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Dignity Health Family Medicine Residency Program at Northridge Hospital is always described in superlatives: The most challenging, the most interesting, the most educational … and the most fun!
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While our Family Medicine Center is at the heart of the residency, the inpatient family medicine service allows residents to gain experience in disease diagnosis and management in a compressed process of care. Residents work in a team with one-on-one supervision from a faculty attending providing care for adults: from adolescents to the elderly.
Just like practicing family physicians, our residents manage - at any one time - medical, surgical, orthopedic, neurologic, and even gynecology patients. And not unlike family physicians in practice, patients are managed by residents from admission to discharge, including critical care medicine.
Faculty attending's not only teach in rounds and morning report, but at the bedside. The hospital faculty attendings are both family physicians and internists. Critical care specialists are available for consultation in the ICU and CCU. Daily radiology rounds are conducted with a radiologist attending along with a medicine attending.
During these rounds patient imaging is projected onto a 60 inch screen in the radiology conference room. While viewing the images with the radiologist, residents are encouraged to ask questions about images as well as discuss the future management of the patients. Patient loads are kept manageable by graded experience with service caps.
Our residency is in the enviable position of having no other competing residency yet being at a referral hospital with a wealth of pathology. Residents learn to manage patients with pneumonia, cholecystitis, stroke, and hip fractures while also caring for patients diagnosed with CNS lymphoma or dengue fever.
Sports medicine is an exciting and integral part of the curriculum at the Northridge Family Medicine Residency Program. The sports medicine program is headed by our very own primary care sports medicine specialist, Dr. Mandeep Ghuman. Residents, as well as rotating medical students under the supervision of Dr. Ghuman, have the opportunity to gain first-hand experience in evaluating and managing a variety of musculoskeletal conditions through our sports medicine clinics, which are held twice a week at the Family Medicine Center.
In addition to these clinics, residents also rotate through dedicated sports medicine and orthopedic electives in their third and second year of residency, respectively. At the completion of their residency training, residents have successfully attained and honed skills in such areas as the orthopedic physical exam, the evaluation, management, and rehabilitation of musculoskeletal injuries and conditions, splinting and casting of fractures, and joint aspiration and injection.
Residents have ample opportunity to enhance their sports medicine experience, while at the same time performing a valuable community service, by serving as team physicians and participating in athletic event coverage. Dr. Ghuman is one of the team physicians for California State University Northridge, a nearby NCAA Division 1 level college.
The residency program under the supervision of Dr. Ghuman serves as the team physician for James Monroe High School. Through these affiliations as well as many others within the local community, residents are actively involved in covering events and treating athletes at the recreational, high school, and elite levels. Among the many sports that the residency program is involved in covering are football, basketball, soccer, and track & field.
With the experience and skills gained in sports medicine through the course of their residency training, many of our residents have gone on to be team physicians in their own right upon graduation. In fact, if you were to drive around Southern California on a Friday night in the fall, there’s a good chance that a graduate of our program is out there covering a game!
Fellowships in Primary Care Sports
Medicine are increasingly popular and competitive in recent years. Residents who want to specialize in this dynamic and growing field have taken the knowledge and experience they attained during residency to successfully pursue additional fellowship training. No matter what your career path may be, the ability to care for musculoskeletal conditions and athletes is a vital and rewarding aspect of any practice. Sports medicine is a skill in which we are confident that you are competent upon the successful completion of your residency training at the Dignity Health Family Medicine Residency Program at Northridge Hospital.
Maternity Care at Dignity Health Family Medicine Residency Program at Northridge Hospital
Caring for your pregnant patients can be one of the highlights of your residency experience!
We have a strong team of five experienced family medicine faculty who provide low risk maternity care. Dr. Diana Lev completed a maternity care fellowship prior to joining the Northridge faculty. She runs the obstetrical ultrasound clinic in our office and rounds on the postpartum floor with the residents.
Residents care for their continuity maternity patients during their family medicine continuity sessions in our family medicine center, where they learn about and model whole family care. All family medicine patients deliver at Northridge Hospital, located next door to the campus of the residency program where we have a busy labor and delivery unit with the latest in remote fetal monitoring and excellent nursing staff.
Residents round out their experiences in maternity care through following patients of select OB teaching staff. Daily teaching rounds with family medicine or OB faculty occur on the maternity care rotation. These rounds include practice reading fetal monitor strips, discussion of active inpatient cases and lectures on a core of other maternity care topics. All deliveries are attended by the attending physician in addition to the resident. Residents learn to assist in Caesarean sections and tubal ligations and see a wide spectrum of patients.
Our pediatric inpatient rotations here at Northridge provide residents with an exciting and unique educational experience. Northridge Hospital houses a full complement of pediatric care including general pediatrics, an NICU and a PICU. Additionally, Northridge Hospital is currently the only Level II pediatric trauma center in the San Fernando Valley.
As a result, our hospital annually sees a large volume of pediatric illnesses that span the breadth of different diagnoses from common “bread and butter” cases to the more exotic. During their 1st year, residents rotate through our general pediatrics ward where they work directly with Dr. Catherine Cho, our pediatric coordinator, or one of the Family Medicine attending's. Daily rounding consists of walk rounds with the residents, where teaching is integrated into every patient case through article reviews, short didactic sessions, review of interesting physical findings, or discussions about new up-to-date perspectives on management.
During their 2nd year rotations, residents rotate through our PICU where they work one-on-one with the pediatric intensivists and get valuable exposure to PICU and trauma patients. The intensivists have a flair for teaching and add a different perspective to the approach of the more critically ill patient. They are in house and available 24 hours a day. Residents consistently report that they enjoy the teaching they receive during their PICU rotation.
Additional electives are available in the PICU for interested third-year residents. Another benefit of Northridge is the availability of pediatric specialists for consultations and recommendations. Residents will work directly with these specialists and on their cases. Residents are also offered the opportunity to be involved in doing procedures done by the specialist.
When residents relay an interest in doing more procedures, the staff is more than happy to accommodate them. Finally, all of the pediatric floors are staffed with nurses who are skilled in the care of pediatric patients and also like to teach our residents. Our hospital has a child life specialist, a pediatric dietician, social workers and volunteers who work together to improve our patient’s quality of life during their stay here with us. Residents frequently report that they receive the biggest hugs from their patients as they leave the hospital.
Inpatient acute care of pediatric patients is only one aspect of the pediatric educational experience here at Northridge. Although it is important to know how to manage sicker hospitalized patients, much of the family doctors future involvement with children will actually be in the outpatient setting. Fortunately for us, we have a busy outpatient practice with a large population of pediatric patients.
Residents manage their own panel of patients, of which a significant number are children. Residents can expect many pediatric visits encompassing both routine well child and acute care. Additionally, we have dedicated a set amount of lecture time towards pediatric topics. Finally, each second year resident rotates at the NEVHC Federally Qualified clinic in ambulatory pediatrics with a staff Pediatrician.
Community Medicine Rotation
We believe that developing competence in community medicine is key in preparing residents to enhance the health of the communities they serve. Understanding how culture and economics affect availability and delivery of health care services, working effectively with existing community partners, and developing competence in health education are key in delivering high quality cost-effective health care.
This year’s revamping of the Community Medicine curriculum aims to create a more longitudinal experience during the first and second years. Introduction to the rotation is with our behavioral health faculty. One of our goals is exposure to a wide range of resources in the community.
In the first year, residents have two rotations. The schedule includes time dedicated to planning a research project. Residents spend about three half days a week in office, where part of their training is learning about the referral resources available to our patients. Some of their patient visits are observed via video by behavioral health or family practice faculty so they can get feedback on their interactions with the culturally diverse patients of the Family Medicine Center.
We are striving for better health outcomes for our patients as well as higher levels of satisfaction for our residents.
The geriatric experience at Northridge is strong both in the hospital and in the office; both populations are about one-third seniors 65 and over. With their attendings help, residents on the inpatient service gain experience holding family meetings and discussing code status with patients and families. Each second and third year resident has continuity nursing home patients.
Residents do introductory skilled nursing home visits with an attending physician in the first year and attend multi-disciplinary rounds at Northridge Care Center during their first year; they also do home visits starting that year and continue with their own patients as needed.
Geriatric topics are included as part of the lunch-time lectures as part of the medicine and behavioral health curricula. Third year residents have the option of an elective in geriatrics at locations including the Motion Picture and Television Fund in Calabasas, the Jewish Homes, and Northridge Hospital with the palliative care team.Elective Experiences
Each resident has an opportunity for an independent elective rotation during their senior year. Residents have the opportunity to explore areas of interest in family medicine, areas that they want more experience, rural or community health, future practice site experiences or research.
All electives must have educational value and be pre-approved by Dr. Zapata. Past Elective experiences include:
Family Medicine Residency Program at Northridge Hospital has a long history of night float experiences. Float originally started as a solution to decreasing in-house overnight call for senior residents, we are able to smoothly transition into the new work hour restrictions with this system. Our program also has the unique addition of a Hospitalist member who is available weeknight’s in-house as well as full time intensivists who are available to teach in-house 24/7.
The float residents are a team of a PGY-1, 2, and 3 during the first six months, and a team of PGY-1 and PGY-2 during the second six months. There is gradually increasing amounts of responsibility throughout the rotation.
We no longer do the traditional Call at Dignity Health Family Medicine Residency Program at Northridge Hospital. With our current well-tested night float system already in place we now have long shifts by team and the day shift now stay until 8:00 pm to sign-out to the float team. The team always consists of a PGY1, 2, and 3, (2-3 at a time) as well as a faculty member who is available 24/7.
Information Technology - Our Family Medicine Center
For over ten years we have been using the Cerner “PowerChart Office” EMR system in our Family Medicine Center. Significant features of our EMR that help improve both patient care and resident education include:
Although it does not yet have a fully integrated EMR, the Hospital does have a web portal through which all inpatient labs, hospital dictations, and radiology reports can be accessed. For those with an iPhone or iPad, the data can be downloaded for review on these devices.
System New Innovations, a web-based residency management system, allows residents 24 hour access to their call and office schedules and lets them report work hours, review rotation curricula, access the educational calendar, complete rotation evaluations and view their performance evaluations.