Program Highlights
The Summa Health System – Akron Campus Family Medicine Residency Program was chartered soon after the American Board of Family Medicine was established in 1969. The program was officially accredited by the ACGME in 1970. In 2006, the program was accredited by the American Osteopathic Association, making the program a dually accredited program. With the move to a single accreditation system, we applied for and received Osteopathic Recognition status from the ACGME in 2017.
Our graduates have gone on to practice in many areas of family medicine - hospice and palliative medicine, sports medicine, addiction medicine, geriatrics, hospitalist care, urgent care, locum tenens, rural medicine, and international medicine. Additionally, we have many graduates serving in practice and medical leadership positions, including multiple physicians in Summa's leadership roles.
These are some of the things that we feel make our program stand out:
- Strong Institutional Support for Residency Education
- Collegial Atmosphere
- Multi-Residency Hospital
- Clinic First approach to scheduling and team-based care
- Summa Fellowships: Geriatrics, Hospice & Palliative Medicine, Sports Medicine, Addiction Medicine
- Pediatrics Rotation at Akron Children's Hospital
- Narrative Medicine Curriculum
- Family Medicine Inpatient Service
- Flexible Curriculum for Emphasis Training
- Excellence in Scholarship
- System-wide electronic health record (EHR) - Epic
- Efficient EMR documentation
- Clinical Informatics
- Opportunities to teach medical students
- Community Medicine
- Global Health
- Behavioral Science
- Procedure Curriculum
- Curricular Innovations in the following areas:
- Leadership, Quality & Safety
- Wellness
- Ethics
- Practice Management
- Addiction care (Medication Assisted Therapy - MAT)
- Communication
- Diversity Action Committee
Strong Institutional Support for Residency Education
Summa has long considered medical education to be one of its core missions, and the Family Medicine Residency Program has always enjoyed strong support. Residents benefit from this environment in many ways. Among these are:
- On-Site Family Medicine Center
- Fourteen Core Faculty whose primary focus is educating residents
- Two full-time psychologists as behavioral science faculty
- Full-time pharmacist with Pharm.D. candidates and Pharmacy Students
Summa's long tradition of excellence in medical education has repeatedly received national recognition. We have been recognized as one of "America's Best Hospitals," by U.S. News & World Report, and in the Cleveland Plain Dealer as a Top Workplace.
Collegial Atmosphere
One of our top priorities is to maintain the warm and collegial atmosphere that is tangible within our residency. Some of the activities faculty and residents enjoy together are daily lunchroom banter, volunteering at the area's free clinics, book club, and holiday parties. Our commitment to balancing our challenging educational program with camaraderie and support is built into the process of the residency.
Support for our residents is provided in multiple ways:
- One-on-one monthly meetings with a resident and their assigned faculty advisor for individual support
- Monthly individual class meetings with the faculty for small group support
- Monthly entire resident body meeting with the faculty for large group support
- Regular check-ins with our psychologist faculty
- Access to Akron Physician Wellness Initiative (AWPI) for free, confidential counseling and psychiatric care
- In addition to the above, faculty members are always available. We have an open-door policy and are available in person or via phone 24/7 for residents’ needs.
These various formats allow for interaction, enhanced collegiality, resident ownership of their education, and opportunity to direct educational offerings while maintaining work-life balance.
Summa – Akron Campus residents have the opportunity to learn in a supportive, active teaching environment enhanced by state-of-the-art facilities as noted below.
- Call quarters that include individual call rooms, computer/game room, large screen TV, stocked pantry and workout room
- Multiple OMT tables in the Family Medicine Clinic, which boasts 17,000 square feet with 28 exam rooms and a treatment/procedure room
- Critical Care Wing
- Palliative Care Unit
- Center for Cancer Care
- YMCA adjacent to the hospital
- 76 bed/10 triage room emergency department
- Virtues Restaurant (fine dining on the Summa – Akron Campus)
- Multiple dining options
- Newer (Summer 2019) Labor and Delivery and Postpartum unit
Multi-Residency Hospital
The opportunity to interact with colleagues from many other departments allows the Family Medicine residents to learn from a variety of teachers and broaden their educational perspectives. Our residents have ample opportunity to run codes, scrub in on surgeries, deliver infants and participate in all aspects of patient care. Education is enhanced by working side by side with residents in other disciplines.
Are our residents respected and valued by the other services in the hospital? The answer is yes, and the proof can be seen in the number of times our residents are chosen by their peers as Intern or Resident of the Year. Most recently, in 2021, two FM PGY 1 residents shared the honor of Intern of the Year, and one of our PGY 3 residents was selected as Resident of the Year. Our residents have served on the House Staff Council, including in the executive leadership team positions. Our family medicine residents are valued members of the care team and are respected for the skills and perspective they bring to each clinical setting.
Clinic First
At the Family Medicine Center, we believe that 'the clinic is the curriculum.' This means that we strive to improve the clinic to optimize resident education. We have implemented most of the building blocks of a high-functioning residency clinic. One element of a high-functioning clinic is to create resident schedules using the Clinic First model. As part of Clinic First, we schedule PGY 2 and PGY 3 residents to see patients for two full days per week. A full day of clinic lets you 'park your car once,' thus eliminating the stress of hurrying to or from a rotation at another location for a half day in the clinic.
Fellowships
Summa Health - Akron Campus Family Medicine Residency has an excellent track record of helping graduates into fellowship training, when desired. Our graduates have pursued fellowship training in many areas, including Sports Medicine, Geriatrics, Hospice & Palliative Care, Women's Health, Addiction Medicine, Surgical Critical Care, Neuromusculoskeletal & Osteopathic Manipulative Medicine, and Academic Medicine.
The Department of Medical Education & Research offers fellowship training in the following areas:
Pediatrics Rotation at Akron Children's Hospital
Our Family Medicine residents complete their inpatient pediatric rotations, pediatric subspecialty electives, urgent care and pediatric emergency room rotations at Akron Children's Hospital (ACH), one of the ten largest pediatric hospitals in the U.S. Along with the benefits of working at a well-respected academic institution, our residents enjoy the ability to care for a large number of children with common medical conditions that are most often seen in primary and secondary care settings. Two months of rotation time are devoted to the outpatient pediatric experience in the PGY 3 year.
Narrative Medicine Curriculum
The Narrative Medicine curriculum is completed during the second year of residency. Goals for the curriculum include learning to practice self-compassion, improve our compassion for our patients, and reduce compassion fatigue. In the first half of the year, we participate in an exercise called “Story of Self.” For this exercise, the faculty facilitators and residents share a story about themselves with the group, highlighting a time of challenge in our lives, and an important life lesson we learned as a result. Past residents have commented that this exercise helped them feel closer to each other. In the second half of the year, each faculty facilitator and resident present a case of a patient they have found personally challenging. The presentation challenges them to see their patient’s life through their patient’s eyes. The presentations lead to engaging discussions and reflections on the moral, ethical and interpersonal aspects of medicine.
Family Medicine Inpatient Service (FMIS)
The residency program has its own family medicine inpatient service (FMIS). Throughout the three years of training, residents admit their own patients and serve as the primary physician through the FMIS. Residents have six months of FMIS throughout their three years of training (two months per year). Residents may choose to use their elective time in PGY 2 and/or PGY 3 year(s) for additional inpatient months.
The night float resident provides coverage for the FMIS through the week and is scheduled off each weekend. During night float months, the PGY 2-night float resident is required to maintain limited continuity patient care office hours, but otherwise has no daytime responsibilities. PGY 3 residents cover the FMIS on the weekend nights or provide backup coverage for the night float resident during the week. PGY 3 residents may choose to stay at the hospital or complete their assignment with at-home call. In addition, senior residents spend two months supervising/teaching residents and any rotating medical students on the FMIS.
The FMIS includes a multi-disciplinary approach to the hospitalized patient, complete with the support from additional teams made up of clinic staff members. Behavioral health, chemical dependency, pharmacy, and social work are all vital to our patient care on FMIS. We have a clinical informationist who attends rounds weekly to help with literature reviews for clinical questions. "Mini-rounds" occur throughout the month as opportunities arise (e.g., radiology rounds, pathology rounds). We always look for inpatient OMT opportunities for our patients and frequently have OMT rounds as well.
Each month, we hold an M&M from the preceding FMIS month team. This is a great time to address needed quality improvement changes and any system opportunities for improvement in a friendly and welcoming environment.
The FMIS team is typically made up of 1-2 residents from each class (4-5 residents total), one attending for the week (Monday through Sunday), several medical students, and other care team members (e.g., pharmacy, behavioral health). This allows for a team-based approach to patient care with plenty of support along with time for education. Order sets, note templates, and peer support help make the rotation a great experience for all learners, regardless of their comfort level with some of our sickest hospitalized patients. The FMIS has a dedicated team room in the hospital above the cafeteria and near the YMCA where residents have a membership and can work out. The team room is complete with seven computers, several white boards, and lots of protected space. This allows for dedicated "deep" work without interruption while keeping the team together.
Flexible Curriculum for Emphasis Training
Many residents are interested in tailoring their residency to an area of emphasis. Some of these include sports medicine, geriatrics, women's health, international health, and procedural medicine. Residents have successfully completed their training with additional exposure to these and other areas by using their elective months to tailor a curriculum to meet their educational needs. Additionally, we will work with residents to create new rotational experiences, if they express interest in a specific area.
System-wide Electronic Health Record (EHR)
Summa Health, including the Family Medicine Center, uses Epic EHR for all clinical documentation. In Fall 2022, Summa Health will be moving to it's own instance and will be adding modules to make care even more integrated.
Medical Informatics
The following programs are available through the residency or via the educational stipend provided by the Department of Medical Education
- UpToDate is available to all Summa physicians
- ClinicalKey is available within the hospital system for residents
- The Summa Health medical library provides additional electronic resources, including journals and textbook access
- Other medical reference apps via educational stipend
Efficient Documentation
Residents have a standard onboarding training during their intern orientation process. They then have a personalized session with the clinical informatics faculty where they receive note templates, order preference lists, workflow review, and many other Family Medicine Center specific tools. In the first six months, residents receive one-on-one, at-elbow support from a faculty member during every patient care session in the office.
Every month, the clinical informatics faculty hold a one-hour Epic optimization session. The curriculum is varied and dependent on provider and staff feedback about needs and inefficiencies. It also serves as an opportunity to review new workflows and features, as well as learn best practices from each other.
Opportunities to Teach
The residents are an integral part of teaching medical students and each other. Residents frequently interact with medical students in the classroom and in the inpatient and outpatient settings. Residents are directly involved in teaching each other and students through morning report/board reviews, core lectures, clinical care, and opportunities to teach M1 and M2 students at our off-campus center for undergraduate education. Additionally, we have an academic track recognition program for PGY2 and PGY3 residents who are interested in gaining even more experience in academic medicine.
Community Medicine
Residents will complete a minimum of 50 hours of community service and leadership activities. Some of these experiences are scheduled during FMC intern month, and residents complete the remainder of the hours on their own during their second or third year.
Current available opportunities include:
- Volunteering at local free clinics serving uninsured patients, such as Faithful Servants or Open-M
- Volunteering at local community service agencies such as Haven of Rest or Battered Women’s Shelter
- Serving on Family Medicine Center or hospital committees
- Shadowing on boards of community service agencies
- Community health education
Global Health
Opportunities exist for international electives. Most recently, residents have completed electives in Uganda and Kenya.
Behavioral Science
The objective of behavioral science education is to assist the resident physician in understanding interpersonal relationships, family dynamics, physician-patient encounters, as well as acute and chronic disease processes. The family physician must be equipped to understand and respect patient behaviors and emotions to build a partnership for health promotion.
Implementation of the curriculum occurs in an integrated model that teaches collaboration between physicians and behavioral health providers. Residents work with a behavioral healthcare team that includes faculty psychologists, behavioral health consultants, a chemical dependency counselor, a social worker, and a consulting psychiatrist. Behavioral health team members are available every day in the clinic, and on the Family Medicine Inpatient Service, to provide assistance with crisis management, addressing behavioral health symptoms, assisting with behavioral aspects of chronic illness, and connecting patients to needed resources.
Highlights of the curriculum include:
- Communication skills curriculum, including coaching and observation in clinic and on Family Medicine Inpatient Service
- Education and coaching in competencies for practicing integrated behavioral health
- Narrative Medicine for PGY 2's offers time to reflect on the emotional and interpersonal aspects of patient care.
Procedures Curriculum
Residents have many opportunities to build their procedural skills and experience. There are hands-on, practical residency wide skill-building workshops held every six months in the office, led by both faculty and residents. There are also other educational sessions. These include:
- Obstetrical - AROM, IUPC and IFM placement, Leopold's maneuvers, postpartum Nexplanon and IUD placement
- Gynecological - LARCs (IUD insertion/removal [Mirena, Kyleena and ParaGard], Nexplanon insertion/removal, endometrial biopsies [EMBs]), Colposcopy with Biopsy and ECC (endocervical curettage)
- Dermatological - biopsies (shave, punch, elliptical/fusiform), cryotherapy, electrodessication/curettage (ED&C), skin tag removal, laceration repair
- Join injections
- Casting/splinting
- Circumcisions
- Anesthesia - field, ring, and digital blocks
- Advanced Life Support in Obstetrics (ALSO)
- Neonatal Resuscitation Program (NRP)
- Basic Life Support (BLS)
- Advanced Cardiac Life Support (ACLS)
- Stroke training (NIH/ACVLS)
- Point of Care Ultrasound (POCUS)
- Access to Summa's Simulation Labs for practice for intensivist-related procedures (intubations, central lines, arterial lines)
- Monthly osteopathic workshops (DOs and MDs) - quarterly "Find-it-Fix-It" labs with office staff, AOBFP mock practical/OSCE, 5-6 practice OMT tables, 3 clinic-based OMT adjustable tables, several scheduled inpatient OMT rounds per week
- Palliative care simulation
Curricular Innovations
Leadership, Quality & Safety
Residents attend a basic introduction to leadership during their first-year rotation in the Family Medicine Center and have the opportunity to gain valuable leadership experience throughout their next three years as members and supervisors of their clinical teams.
Our leadership curriculum includes involvement by residents in the ongoing quality activities of our department. Residents actively participate in presenting and leading discussions of case reviews for peer review selected from our residency cases, attend our Department of Family Medicine monthly Peer Review Board, and lead a “deeper dive” format during which a case is broken down using tools of their Lean Six Sigma training (e.g., constructing a root cause analysis) and presented over three sessions. This extensive experience allows our graduates to be very comfortable in their future leadership roles which involve overseeing performance and quality improvement initiatives.
Wellness Curriculum
Resident wellness is highly prioritized in the Family Medicine Residency. Wellness activities occur throughout the academic year in multiple ways:
- Individual wellness check-in meetings with Behavioral Science Faculty, Dr. Perkins or Dr. Harrington
- Scheduled monthly during intern year, with option to continue monthly check-ins during PGY2 and PGY3 year
- Available any time to all residents
- Wellness group support sessions
- 6-8 sessions per year
- Educational topics covered include identifying burnout and compassion fatigue, habits to promote physician wellness, mindfulness, and resilience
- Team-building and recreational activities
- Mental health is just as important as physical health! Akron Physician Wellness Initiative (APWI) offers free and confidential counseling and psychiatry services to Summa physicians. Sessions take place at Summa St. Thomas Campus, which is about five minutes away from the residency program or can be attended virtually. Residents are usually able to schedule counseling or psychiatry appointments during their workday. Interns will be scheduled with an APWI psychologist early in their intern year to formulate a plan for optimizing their wellness and can continue sessions as needed. Interns are recommended, but not required, to attend sessions at APWI. Residents who prefer different options for behavioral health treatment can discuss options with Dr. Perkins, Dr. Harrington, or their PCP.
Appreciation Committee
- Staff-led effort to implement fun activities to help us show our appreciation for each other and create an atmosphere of wellness in the office.
- Examples - Halloween “Boo-ing”, Holiday tree decorating, Valentine's and birthday cards
Ethics
Beyond the potential to engage with the Summa Health Akron Campus Ethics Committee while participating in direct patient care, there are at least two educational sessions within the family medicine residency ethics curriculum each year. These sessions are typically case and discussion-based and focus on topics in medical ethics such as evaluation of decision-making capacity, advance directives and advance care planning, code status discussions, identification of surrogates when patients lack capacity, and issues regarding guardianship.
Practice Management
Residents have a longitudinal curriculum on practice management during their residency with specific lectures on practice management topics and direct applications in the family medicine center. In the PGY 2 year, a dedicated two-week required rotation in practice management allows residents to spend time with a variety of community office practices to gain more knowledge of the different business models. Residents gain exposure to the full life cycle of running a medical practice from people management to financial strategy, regardless of their intentions after graduation.
Addiction Medicine
Residents have many opportunities to build their addiction medicine knowledge and experience, including:
- Working one-on-one with family medicine faculty physicians treating opioid addiction in the primary care setting via rotating through the medication-assisted therapy (MAT) clinic
- Opportunity to obtain DATA 2000 DEA waiver for prescribing MAT such as Suboxone®, through local waiver trainings held several times throughout the year
- Collaborating with behavioral health specialists and our licensed independent chemical dependency counselor (LICDC) to treat various degrees of addiction
- Learning through the new addiction medicine curriculum
- Rotating with fellowship-trained addiction medicine faculty and area methadone clinics
- Considering Summa for their addiction medicine fellowship position
- Attending the statewide Ohio Opiate Conference every year (held in Columbus every June) with MAT faculty and our LICDC
Communication
The communication skills curriculum covers many areas such as: Active and reflective listening, motivational interviewing, agenda-setting, and trauma-informed interviewing. Educational sessions are held during morning report and afternoon didactics and consist of lecture, discussion, and role-play. Residents have the opportunity to present challenging cases and receive group feedback on improving communication skills. Residents are video-precepted and directly observed by behavioral health team members and provided with individualized coaching to assist in developing communication skills.
Diversity Action Committee
This is a resident-led committee which was new to the Family Medicine program as of 2020-2021. Members consist of FM employees, residents and faculty. The group works on initiatives to promote diversity, awareness, and inclusion at the program for our employees and patients. We conducted a survey of all employees to gauge their perceptions of acceptance of diversity at the Family Medicine program. Currently, team members are working on obtaining children's books with diverse characters to give to our pediatric patients. We have offered or arranged for educational presentations at our monthly office meetings on the following topics: Recognizing implicit bias, how to be an ally, LGBTQ+ identity, Juneteenth, and other topics related to diversity. We have many more educational and practice improvement projects in store and look forward to the input of any interested residents in the 2023-2024 academic year.