics and Rheumatology
Orthopedics and Rheumatology rotations provide residents with board variety of acute and emergency musculoskeletal injuries and illnesses as well as chronic disorders. Taught by Orthopedic and Rheumatology faculty the residents will spend time in the orthopedic and rheumatology outpatient setting, physical therapy and casting room.
Radiology and Nuclear Medicine:
Residents participate in a rotation taught by the Radiology faculty that includes radiographic film and diagnostic imaging interpretation including chest, gastrointestinal and orthopedic studies. Residents also learn the appropriate application of techniques and specialty consultations in diagnostic imaging and nuclear medicine therapy of organs and body systems in the Family Medicine Clinic and during the Family Medicine Inpatient rotations.
Sports Medicine
Focused training in sports medicine is taught under the supervision of primary care physicians with CAQ in sports medicine, orthopedics faculty, and certified athletic trainers in the areas of pre-participation assessment, injury prevention, evaluation, management and rehabilitation. Residents also provide care to their Family Medicine Clinic patients with athletic and recreational injuries.
Continuity of Care Clinic
During the second year, residents will spend 2-3 half days each week in their Continuity of Care Clinic. It is in this setting that residents develop their office medicine skills and provide care to patients who selected them as their family physician. Residents maintain responsibility for their patients' care throughout the three years of training, thereby acquiring the skills needed to deliver continuing and comprehensive care. Emphasis is placed on patient education and maintaining health as well as treating disease.
Longitudinal Behavioral Medicine
Knowledge and skills in behavioral medicine and psychiatry are integrated throughout the residents' educational experience. Training is primarily in the outpatient setting through a combination of longitudinal experiences and didactic presentations. The behavioral medicine and family physician faculty members work closely with the residents to develop and refine physician/patient relationships, patient interviewing skills and counseling skills in the Family Medicine Clinic.
Longitudinal Geriatrics
Care of the older patient is provided throughout the residency in the care of assigned patients in the Family Medicine Clinic and Family Medicine Inpatient Service settings. Residents also participate in Geriatric Clinics and Nursing Home Rounds with family medicine and internal medicine faculty, and meet with the Geriatrics Multidisciplinary Team to discuss unique problems of their geriatric patients. These longitudinal and focused learning experiences provide residents educational experiences in common and complex clinical problems of the older patient, including preventive aspects of health care, the acute and chronic entities of aging, and the effective use of all members of the health care team. Seven members of the Family Medicine faculty have Certificate of Added Qualification (CAQ) in Geriatrics and participate in the Geriatrics Fellowship.
Longitudinal Management of Health Symptoms
Practice management has become increasingly important in the training of family physicians, regardless of the mode of practice within the specialty. The curriculum provides a broad economic, legal, human and conceptual foundation so as to prepare residency graduates to ask sound business questions, interpret financial data, and promote and develop a productive work environment in the practice setting. Curriculum is presented throughout the three years in the form of seminars, workshops and practical experience in the Family Medicine Clinic and independent study. Members of the University of Iowa business and law faculty and experts from statewide and community health care settings give presentations on finance and accounting, legal issues, human resources and personnel issues, effects of legal and economic environmental trends, leadership perspectives, marketing and technology in the office.

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