Block rotation

Our Family Medicine Residency program is 36 months and follows a block rotation schedule, designed to comply with all ACGME Family Medicine Review Committee requirements.

Each year has 13 four-week blocks of “traditional” rotations, with longitudinal experiences throughout the training in Health Systems Management/Q1 (3 years), and Behavioral Health (3 years). Our residency clinic also is part of the longitudinal experience that crosses all three years of training.

All residents are expected to complete each rotation as scheduled. Rotation information is available on New Innovations. Goals and Objectives for each rotation will be sent via New Innovations to all residents two weeks prior to the start of each rotation.

Rotation sites

  • Adventist Health Medical Office – Tulare (residency clinic): 6 minutes, 2 miles from Adventist Health Tulare
  • Adventist Health Tulare: 6 minutes, 2 miles from Adventist Health Medical Office – Tulare (residency clinic)
  • Valley Children’s Hospital: 56 minutes, 58 miles from Adventist Health Tulare
  • Adventist Health Hanford: 26 minutes, 24 miles from Adventist Health Tulare
  • Adventist Health Medical Office – Hanford Residency: 26 minutes, 23 miles from Adventist Health Tulare
  • Adventist Health Medical Office – Fowler: 37 minutes, 36 miles from Adventist Health Tulare
  • Merritt Manor Convalescent Hospital: 2 minutes, 0.5 miles from Adventist Health Tulare

Family Medicine Residency Curriculum

See example block schedule

Longitudinal curriculum: Continuity Clinic, Nursing Home, & Scholarly Activity, blocks are ones in which you will have some exposure to a specialty rotation to which you will be assigned but you will inevitably end up spending more time in your FMC.

Three PGY-3 tracks: Admin/Chiefs, Hospitalist/Junior Preceptors, OP/Junior Preceptors.

Essential rotations = Inpatient, Night Float, CM, VCH Inpatient Peds, EM Peds, L&D/Gyn = no vacations allowed.

Continuity Clinic

Patient Visits:

  • 1st year: 1 half-day session/week; 3-5 pts per session
  • 2nd year: 2-3 half-day sessions/week; 6-8 pts per session
  • 3rd year: 3-4 half-day sessions/week; 8-10 pts per session

Back-Up Call Residents:

  • Two weeks at a time on Back-Up, resident must remain available via phone
  • Mainly be used for call-offs during essential rotations but could also be employed for coverage needed to sustain health system tasks (CM coverage, Community Events, L&D coverage, etc.; during which time residents on non-essential rotations will be approached for help as needed).
  • Upheld to the same work hours as ACGME has enforced.
  • PGY-1 will mainly provide BU to PGY-1 and on occasion to PGY-2/3.
  • PGY-2/3 can be used for BU provided to PGY-1/2/3.
  • Back-Up residents will stay within one hour driving distance to ensure availability, if in case help is needed.

Night float has 4 primary responsibilities, supervised directly by the ED attending physician (physically present at all times), nocturnist attending physician and clinic coverage physician:

  1. Cross coverage of patients on the Residency Inpatient Teaching Team
  2. Admit new patients to the Teaching OR Hospitalist Teams (cap of 3)
  3. Attend all Rapid Responses and Code Blues
  4. Attend to Outpatient Calls from the Residency Clinic
Block schedule example