Enhancing the Education of Family Medicine Physicians

April 5, 2011

The College of Community Health Sciences is responding to changing needs in health care by offering more fellowships for family medicine physicians. The College, which is also the Tuscaloosa branch campus of The University of Alabama School of Medicine, recently added a fellowship in hospital medicine and one in emergency medicine. A sports medicine fellowship and academic medicine fellowship began this summer, and fellowships in rural public psychiatry and behavioral health began this fall. The College has long offered a fellowship in obstetrics. Additionally, a rural medicine training track during the residency years is now in its second year. The fellowships are offered through the College’s Tuscaloosa Family Medicine Residency and academic departments; each fellowship adds one year of training following three years of residency. “While these fellowship programs benefit the individuals who pursue additional training, they also benefit all of our residents and medical students with the educational infrastructure they provide,” says College Dean E. Eugene Marsh, MD.

Improving Their Game

A recent survey of family medicine physicians shows 45 percent serving as team physicians in one or more sports. To help future physicians fill that role, the College’s Sports Medicine Fellowship welcomed its first fellow this summer, offering education, training and certification in state-of-the-art sports medicine care. Fellows work with University of Alabama athletic team physicians, coaches, trainers, and athletes between and during University sporting events. Fellows also work with local area high school athletes. Marsh says the Sports Medicine Fellowship will benefit the University and its athletes and provide additional training “that will be felt in community sports programs as fellows graduate and establish their practices throughout Alabama and the region. The fellowship will also enhance the training of other family medicine residents who might not elect to take an extra year to complete the fellowship but who could well find themselves serving as team physicians for sports programs and athletes in the communities where they will practice.” The Sports Medicine Fellowship is the culmination of several years of work by the College and The University of Alabama Department of Intercollegiate Athletics. The fellowship is part of the College’s Dr. Patrick Lee Trammell Sr. Excellence in Sports Medicine Program, named in honor of the quarterback who led the Crimson Tide to the 1961 national championship. Trammell received his undergraduate degree from The University of Alabama in 1963; three years later, he graduated from the University’s School of Medicine. As he prepared to start his residency, he was diagnosed with cancer and died at the age of 28 in 1968. As part of the Sports Medicine Program, an endowed chair will be established to recruit a nationally known sports medicine physician to lead the College’s efforts in sports medicine research and strengthen its sports medicine training.

Hospital Based Training

The College’s University Hospitalist Fellowship program is the nation’s first certified hospitalist fellowship for family medicine physicians. The yearlong fellowship offers training at Tuscaloosa’s DCH Regional Medical Center, a tertiary-care facility with more than 580 beds. University of Alabama Hospitalists Group physicians, all of whom are College faculty, care for nearly half of inpatients at the medical center. The fellowship began in 2008 and had its first graduate last year. The Emergency Medicine Fellowship for Primary Care Physicians is another yearlong program based at DCH Regional Medical Center. A level II trauma center and regional referral center for West Alabama, the medical center’s emergency department is one of the five busiest in Alabama, treating approximately 70,000 patients a year. The fellowship, a collaboration of the College and Tuscaloosa’s Northriver Emergency Physicians, began in 2008. Its goal is to provide clinical and procedural training and experience so that family medicine physicians can practice emergency medicine more comfortably, says fellowship Director Dustin Sheppard, MD.

Preparing for Rural Practice

The Rural Residency Training Track, also established in 2008, enables resident physicians to gain 24 months of hands-on experience in a rural clinic in Centreville, Alabama. The Tuscaloosa Family Medicine Residency is the state’s first family medicine residency to provide an accredited rural training track, says residency Director John B. Waits, MD. He adds that the first rural-track resident chose to practice in a rural Alabama community after his June graduation. The College has offered an Obstetrics Fellowship since 1986. The fellowship was developed by Paul David Mozley, MD, then chair of the College’s Department of Obstetrics and Gynecology and now professor emeritus, to address the overwhelming need for obstetric care in rural and remote areas of Alabama. During the yearlong program, fellows master high-risk, operative obstetrics and office obstetric and gynecologic procedures, including ultrasound, colposcopy, cryotherapy and endometrial biopsies. Fellowship Director Dwight Hooper, MD, says that as the attrition of obstetricians in the United States exceeds the number of obstetricians completing residencies and entering general practice, programs that train family medicine physicians to provide quality obstetrical care will continue to grow in importance.

Healing the Mind

Family medicine physicians in rural areas have few psychiatrists close by for patient referrals and often must address psychiatric care issues themselves, says Marisa Giggie, MD, director of the College’s Behavioral Health Fellowship. She says 50 percent or more of a family medicine physician’s caseload involves patients with psychiatric issues. The yearlong Behavioral Health Fellowship trains family medicine physicians, particularly those planning to practice in rural communities, to better care for patients with psychiatric concerns. Giggie also directs the College’s Rural Public Psychiatry Fellowship, a yearlong program for physicians who have completed an accredited psychiatry residency. The goal of the fellowship is to provide administrative training and public psychiatric experience for psychiatrists interested in practicing or serving in a community setting.

It’s Academic

The yearlong Academic Medicine Fellowship provides physicians with the knowledge and skills to be effective teachers, mentors and scholars, says fellowship Director Alan Maxwell, MD. The fellowship is designed for physicians who have successfully completed a family medicine residency. Maxwell says there are other academic medicine fellowships for family physicians throughout the country, but the College’s Academic Medicine Fellowship is the only one in Alabama for family medicine physicians. He says Academic Medicine fellows receive faculty appointments in the College’s Department of Family Medicine and participate in educational projects and activities in collaboration with department faculty.