Curricular Highlights
Reproductive and Perinatal Health
At NewYork-Presbyterian/Columbia Family Medicine Residency Program, we pride ourselves on providing comprehensive health care to the women of our community and on training the next generation of full spectrum reproductive health physicians. We believe that reproductive health care should encompass all stages of a person’s life, and should be centered on the medical needs, experience, and autonomy of our patients. Within that vision, we perform prenatal care, mental health care, and medical and procedural abortions at our core medical practice. Residents can expect to be immersed in prenatal care for low and high risk pregnant patients, to deliver patients they care for, and, in many cases, to continue to care for newborn infants. They will be trained in evidence based cancer preventive services, including cervical cancer screening, endometrial biopsy, and the basics of colposcopy. With regards to reproductive management, residents are expected to reach levels of competence and comfort with all modes of reversible contraception, including placement and removal of IUDs and contraceptive implants. We also offer clinical care and training in miscarriage and abortion on an opt out basis. Graduating residents can expect to be competent managing medical abortions and early pregnancy loss, and to lay the foundation for potential future training in procedural abortions.
Yorgos Strangas, MD
Didactics
We dedicate a weekly Thursday afternoon to the family medicine didactic series which is geared towards educating residents on core topics and guidelines, as well as current practice changing updates in primary care. We have multiple ongoing series: Women’s Medicine, Behavioral Medicine, Quality and Safety Forum, and Complementary and Integrative Medicine, to name a few. Other examples of relevant sessions include Personal Finance for Physicians, wellness activities, and local Washington Heights culture and Spanish language enrichment.
Lectures are presented by faculty, residents, and alumni from our program, colleagues from specialty departments in our institution, and renowned presenters from other academic centers. We include dedicated time for learning procedures and gaining certifications in areas such as Nexplanon placement and naltrexone administration. We reserve time for focused workshops on important topics such as racism in medicine and advocacy, as well as training sessions for specific licenses such as buprenorphine management.
Residents are front and center in planning and implementing all of our didactic programs. Their input is highly valued and they are drivers of how their learning is structured. We emphasize collaboration between faculty and residents, innovative delivery methods, interactive formats, and recognize that our learners may have a variety of ways in which they absorb information. Family medicine conferences provide an ongoing opportunity for all of us to expand our knowledge and skills together.
Marion Richman, MD
Family Medicine Inpatient Service
The inpatient service within the Family Medicine Residency Program at NewYork-Presbyterian Hospital is dedicated to providing quality medical care to our patients within the urban underserved communities of Washington Heights, Inwood, and the Bronx within New York City. Our patients range from young adults to individuals over 100 years old. Collectively, they display the complex interplay between multiple comorbidities and social determinants of health. Our service is run exclusively by family medicine and includes one full-time family medicine hospitalist, one rotating family medicine attending, two senior residents (one covering days and one covering nights), and two interns (both covering days). On average, the daily census consists of 15 patients with each intern carrying 7-8 patients per shift.
Our service cares for approximately 1,000 patients per academic year. The cases assigned to family medicine are identical in terms of acuity and teaching value to those assigned to the internal medicine teaching service. Residents are immersed over the course of their training in a rigorous evidence-based curriculum that discusses and considers the most current peer-reviewed literature and how it impacts our medical management. The varied and engaging formats of learning include case-based review, clinical question rounds, radiology rounds, biopsychosocial rounds, narrative medicine, and consultation with Columbia’s world-renowned subspecialists. Residents can expect to achieve competency in managing acute and chronic manifestation of the following conditions both in the inpatient as well as the outpatient settings: acute coronary syndrome, congestive heart failure, atrial fibrillation, COPD and asthma, end stage kidney and liver disease, GI bleeding, infection and/or sepsis from any source, electrolyte and acid-base derangement, stroke, dizziness, and syncope.
Aside from the quality medical care we aim to provide, we are cognizant of the systemic racism and other interrelated social determinants of health that heavily impact our patients’ lives. As the full-time family medicine hospitalist and DEI director for CFCM, Dr. Ekanadham is invested in our faculty and residents understanding our patients’ needs within the context of the communities they live in. Additionally, she is committed to ensuring that CFCM directly recognizes witnessed injustice and advocates for needed change within and outside of the hospital system.
Hima Ekanadham, MD
Quality Improvement
Quality improvement is a requirement of all family medicine residency programs and is important to graduates’ future practices. Our residents have longitudinal protected time for quality improvement projects and education throughout the three years of training. Our residents, faculty, and practice staff at the Farrell Community Health Center are divided into three teams for their clinical care. Each team completes a quality improvement project each year, lead by the second and third year residents on the team.
First year residents learn the basics of QI by participating in the project implementation and by completing the quality improvement modules through the Institute for Healthcare Improvement. Our current QI projects are to improve the rates of childhood vaccination, to increase the rate of screening for food insecurity, and to increase the rates of urine microalbumin testing for diabetic nephropathy.
Daniela Diaz, MD, MS and Heather Paladine, MD, MEd
Outpatient Family Medicine
The Herman "Denny" Farrell, Jr. Community Health Center is the ambulatory hub of Family Medicine at NewYork-Presbyterian Hospital and where resident and attending physicians provide compassionate care to families in upper Manhattan including the Washington Heights, Inwood, Harlem, and Bronx communities. We are a Patient Centered Medical Home with a robust interdisciplinary team including social work, mental health providers, a registered dietician, community health workers, pharmacists, and more. Our resident physicians care for patients under the preceptorship of expert clinical faculty from the Center of Family and Community Medicine. The members of the Farrell team work collectively to advocate for our patients and care for the community. We offer extraordinary training for generations of future physicians to develop longitudinal relationships with patients at every stage of life through the biopsychosocial model, promote health and wellness, and use evidence-based medicine to treat chronic diseases.
Family medicine was established as part of the NewYork-Presbyterian Hospital/Columbia University Irving Medical Center's Ambulatory Care Network (ACN) over twenty years ago to meet the underserved health needs of our community. At Farrell, we provide comprehensive care for the entire family, including routine well-baby and well-child care, gynecology and prenatal care, care of those with complex acute and chronic medical conditions as well as in-office procedures. We strive to reduce disparities in health care both within the individual patient-physician relationship and by connecting patients to NYP’s world-renowned specialists. We strive for exceptional patient care through advocacy, quality improvement, and population health initiatives.
Joanne Dempster, MD and Juliana Berenyi, DO
Community Medicine Month
At the NewYork-Presbyterian/Columbia Family Medicine Residency Program, we are aware that we provide primary care not simply to individuals, but to families and to a larger community. Every year, one month of the interns’ schedule is dedicated to a community medicine block. The goal of this time is to increase interns’ understanding of patients in the context of the Washington Heights community early in their residency. They participate in guided explorations through the neighborhood surrounding our health center and undergo intensive Spanish language instruction during this time as part of the larger longitudinal Spanish curriculum. At the NewYork-Presbyterian/Columbia Family Medicine Residency Program, we are aware that we provide primary care not simply to individuals, but to families and to a larger community. Every year, one month of the interns’ schedule is dedicated to a community medicine block. The goal of this time is to increase interns’ understanding of patients in the context of the Washington Heights community early in their residency. They participate in guided explorations through the neighborhood surrounding our health center and undergo intensive Spanish language instruction during this time as part of the larger longitudinal Spanish curriculum. Residents also explore the Washington Heights Community Based Organizations (CBOs) and learn of the different services these organizations provide to the community. During this time, residents learn of expanded community resources that can be utilized for the benefit of patients. Residents are introduced to the community-based participatory research approach and learn about collaborating effectively with community organizations and services for the benefit of our community's patients and families. Crucially, this month is also dedicated to intentionally developing the language of structural competence, and interns receive instruction regarding social determinants of health and how existing systems perpetuate health care disparities.Crucially, this month is also dedicated to intentionally developing the language of structural competence, and interns receive instruction regarding social determinants of health and how existing systems perpetuate health care disparities.
Silvia Cunto-Amesty, MD, MPH, MSEd and Ana Esteban-González, MD, MSEd, CI and Aury Garcia MD
Community Medicine Advocacy and Scholarship (CMAS)
At the NewYork-Presbyterian/Columbia Family Medicine Residency Program, our resident scholarly projects are done in the framework of CMAS. Residents on outpatient rotations and faculty meet together every other week on Friday morning to learn about the community and develop scholarly projects together with a community partner. All residents learn the fundamentals of community engagement and participation, community health, community-based participatory research principles and collaborations, social determinants of health (SDoH) and SDOH’s role in the production and perpetuation of health disparities. Residents will learn about contextual factors that affect health and will explore the impact of implicit bias: they will learn to practice in interdisciplinary teams and collaboratively with communities and organizations. Residents will also learn of ways to incorporate the use of community medicine in advocacy frameworks into their day-to-day primary care practice and develop skills to increase awareness and understanding of health disparities and strategies to work effectively towards minimizing bias. CMAS includes group discussions, presentations, and self-guided learning based on a curriculum that is built together with residents. We are a dynamic group, enthusiastic about creating community within our own family medicine residency, and we expect that residents will contribute to the growth and development of CMAS.
Silvia Cunto-Amesty, MD, MPH, MSEd and Ana Esteban-González, MD, MSEd, CI
Integrative Medicine
At the New York-Presbyterian/Columbia Family Medicine Residency Program, we offer a curriculum in Integrative Medicine (IM) for all residents. Residents also have the opportunity for more specialized training by joining the Integrative Medicine Track (IMT) with the option of doing an Area of Concentration in IM, both of which span all 3 years of training. Established in 2014, this track allows residents to explore the fundamentals of integrative medicine (IM), learn ways to incorporate aspects of IM into their day-to-day primary care practice, and develop methods for self-care and wellness. The IMT includes 100 hours of interactive learning modules through the University of Arizona's Integrative Medicine in Residency (IMR) curriculum that must be completed by graduation. Residents who are part of the track develop annual personalized wellness/self-care plans with the goal of engaging in health promoting behaviors. The IMT cohort of residents and faculty come together for IM related activities throughout the 3 years of residency fostering a sense of community. The longitudinal IM curriculum also features community-based experiential integrative medicine activities, providing hands-on experience and fostering collaboration with community partners and local health resources to enhance patient care. The program has received several grants from the Weil Foundation, funding innovative educational sessions such as visits to local botanicas and health food stores to learn about herbs, botanicals, and supplements; trips to farmers' markets; culinary medicine classes with a plant-based chef; bilingual yoga classes; Reiki; acupuncture; and meditation classes. The curriculum is delivered through the lens of social determinants of health and residents are engaged in utilizing integrative medicine as a tool to decolonize medicine, advance health equity, and promote social justice. We have a fantastic community of integrative medicine residents and faculty and we'd love for you to be a part of it!
Pooja Shah, MD and Krishna Desai, MD, FAAFP
Musculoskeletal Education
At the Farrell Community Health Center, we offer a full-spectrum teaching clinic dedicated to musculoskeletal issues, acute pain and chronic pain syndromes, and sports medicine injuries. Residents can expect to be immersed in musculoskeletal care for all age groups and will be trained in evidence-based methods of evaluation and treatment of common musculoskeletal and rheumatologic conditions. We will focus on improving procedural skills by offering our patients pain-relieving interventions, such as corticosteroid joint injections and trigger point injections. Furthermore, we value a holistic view of the musculoskeletal system of the body, as we believe all facets of the mind and body can influence pain and daily function. Frequently, we will incorporate integrative approaches into our patient's visits and post-visit care. We have also started an OMT (osteopathic manipulative treatment) session and curriculum where MD and DO residents receive exposure and training in providing manipulative treatment to patients with musculoskeletal pain.
Pooja Shah, MD and Juliana Berenyi, DO
Longitudinal Community Based Curriculum (LCBC)
Starting with the 2023-24 academic year, residents have been scheduled to meet with clients of Community Based Organizations (CBO) during their Family Health Center rotation. These meetings are scheduled together with faculty and are designed to discuss topics that were requested by the CBO. The goals of the LCBC are to provide additional experiences for residents and faculty to engage with and learn from our community, to build longstanding relationships, to enrich our understanding of our patients and communities to improve our patient care and our advocacy for health equity, and to provide an opportunity for additional Spanish language learning.
Himabindu Ekanadham, MD, MS Epi, FAAFP; Aury Garcia MD; Ana Esteban-Gonzalez MD, MEd, CI; Melissa Encarnacion MD
Concentrations
At the end of PGY1 year, each resident will choose a concentration as an area of focus for the following two years of residency training. The concentration will include at least four weeks of elective time in both PGY2 and PGY3 years and also longitudinal components. Current concentrations include Reproductive Health, Obstetrics, Sports Medicine, Community Medicine, Health Policy, Integrative Medicine (in addition to the Integrative Medicine track), and Palliative Care, and residents can self-design a concentration together with a faculty mentor.