Cahaba Family Medicine Residency Rural Track

Cahaba Family Medicine Residency Rural Track

History

Cahaba Family Medicine Residency started in 2013 as a truly rural full spectrum Family Medicine residency program located in Centreville, AL. The mission of the program is to train residents to provide medical care to children, adults, and elderly, including care throughout pregnancy and delivery so that graduates are equipped to work in rural, underserved and international communities, capable of meeting the medical needs of the marginalized. In 2018 CFMR expanded by adding the Urban Track in Birmingham, AL. Currently, there are 4 tracks, Rural, Urban, Frontier and Highlands.

Community

Living in a rural community means that you are a critical part of the medical services available for your neighbors, coworkers and friends. You see your patients as you go for a run or go to a store, or at church. You see an athlete on the field and in the clinic. You recognize familiar faces and know the families they represent. You see need, and have the ability to help meet that need.

CFMR Rural Track surpasses definition as a training program. While working closely together for 3 years incredible bonds are formed between residents that live nearby and support one another. Sincere care for one another, an unyielding team mentality and an appreciation for laughter and fun are fundamental characteristics of our rural program.

Full Scope Family Medicine

Rural residency training closely approximates long term rural medical practice. Serving patients well in this context means being prepared to meet their procedural needs.

Our mission is to train and equip graduates to work in underserved environments whether they be in rural, urban or international communities. Recognizing similarities between resource-poor areas domestically and internationally, our residents acquire a tangible and translatable skill set and knowledge base to provide for the needs of patients in inpatient and outpatient settings. Responding to the breadth of knowledge required of a competent Family Medicine physician, our longitudinal curriculum teaches residents to integrate what they are learning on a day by day, patient by patient basis. Understanding that access to thorough prenatal and post delivery care, well child and sick child care dictates the health of Alabama families, Cahaba Family Medicine Residency has devoted significant educational time, effort and resources for residents to meet these patients' needs. Finally, whether it be obtaining their insulin through our Dispensary of Hope, assisting with access to procedural care detailed below or representing our patients' needs in Washington, D.C. advocacy in its various forms is a key element of CFMR Rural Track.

Because of the vast shift of resources and cultural shifts, many rural communities are left with pervasive hopelessness and shocking inequities in health.

For these reasons and more it’s been said that rural America is the new inner city, and these areas are arguably the most marginalized areas of the United States. Our rural track is based out of Centreville, AL in a region known as the “Black Belt,” a severely economically depressed region with rich black soil that previously was the sight of wealthy white planters and enslaved black persons. For several decades now, The Health Care System has been Leaving the Southern Black Belt Behind.

This is the context in which Cahaba Medical Care was born in 2004. Long before the residency program began we were striving to promote community health for our neighbors. Over the years we have been able to expand to other communities, with many milestones along the way like when we bucked the trend of rural hospital L&D closures by helping reopen Bibb County's only L&D, which had been closed for 20 years. Then in 2013 the Cahaba Family Medicine Residency was born. Starting the residency among a population of 5,000 required lots of good old fashioned hard work and innovation. But as our program director, Dr. John Waits, likes to say, “That’s just our game.”

Curriculum Overview

Medical

The program has implemented a very innovative and unique approach to its family medicine curriculum.
We call it the Longitudinal Integrated Curriculum (LIC).

Within the LIC, the majority of the required experiences for family medicine training are spread out over years 1 and 3 instead of being lumped together in traditional block rotations. Educational and expert practice research shows that interspersing and interweaving different components creates more durable mastery. To use an analogy, a batter who sees 30 fast balls then 30 curve balls then 30 sliders will be great at those pitches momentarily. But to be a great batter she’ll need to face real-life pitch mixes. That’s what the LIC does. Also, it allows the resident to experience the life of a full scope community physician … i.e. our residents will be experts at coordinating inpatient, clinic, and obstetrics into their typical workday. We’re preparing full-scope family physicians for underserved communities domestically and internationally, so we take this philosophy seriously.

A typical day in the life of a rural track resident includes hospital rounds at Bibb Medical Center in the AM, followed by clinic at 9:00am, with deliveries interspersed throughout. When on call the resident will also cover the emergency department in the evenings. Additionally, residents will spend half days doing ultrasounds and echocardiograms, endoscopy, working in the specialty clinic on-site, working in our school based health clinics, and much more.

In the second year of training, residents will complete several months of traditional block rotations at our partner sites (see list below) while still maintaining their panel of patients in continuity clinic.

• Inpatient hospitalist, trauma surgery (rural & frontier), emergency medicine (urban & highlands), sports medicine, high risk OB/MFM (frontier & highlands), and orthopedics at UAB in downtown Birmingham

• Inpatient Pediatrics and pediatric emergency medicine at Children’s Hospital of Alabama

Furthermore, each resident has a block EACH YEAR to spend overseas at a site of their choice. This is a critical part of our curriculum in which we help foster a WORLD view in our residents. We hope each graduate will go, send, and support around the world.

Community (Health)

More than a residency, we are a community.

We encourage our residents to fully invest in our communities. We strongly value relocation into the communities where our clinics and patients are. As we walk in the footsteps of Jesus and minister in His love together, all the while living in proximity to one another and to our health centers, we lead interwoven lives of such great depth and richness.

There is no greater way to understand the social determinants of health impacting our patients than to experience the issues with housing, education, crime, nutrition, transportation, infrastructure, etc. first hand. There is no greater way to seek the health of our communities than to invest our lives in them. As the old exhortation goes, “Build houses and live in them; plant gardens and eat their produce … seek the welfare of the city where I have sent you into exile, and pray to the Lord on its behalf, for in its welfare you will find your welfare.”

Perhaps the greatest thing about relocating to our patients’ neighborhoods is the relationships we form that change us forever.

Beyond that, we have a robust community health experience that includes:

• spending time with local students in their schools teaching on a range of health topics
• working in our school based health clinics
• spending time with partner organizations working on education, housing, vocational training, etc.
• working in our food pantry and clothes closets alongside our social workers
• teaching AP biology courses
• fundraising for community health projects like our Cahaba River Canoe Launch project.
• And so much more ….

Pioneers, Leaders

We prepare our graduates to open new clinics and start new projects domestically and internationally that will impact areas with the greatest need.  

Experiences

• International Rotations - our residents spend up to one month per year overseas in an area of their choice. For many, this is in preparation to go to those areas (or at least be able to support and send workers in those areas) after residency.
• Launch Weeks - each year our residents have a week set aside to take a step back and pray and plan for the post-residency work. Residency is hard, and these weeks are lifelines.
• Pioneers, Leaders Sessions - we invite some of our heroes to teach us from their own experiences in pioneering and leading.
• MGR - a monthly forum where some of our hero overseas workers spend an evening in a living room with us talking about various aspects of international medicine.