Program Info & Resources
Family Medicine Residency
The Family Medicine Residency is a three-year, university-affiliated program sponsored by a large, active community teaching hospital. The Family Medicine program is accredited by the ACGME with Osteopathic Recognition. Six residents enter the program each year. The faculty consists of 10 family physicians, a psychologist, and 3 clinical pharmacists. The faculty and residents practice team-based care side-by-side in a clinic located three miles northwest of the hospital.
Education is provided in a variety of inpatient and outpatient settings. The program utilizes the "Clinic First" standard, progressively modeling the role of a practicing family physician. Our Family Medicine inpatient service is integrated, meaning our residents care for laboring & postpartum patients, newborns, children and adults on the same service, modeling quintessential family medicine. The second post-graduate year particularly emphasizes community health through a variety of rotational experiences, state advocacy and a class retreat.
The mission of Mercy Family Medicine Residency is to develop future family physicians by modeling exceptional patient care for all ages in our community within an environment of collaboration and inclusion, while honoring the gift of life. We encourage our residents to be not only excellent clinicians but also community leaders who emphasize health equity.
Family Medicine Application Information
Mercy Family Medicine seeks a diverse, inclusive physician workforce as one bridge to health equity in Missouri. Mercy Family Medicine accepts applications for residency positions through ERAS. A minimum of three letters of reference (at least one of which must be from a family physician), a Medical School Performance Evaluation, medical school transcript and report of all USMLE and/or COMLEX attempts is required for a complete application. Candidates who would be ineligible for a permanent Missouri physician license are unlikely to be considered for an interview or ranking. Periodic vaccination for influenza and SARS-Co-V-2 (COVID19) are required of all Mercy co-workers, including resident physicians.
About Our St. Louis Family Medicine Center
Our resident doctors help provide care for approximately 10,000 people during approximately 30,000 patient encounters per year. Our clinic’s unique geographic location (indicated by the star on the map) allows us to serve both urban and rural residents of the St. Louis Metropolitan Statistical Area. Within St. Louis County itself, our service area (indicated by the highlighted yellow line) straddles high and low need communities, meaning residents care for a diverse patient population.
Approximately 55% of Mercy Hospital St. Louis patients have commercial insurance, while approximately 45% have public or no insurance. Mercy Family Medicine Residency clinic itself is located 3.5 miles from Mercy Hospital St. Louis.
The facility features wireless EMR, onsite radiology, lab, pharmacy, physical therapy and dietary services. The clinic includes facilities for colposcopy, dermatologic procedures, sports medicine, osteopathic manipulation and point-of-care ultrasound. A large volume of patient contact with our staff is via telephone or secure email. The practice regularly uses E-visits and teleconsultation, including video visits. Our staff takes an active role in teaching the resident doctors, emphasizing interdisciplinary team care with on-site behavioral health specialists, clinical pharmacists and nurse supervisors/case managers as well as medical assistants and receptionists.
Family Medicine Program Specifics
Residents and faculty of Mercy Family Medicine have the advantage of working with teachers of the Creighton Model of Natural Family Planning. The science of NaProTechnology (Natural Procreative Technology) allows a physician to treat patients with these problems while maintaining the normal physiologic and reproductive potential that may still be present. Residents interested in learning more about the medical science of NaProTechnology can work with a certified Medical Consultant in Natural Family Planning (Sarah Cole, DO, Peter Danis, MD or Stefanie White, MD). In the second or third year, residents can pursue an elective leading to certification as a medical consultant in natural family planning. To learn more about the Creighton Model visit https://creightonmodel.com.
The department offers training in special procedures that residents may pursue in their own practices. These include colposcopy, endometrial biopsy, splinting and point-of-care, musculoskeletal & obstetrical ultrasound; in addition to training in common office procedures such as minor surgery (toenail removal, skin biopsies, incision & drainage), cryotherapy, and training in inpatient procedures learned on the medical wards, such as central lines, lumbar puncture, thoracentesis, etc. Special techniques in obstetrical care are learned by residents pursuing the OB track. Online documentation and tracking of procedures is required. For more information about POCUS in Family Medicine see https://www.aafp.org/afp/2018/0815/p200.html.
Our residency teaches medical practice that is firmly grounded in available evidence from the literature. All didactics emphasize evidence-based practice and a series of didactic sessions teach residents the principles of EBM. Didactic lectures cover a variety of topics including sports medicine, maternity care, gynecology, dermatology, pediatrics, behavioral science, patient-based clinical case review, practice improvement, chronic disease management, osteopathic principles & practice and communication skills.
In addition to the above lectures there is Journal Club, where each resident presents an article annually. The residents also participate in a quarterly procedure workshop. Also quarterly is a Balint group led by the faculty psychologist offering a supportive atmosphere to discuss areas of mutual concern among residents.
As an ACGME program with Osteopathic Recognition, all Mercy Family Medicine residents have the opportunity to further their competency in manual medicine. The longitudinal Osteopathic Track curriculum includes regular osteopathic didactics, workshops, journal clubs and continuity clinic. Elective time may be scheduled in Osteopathic Manipulative Therapy. DO residents are automatically enrolled in the Osteopathic Track unless they specifically opt out. MD residents are eligible to enroll in the Osteopathic Track upon successful completion of a one-month elective in introductory Osteopathic Principles & Practice. To learn more about Osteopathic Recognition visit https://www.acgme.org/What-We-Do/Recognition/Osteopathic-Recognition.
Our philosophy is to foster continual improvement and life-long learning by helping residents learn the skills needed for self-assessment of strengths and areas of improvement. Our evaluation system is a 360 degree perspective, collecting feedback from rotation supervisors, patients, clinical staff and self-assessments. Twice a year each resident’s progress is reviewed by the program’s Clinical Competency Committee.
The department offers training in special procedures that residents may pursue in their own practices. These include colposcopy, endometrial biopsy, and splinting, in addition to training in common office procedures such as minor surgery (toenail removal, skin biopsies, incision & drainage), cryotherapy, and training in inpatient procedures learned on the medical wards, such as central lines, lumbar puncture, thoracentesis, etc. Special techniques in obstetrical care are learned by residents pursuing the OB track. All residents are required to be certified in ACLS, neonatal resuscitation and ALSO (Advanced Life Support in Obstetrics). Online documentation and tracking of procedures is required.
Documentation of the types of patients cared for during residency and any procedural experience is important for obtaining hospital privileges after residency. Procedures done on inpatients should be documented, including patient name, age, and supervising resident or faculty. Common procedures requiring documentation, and for which training is possible at Mercy, include:
- Abdominal paracentesis
- Amnioinfusion placement
- Arterial blood gas puncture
- Central venous line
- Endotracheal intubation (adult/pediatric/neonatal)
- Episiotomy repair
- Lumbar puncture (adult and pediatric)
- Nasogastric intubation
- Neonatal resuscitation
- Obstetric ultrasound – fetal position/confirmation/AFI
- Repair of 3rd/4th degree perineal laceration
- Vaginal Delivery (including via induction or after c-section)
- Vaginal Delivery with vacuum assistance
- Abscess incise and drain
- Arm/Wrist/Hand Splint
- Arthrocentesis: knee/ankle/shoulder/other joint
- Endometrial Biopsy
- Joint Injection
- Laceration Repair
- Leg/Ankle/Foot Splint
- Nail Plate Avulsion/Removal
- Obstetric ultrasound – fetal position/confirmation/AFI
- Skin biopsy ( excisional, punch, shave)
- Thrombosed Hemorrhoid Evacuation
Second and third year residents in good standing with a permanent Missouri license are eligible to moonlight.
Each resident is assigned a family physician faculty member as a professional advisor, with whom they meet quarterly. The advisor’s role is multifaceted and includes assisting the resident in development of an individualized learning plan based on clinical interests and evaluations.
The residency is a member of Family Practice Inquiries Network, a collaborative national network dedicated to answering clinical questions using the best evidence. Faculty members are involved at national meetings each year including AAFP, ACGME, AFMRD, and STFM. Journal writing is a regular accomplishment with recent articles by our faculty published in American Family Physician, Journal of Family Practice, Journal of GME and Osteopathic Family Physician.
New residents soon begin providing prenatal care to patients in the Family Medicine Center as well as performing the deliveries and follow-up care for those patients. Resident care of OB patients in the office is supervised by five Faculty members who also practice prenatal care (Drs. Minchow-Proffitt, Hoekzema, Phruttitum and Danis) In addition, all residents are required to successfully complete the A.L.S.O. (Advanced Life Support for Obstetrics) course. An OB/GYN group is also available for consultation on more complicated patients as well as for providing ultrasound and antenatal testing if indicated, this is done through a private office setting. Additional rotations can be set up by the individual resident as they perceive their needs. Our program is proud to have a successful resident OB practice. Residents also gain experience with managing complications of pregnancy, labor and delivery when on the Family Medicine inpatient service.
PGY1 resident must be ACLS and BLS certified by the American Heart Association before beginning their residency. The program does not pay for the initial certification. When the certifications expire the program will pay for the renewals.
During the first month of PGY1, residents will earn certification in Advanced Life Support in Obstetrics, Neonatal Resuscitation, and Pediatric Advanced Life Support all paid for by the program.
Residents must complete their step level 3 licensing exam during their first or second year. A successful passing of the exam is required to advance to PGY3. Residents will be excused from clinical duties, regardless of the rotation, in order to take the exam and will not have to use vacation time. The program does not pay for the exam.
Residents that have successfully passed all of the licensing exams and completed PGY1 are able to apply for a permanent Missouri license. The program does not pay for permanent licenses.