School of Medicine Departments
Family Medicine
Associate Professor and Acting Chair
David L. Stewart, MD, MPH
The Department of Family Medicine educates family physicians to render high-quality medical care to individual patients and families of all ages in a continuous and comprehensive manner. Family physicians are responsible for patient care at the point of entry into the health care system, are providers or coordinators of health care at the secondary and long-term care phases of illness, and are coordinators of tertiary care.
The department offers educational experiences in family medicine for students at the University Family Medicine office, on the Family Practice Inpatient Service, and through an interdisciplinary, longitudinal educational program that is guided by a staff of experienced family physicians. Moreover, students may participate in community health services, supervised practice experiences and healthcare research.
Within the discipline of family medicine, several areas are emphasized. The department provides regular house calls for 50 frail, homebound elderly in the city. The department has a division of behavioral medicine that further integrates the teaching of basic science, clinical medicine and the psychosocial aspects of health care. The division assists in the education of substance abuse, training issues related to family violence and abuse, and common mental health conditions seen in family medicine, such as anxiety and depression.
The department has a Program in Complementary Medicine (CMP). The Complementary Medicine Program is an interdisciplinary program within the University of Maryland School of Medicine which consists of four interdependent units: 1) research; 2) database/literature evaluation; 3) education; and 4) clinical care. CMP is directed by Brian Berman, MD and currently employs 25 people. The academic offices of CMP are based in the Mansion House at the James L. Kernan Hospital; basic science lab is located in the School of Medicine's Howard Hall; the integrated medical clinic is part of the University Physicians' clinic at Kernan Hospital. A scientific advisory board meets yearly to give guidance on all aspects of the Program.
The department has developed an active sports medicine division. Family medicine physicians participate in the care of the Baltimore Ravens, University of Maryland Terrapins and the Coppin State athletes. A fellowship in primary care sports medicine is available.
The department has a major focus on providing health care to underserved patients and communities, involving community outreach and disease prevention.
RESEARCH INTERESTS
The research efforts of the Department of Family Medicine reflect the broad interests of the department's faculty. Current projects, which are clinically oriented and relate to current medical problems, range from epidemiologic studies to evaluations of specific therapies. The department has a strong interest in health promotion and nutrition, especially as they relate to the family and the elderly. The department concentrates on investigating ways to improve community health. Collaborative efforts with other departments involve investigations into health promotion, screening for HPV infections and the management of the abnormal PAP smear. During their last year of training, all family medicine residents are required to complete a research project and to present their results at the Annual Family Medicine Residents' Research Day. Department faculty, fellows and residents present their research at national meetings, and in journals, books and other publications.
UNDERGRADUATE MEDICAL PROGRAM
Minimester Electives. During the summer months, students may elect to spend time in the office of a selected family physician in order to observe the varied professional activities of a physician practicing in the community. During preceptorship experiences, students may participate in direct patient care or primary healthcare research.
Family Care Track Program. The Family Care Track (FCT) is an elective undergraduate experience designed to teach medical students the principles of family medicine with a focus on the urban, poor, multi-problem family. It provides a continuous clinical experience through all four undergraduate years. Students are assigned to follow families over the first two years in the department's Family Practice Centers. The families are selected to provide exposure to obstetric, pediatric and geriatric care, and to family dysfunction. Supervision is provided to the individual student and through the use of small group integration seminars for case discussion. The students are also required to complete a community medicine seminar series, a social services preceptorship, a needs assessment, a community project and a four-week clinical preceptorship in sites, including some located in health professional shortage areas.
Up to 40 students are selected each year from the freshman Longitudinal Elective in Family Medicine to participate in the FCT program. Credits for this elective include four weeks of senior elective credit at the completion of the program.
Longitudinal Ambulatory. The longitudinal ambulatory clerkship is designed to: 1) give students a longitudinal experience in primary care, 2) help the student integrate the management of patient problems through the continuum of initial presentation, outpatient and inpatient clinical medicine, and 3) allow the student to have an extended interaction with a primary care physician for role modeling purposes. Students spend one afternoon every other week with a primary care physician (pediatrician, family practitioner or general internist) during their junior year of medical school.
Third-Year Family Medicine Clerkship. The family medicine clerkship focuses on the guiding principles of family medicine-continuity and coordination of care, comprehensiveness, community, prevention, and family. Students spend four weeks in a family medicine practice in either an urban or suburban locale. Each Friday during the clerkship students meet at the Department of Family Medicine for a series of lectures on the family life cycle and to research, evaluate, and present case studies/patients.
Senior Elective in Family Practice. In this elective, students work with a community family physician preceptor. They have the opportunity, under supervision, to manage problems typical of a busy practice, ranging from obstetrics to geriatrics. There is ample opportunity to be involved in coordinating continuous care of patients over a four-to six-week period. Students begin to understand the patient in relation to family, job and environment. Furthermore, the student observes the role of the physician in society, the social and civic obligations and responsibilities to the patient. Site options range from urban health manpower shortage sites to rural private practice. In these varied settings, students are expected to conduct a limited clinical investigation, using data collected in the practice, and to attend weekly Alcoholics Anonymous or Al-Anon meetings in the community.
Senior Sub-Internship in Family Practice. The Department of Family Medicine offers an eight-week internship to senior students. This is an extensive inpatient experience utilizing the family medicine inpatient service. Variety is a major attraction as the patients' needs range from newborn care and obstetrics to adult general medical and geriatric care. The student is exposed to the family practice approach to inpatient care with an emphasis on interdisciplinary, comprehensive and continuous care and participates in night and weekend call. Students may choose to accomplish the rotation at University of Maryland Medical Center or Union Memorial Hospital. The rotation at Union Memorial is primarily an internal medicine experience.
Senior Ambulatory Clerkship in Family Practice. Students may select University Family Practice as an option in the required Senior Ambulatory Course. This eight-week rotation exposes students to the clinical practice of the Department of Family Medicine residency program. In this setting, students are scheduled to see patients daily in the University Family Practice Center, work with a variety of preceptors from the Department of Family Medicine and participate in didactic sessions. This ambulatory experience is designed to expose students to the principles and practice of family medicine.
GRADUATE MEDICAL PROGRAM
The University of Maryland's approved three-year residency in family practice is one of the oldest in the nation. Approximately 30 residents are enrolled in the program. The program's goal is to provide comprehensive training in the specialty, utilizing the latest information and educational methods. Resident training takes place at University of Maryland Medical Center, where the expertise of faculty in all specialties can be utilized, and in several community hospitals where the residents are exposed to a wide variety of patient problems. Flexibility is maintained through the availability of electives in order to accommodate specific needs of the trainee. Although the majority of graduates are actively engaged in family practice in rural, suburban and urban areas, a significant number are pursuing academic careers.
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