Curriculum

The focus of the Northern Light Eastern Maine Medical Center Family Medicine Residency Program is to train residents to practice in rural settings. In order to accomplish this, the curriculum is designed to address specific aspects of medical care in rural populations.

In addition to the required rotations, residents are responsible for outpatient and inpatient care of their family practice center patients. Elective opportunities abound as our program is the only Residency in our tertiary care facility serving the Northern two thirds of our rural state. Our faculty has a wide range of expertise in a variety of areas to provide teaching and consultation on all patients.

Residents are encouraged to establish links with the community. Home care and nursing home visits, as well as community outreach with the support of faculty are encouraged.

Regularly scheduled hospital conferences presenting a variety of topics, are sponsored by the following departments: obstetrics/gynecology, pediatrics, family practice, pathology, orthopedics, emergency service, urology, surgery, and dermatology. Weekly half-day didactics are held by the Residency to address a broad range of medical and behavioral medicine issues.

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Narrative Medicine leverages the theories and tools of philosophy, neuro, and social sciences of story in medicine. Human beings are wired for story. When we pause, we create stories and understanding. Narrative and story are key not only for a good medical history, but for understanding the context of the patient experience. Without this context, many if not most of our interventions will have less efficacy.

Narrative Medicine more broadly allows for reflective practice, and physician self-care in terms of having not only a broad context to understand our patients, but an ability to understand our own story and the impact on the patient – physician relationship.

We teach and practice medicine using narrative methods including screening for adverse childhood and experiences, resiliency and life stories We leverage what we learn to treat the patient and family in the context of their story, as well as examining our own story as providers.

Narrative Medicine, along with an excellent physical exam leads us to reduce errors in logic and improve patient care outcomes with the added bonus of reducing physician burn out.

 

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The Clinical Scholars Curriculum at the EMMC FMRP has been an area of tremendous growth in recent years.

Several faculty are actively engaged in grant funded research on nutrition and bipolar disorder, mindfulness-based interventions in the setting of addiction, and the impact of narrative medicine on the patient-doctor relationship.  We recently received a major federal grant to investigate how to deliver medication-assisted treatment for opiate use disorder to the rural and remote Native American populations of our State.

As part of the curriculum, there is focused time during the fall of intern year learning about critical reading of journal articles, writing good research questions, and thinking about research design. Residents present to their colleagues and faculty at least once per year on a prevention topic, a journal club, a case conference, and a Morbidity and Mortality case (M&M). These presentations are highly supported by faculty advisors and help residents become confident in navigating the medical literature and communicating about clinical cases in a variety of ways.

The resident required scholarly projects are highly flexible with the goal of allowing residents to pursue a question they are passionate about answering. Extensive support from the EMMC Clinical Research Center is provided. All residents are expected to produce a poster that is presented at the EMMC Annual Student and Resident Research EXPO in June, an interprofessional event for the family medicine residents, pharmacy and nursing residents, and students from all of these programs. Some residents may additionally participate in multidisciplinary case reports for publication, grant writing, and presenting and regional or national conferences, for which there is financial support available. 

We participate in Family Physicians Inquiries Network (FPIN) providing a structured format and support for Residents to contribute to a growing body of evidence based medicine literature.

Interested residents can develop a research rotation and work with a faculty mentor to produce a publishable paper during the course of their residency. Coursework and resources are available to support residents in these activities with our faculty, our EMMC Office of Research, and the nearby University of Maine.
 

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Our curriculum is actively expanding to incorporate ultrasound across all settings of care from OB ultrasound in the office and on labor and delivery to point of care ultrasound used in decision making in the clinic and at the hospital bedside.
We additionally are adding imaging guidance by ultrasound for a wide array of procedures to improve safety.  Ultrasound didactics and workshops for Residents are complemented by learning in real-time with patient care and elective rotations in POCUS.

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Integrative medicine is a part of our longitudinal curriculum with many Residents choosing to participate in the online curriculum through the University of Arizona Andrew Weil Center for Integrative Medicine. 

Faculty experienced in integrative medicine including acupuncture, osteopathic manipulation, hypnotherapy and more infuse these complementary approaches each day as we care for patients.  Elective rotations in integrative medicine with physicians practicing in surrounding communities are also an option.

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