McKay-Dee Hospital Center is a fully equipped tertiary care facility with state-of-the-art technology that supports nationally ranked programs in critical areas of patient care such as heart surgery and newborn intensive care. As the primary inpatient facility serving several northern Utah counties, McKay-Dee also offers full rehabilitation and psychiatry programs. Hospital rotations provide residents opportunities to learn inpatient medical skills in ICU, CCU and obstetrics.

The Porter Family Medicine Residency Clinic located within the hospital serves as an ambulatory training center for the residency program. This setting provides the residents with experience in the most modern outpatient care practices, technology, and nationally recognized computerized clinical databases. The resident is viewed as an integral part of this facility and receives excellent administrative and financial support.

McKay-Dee Hospital Center is part of Intermountain Health Care, a community-owned nonprofit health care organization based in Salt Lake City. The IHC system includes 22 hospitals, clinics, affiliated physicians and health insurance plans. The mission of IHC is to provide quality medical care to those with a medical need, regardless of ability to pay. Each year IHC hospitals provide more than $20 million in charitable assistance.

Family Medicine Residency
The mission of the McKay-Dee Family Medicine Residency is to provide resident physicians with excellence in training, to encourage opportunities for their personal growth, and to ensure the consistent, quality care of their patients. Our commitments are...

* To provide training, and encourage competence in the full spectrum of family medicine in urban and/or rural settings.
* To provide opportunity for residents to utilize new technologies in healthcare delivery systems.
* To encourage specific individualized opportunities and their related development of medical skills and interests.
* To foster an environment in which residents are partners in their educational development.
* To encourage resident involvement with family, the residency, and the community.
* To attend to and promote the resident's physical and emotional well-being.
* To encourage residents to play an active role in the development in the specialty of family medicine.

The Curriculum
Family Medicine Inpatient Service (8 months)
First year residents spend 4 months, second year residents spend 2 months and third year residents spend 2 months on this inpatient service. Call is every fourth night. This service exposes residents to every gamut of family medicine including adult medicine, pediatric medicine, obstetrics and newborn care. One of our own faculty members serves as the attending each week. The resident will admit from the family medical faculty and resident clinic patients, and other obstetric and pediatric patients from physicians in the community.

Medicine Inpatient Service (8 months)
First year residents spend 5 months and second year residents spend 3 months on this inpatient service. Call is every fourth night. Residents work with the McKay-Dee hospitalists as well as internists, sub-specialists and family physicians, caring for patients admitted to McKay-Dee Hospital Center. The patient mix extends from general medical problems to acutely ill intensive care and coronary care patients. Residents respond to and help the hospitalists direct all codes.

Obstetrics (longitudinal)
The obstetrical training occurs both during family medicine service rotations and while caring for the resident's private obstetrical patients who are part of the resident's continuity clinic. The residency serves as primary obstetrical provider for a large community agency serving low-income populations. Through this affiliation, and through the residency clinic, there is the opportunity to follow a large number of women through the entire course of pregnancy and delivery under the supervision of family physicians, obstetricians, perinatologists, and midwives.

There is extensive training in the use of ultrasound, intrapartum monitoring, and in the management of delivery. The average resident cares for and delivers approximately 60 continuity patients during his or her three years. In addition, residents participate in over 100 other deliveries with community obstetricians, Family Medicine and midwife attendings. Residents also have the opportunity to learn Caesarean section skills.

Pediatrics (longitudinal)
The resident's pediatric training encompasses a full range of pediatric care. Inpatient experience occurs within the hospital pediatric unit while on the Family Medicine inpatient service. A formal NICU rotation is also required. While on the Family Medicine Service the first year residents spend 6 half-days a month with local pediatricians--this is the core of their outpatient pediatric training. Ongoing acute and well-child care training is gained through the resident's continuity clinic at the Porter Family Medicine Residency Clinic. All residents continue to follow the majority of the newborns they deliver and this provides every resident with a large pediatric population within their continuity clinics.

Orthopedics/Sports Medicine (2 months and longitudinal)
There are three residency run Sports Medicine clinics a week, attended by Dr. Scharmann, our assistant residency director. All residents participate in these clinics throughout their residency. Additionally, there is a formal one-month rotation in both the 2nd and 3rd year of residency. During these rotations, residents work with orthopedists, physical therapists and various other specialists learning advanced musculoskeletal medicine. All residents are assigned to a local high school football team during the Fall of their second year and attend all games to provide coverage on the field and sidelines. A sports medicine bag is provided to each resident. Residents feel the sports medicine training at McKay is one of the best in the country and enjoy not having to compete with any fellows.

Surgery (2 months)
The surgery rotation provides residents a broad range of training and experience from the handling of major trauma to "lump and bump" office procedures. The resident gains experience in the delivery of pre- and post-operative care, as well as experience in operating room procedures. Competency in minor surgical techniques and outpatient surgery is stressed. The program may be tailored to meet special demands of the resident expecting to practice in a rural area. Graduates currently practicing in rural areas perform procedures such as: hernia repairs, cholecystectomies, upper and lower endoscopies, carpel tunnel release, appendectomies, tonsillectomies, adenoidectomies, and tympanostomy tube placement.

Rural Medicine (2 weeks)
Every second year resident spends two weeks in a rural Utah community learning small town Family Medicine. The resident participates in outpatient, inpatient, obstetrical, and emergency care while on this rotation. Housing is provided. Residents are also encouraged to explore community resources and the differences between rural, suburban and urban medicine.

Psychiatry (1 month)
The behavioral health training consists of longitudinal training, as well as a one-month rotation based on a combination of hospital and community experiences. Residents treat a variety of patients with psychiatrists and other mental health professionals. There is ongoing collaboration and consultation on selected cases during each year of the residency. The training can be tailored to fit the needs of the individual resident.

Emergency Medicine (2 months)
The emergency medicine rotation is completed at McKay-Dee Hospital, which is a Level II Trauma Center serving Northern Utah and Southern Idaho through the busiest ED in the state. Residents receive training in the management of a wide range of medical and surgical emergencies, and acquire competency in CPR, endotracheal intubation, and the initial management of both major and minor trauma victims. This is often the resident's highest rated experience.

Community Medicine (2 weeks)
During the first year, each resident spends 2 weeks visiting various community resources and working at the local health department and homeless shelter medical clinics.

Geriatrics (2 weeks and longitudinal)
Residents will spend 2 weeks working with local geriatricians. 2nd and 3rd year residents will have a couple of assigned patients at a local nursing home with the medical director, who also provided some didactic teaching in geriatric care.

Gynecology (1 month)
Gynecological training is gained during a one month rotation during the first year and also longitudinally throughout the three years. The formal one-month rotation is spent with several gynecologist in the community. Experience is gained in pre and post-operative care as well. One day a week during the rotation is spent in the operating room assisting in gynecological surgeries. The residents are also involved in a monthly colposcopy clinic that takes place in the Porter Family Medicine Residency Clinic.

Critical Care (1 month)
A formal one-month rotation is spent in the Intensive Care Unit at McKay-Dee Hospital during the third year. Residents admit patients with the intensivists and follow these patients daily. Formal rounds are held by the multidisciplinary intensive care team, and residents present their patient at these rounds. Daily didactic lectures are given by the intensivists to the residents.

Electives (11 months)
Electives are available in the second and third years of the program to permit residents to tailor their training program specifically to their anticipated practice settings, and to their individual needs. A wide variety of electives are available at McKay-Dee Hospital, or with community physicians in the Ogden/Salt Lake City and surrounding areas. Residents expecting to practice in a rural setting generally spend a number of months obtaining experience in operative obstetrics, surgical techniques, and endoscopy.

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This article is reposted with thanks to McKay-Dee Hospital Center.