The Department of Family and Community Medicine has been at the forefront of innovation in medical education for years. Thanks to an active curriculum committee that meets monthly and reviews rotations, each year has seen reshaping and revision of the residency curriculum to take advantage of new opportunities, correct deficits, and meet the ever changing needs of residents. Past innovations have included a close mentoring relationship with individual faculty, longitudinal experiences in many disciplines, competency-based curriculum for certain rotations, the chance for an increased emphasis on OB, procedural skills, sports medicine, and geriatrics.

Resident training in our department is directed by the Family Medicine faculty. Rotations provide practice and education that is relevant to primary care, even if acquired in other specialty areas. Specific rotations have been carefully selected to meet the educational goals and objectives laid out by our department. Residents' evaluation of learning experiences are carefully monitored and close contact is maintained between faculty representatives of our department and the other specialty departments in which the residents work.

The first year schedule is made up of a brief orientation to the hospital and an orientation to the Family Medicine Department before starting the first year, follow by 13 four-week block rotations.

Residents begin their training with an initial orientation period to acquaint them with their new surroundings and colleagues. Included is a team building day. This is designed to lay the foundation for the study and practice of family medicine, as well as to give the resident a sense of his or her home territory before beginning rotations in other clinical departments. In the first year, eight four-week blocks are spent at Wake Forest University Baptist Medical Center, the tertiary care hospital affiliated with the School of Medicine. Two blocks are spent at Forsyth Memorial Hospital, an 800-bed community hospital located a few miles away. Three blocks are spent in the Family Medicine Center. Only four blocks, General Medicine, Pediatrics and Obstetrics blocks assign in-house call averaging every fourth night. Family Medicine inpatient service and the Family Medicine Ambulatory month require call on average every six to eight nights. This call can be taken from home and is for admissions only. Adult and Pediatric Emergency Departments are covered with a mixture of daytime and nighttime shifts. Orientation and human behavior blocks have no night call. One week of orientation comes at the beginning of the second year and focuses on the acquisition of knowledge and development of procedural skills consistent with new upcoming responsibilities that the residents assume in year two.

In the second year two blocks are spent in the Family Medicine department doing inpatient and outpatient work. Geriatrics and practice management are included in these outpatient rotations. One month is spent as the supervising resident on the Family Medicine in-patient service. Surgery is a one-on-one experience with community physicians in their offices at the community hospital. Ambulatory Pediatrics occurs in the community, while the Gynecology rotation is centered in the Family Medicine Center. Orthopedics is focused on outpatient skills and is coordinated by our own Sports Medicine Faculty.

Residents receive real-life exposure to rural medicine and community medicine during a rotation in a neighboring rural county at a Family Medicine Center. Two blocks of elective time are available. During these rotations, residents take Family Medicine call which averages less than once a week and is taken from home in a fashion comparable to a typical private practice. The one block of critical care (CIU/ICU) are spent at the Medical Center and involve call every fourth night, as part of a “cutting edge” team caring for acutely ill patients.

Much of the third year is spent with community physicians. Five blocks are elective and can be chosen from a wide array of rotations available through the School of Medicine and local community physicians, as well as distant and international sites. Specialty surgery rotations emphasize ambulatory care and involve learning in a variety of medical center and community locations

A gastroenterology rotation is balanced between exposure to common GI disease and acquiring GI procedural skills. Family Medicine responsibilities during this year include two blocks of outpatient and one and one half of inpatient work. All call is taken from home for the practice and will include backup practice call as well as primary call.

Full licensure is expected after the completion of the internship. As a result residents in both their second and third year may take advantage of the excellent moonlighting opportunities available in the area.

First Year	Second Year	Third Year
3 Blocks - Family Medicine Inpatient Service 2 Blocks – Ambulatory Medicine 1½Blocks – Obstetrics 1 Block - Pediatrics Wards 2 Blocks – Emergency Department (1 Adult, 1 Pediatric) 1 Block – Unit Month (MICU or CCU) 1 Block - General Medicine 1 Block – Behavioral Science  ½Block - Nursery	2 Blocks - Family Medicine Urgent Care Clinics (Focus on Geriatrics and Practice Management)  1 Block - Family Medicine Inpatient Service 1 Block - Community Family Medicine 1 Block – Unit Month (CCU or MICU) 1 Block - Ambulatory General Pediatrics 1 Block – Ambulatory Specialty Pediatrics 1½ Block – Gynecology 1 Block – Community Surgery 1 Block - Orthopaedics 1 Block - Rural Medicine 1½ Block - Elective	2 Blocks - Family Medicine Urgent Care Clinics 1 Block – Dermatology/ Procedures 1 Block – Gastroenterology 1 Block - Ophthalmology/ Otolaryngology 1 Block - Radiology/Urology 1 Block – Community Surgery ½ Sports Medicine 1½ Block – Family Medicine Inpatient Service 4 Blocks – Elective