Saint Louis University's family medicine residency program has been serving the community of Belleville, Illinois, located 30 minutes east of the city of St. Louis, since 1997.
The Saint Louis University Family Medicine Residency Program is the only fully-integrated civilian/military residency combining a community-based and a military residency. This is an opportunity to work with an expert team of faculty and residents focused on quality resident education, full spectrum medical care and innovative approaches to maximize learning opportunities.
In partnership with St. Elizabeth’s Hospital and Southern Illinois Health Foundation, faculty and residents experience diverse outpatient clinical care of the underserved, uninsured, and military communities, comprehensive obstetrical care, inpatient medicine with ICU privileges and a wide variety of in-house specialties available for consultation.
The sequence of rotations varies depending on each resident's individual call schedule.
Residents attend clinic one to two half days per week at the Belleville Family Health Center regardless of their current rotation. As a first-year resident, you will start with four patients per half day of clinic for the first half of the year and have six patients per half day for the second half of the year.
New interns are given a one-month orientation period at the beginning of the year. During this month, new residents spend time bonding and building core skills that ease the transition from student to doctor. Orientation to the inpatient and obstetrical services will occur during short shifts alongside current second and third-year residents. Interns will complete training in ACLS, ALSO, and NRP.
Four months are spent on the Family Medicine Inpatient Service at St. Elizabeth's Hospital. The residents work as a team of four, with two interns and two seniors (one PGY2 and one PGY3) caring for patients admitted to the Family Medicine Inpatient Service.
There are two teams on service at all times; with each team on call every other day. These months provide experience with a wide range of medical patients from the surrounding community, interaction with a variety of specialists and inpatient management of medical and social concerns. It is also an excellent opportunity for each civilian resident to begin building a panel of patients to follow for the full three years of residency.
An intern's call is broken up between one week of night float and three weeks of day shifts during which the intern takes approximately seven “short call” shifts which are from 7 a.m. to 8:30 p.m. Night shifts start at 8:30 p.m. and end at 10 a.m. Interns care for patients admitted to the rehabilitation, psychiatric, general medicine and telemetry medicine floors. Interns typically carry an average of seven patients. Interns are assigned four articles to read per inpatient block and an end of rotation quiz covering the articles.
Two months are spent working in Labor and Delivery at St. Elizabeth's Hospital. This is an unopposed setting where residents can participate in the triage, labor management, delivery and postpartum care of obstetrical patients.
Residents assume increasing responsibility for the care of OB patients in all aspects of peripartum care as well as the care of the newborn from bedside to the nursery. Residents average 10 to 20 vaginal deliveries in a month’s time as well as five to 10 c-sections. Two weeks are spent on night float, shifts lasting from 10 p.m. to 10 a.m., and two weeks of day shifts with hours from 7 a.m. to 7 p.m. A senior is also on in-house call from 5 p.m. to 7 a.m. every weekday, and around the clock on weekends.
One month is spent focusing on prenatal care. Residents rotate in a number of prenatal clinics both at the Family Medicine Clinic and at the OB/Gyn department at Scott Air Force Base. The outpatient OB resident covers the labor deck every Wednesday during the day to allow the inpatient OB resident to attend clinic and lectures. The interns also prepare a 15-minute lecture on an inpatient or outpatient obstetrical topic to be presented during residents' weekly didactics.
One month is spent working with a community surgery group, rotating through one of the hospitals in the Metro East region. Residents are the first assist on all operative procedures and are given increasing responsibility as their rotation progresses. Residents also assist with office procedures if applicable, depending on the specific surgeon or group with which they are rotating.
One month of pediatrics experience is conducted at SSM Health Cardinal Glennon Children's Hospital. Family medicine residents are assigned to a team consisting of a pediatric intern and senior pediatric resident, supervised by a faculty member from SLU's Department of Pediatrics. Residents are responsible for the admission, inpatient care, follow-up planning and discharge of assigned patients. Call varies depending on the team to which the intern is assigned.
One month is spent in the general pediatric clinic at Scott Air Force Base, including well child visits, acute illnesses, hospital follow-up or long-term treatment. Residents work one-on-one with pediatric attending physicians, learning about the clinic management of a variety of pediatric issues and routine health maintenance concerns.
Residents spend one month learning physical diagnosis techniques and injection techniques as well as splinting and casting procedures. Residents work with current sports medicine faculty, community sports medicine physicians and orthopedic physicians.
One month is spent working at Belleville Health Care and Rehab, a local long-term care center. Residents are responsible for performing initial assessments and addressing acute patient concerns as they come up throughout the month. This rotation helps residents prepare for their longitudinal geriatric care experience during the second and third year when they will be assigned three to four geriatric patients at Belleville Health Care and Rehab to take on as continuity patients, visiting them at least once every three months.
Residents spend one month in the emergency department at St. Elizabeth's Hospital under direct supervision of the emergency medicine staff. This month provides exposure to emergency medicine and enhances the residents' skills dealing with trauma, life support, procedures and general medicine.
The sequence of rotations will vary with each resident.
PGY-2 residents attend clinic two to three half days per week at the Belleville Family Health Center. Starting in the second year, residents take care of a panel of three to five nursing home residents at a local nursing home. PGY-2 residents also take one to two weekend in-house obstetrics calls per month during outpatient rotations.
Residents spend two months on the Family Medicine Inpatient Service at St. Elizabeth's Hospital. The residents work as a team of fours, with two interns and two seniors (one PGY-2 and one PGY-3). As part of a team, PGY-2 residents alternate between two weeks of caring for patients admitted to the ICU and two weeks caring for patients on the telemetry and general medicine floors. Call for PGY2 seniors is every fourth night.
On this rotation residents spend one month (two weeks on each FMIS blocks) caring for severely ill patients at St. Elizabeth's Hospital. Residents work with a family medicine faculty member and with St. Elizabeth intensivists learning the basics of ventilator management and other critical care issues. Call is every fourth night for their respective inpatient team. Additional ICU experience may also be gained as an elective rotation.
Residents serve as the OB night float senior 5 p.m. to 7 a.m. Monday through Thursday night for four weeks split between two blocks. The float resident is responsible for the care of laboring and postpartum mothers and newborns at St. Elizabeth’s Hospital overnight as well as taking the after-hours exchange call for the residency.
Four weeks split between two blocks are spent on scholarly work as determined by the resident and his or her advisor. During these two separate two-week blocks, the PGY-2 resident also serves as the back-up senior for the Family Medicine Inpatient Service should they exceed their admission cap. The backup senior assumes a hospitalist type role for care of the patients they admit (progress notes the following day and discharge if needed) unless the inpatient team determines they can carry the patient.
Residents spend one month in the outpatient gynecology clinics at Scott Air Force Base. They learn a variety of diagnostic and therapeutic skills related to gynecology: hysterosalpingogram, uterine ablation, colposcopies and Essure. A portion of this experience includes participation in gynecology surgery if the resident desires.
One month is spent in the Emergency Department at SSM Health Cardinal Glennon Children's Hospital in St. Louis under direct supervision of the pediatric emergency medicine staff. This month provides exceptional exposure to pediatrics and emergency medicine and enhances the residents' skills in dealing with trauma and minor procedures.
One month is spent working with dermatologists at Scott AFB in a clinic setting and becoming familiar with diagnosis and treatment of common dermatologic conditions. You will also get the opportunity to participate in minor dermatologic surgical procedures. Residents will also be given modules to review of common dermatologic conditions and administered a pre and post-rotation quiz.
One month is spent with the Prairie Cardiovascular group at a nearby ambulatory care clinic. This month provides an outstanding opportunity for residents to learn the acute and chronic care of the cardiac patient as well as observe cardiac procedures such as catheterization and pacemaker/ICD placement and management.
One month is dedicated to outpatient procedures. The "procedure resident" is in clinic five days a week performing various procedures including colonoscopy, toenail removal, lump and bump removal, colposcopy, vasectomy, IUD and subcutaneous implantable progesterone rods.
Residents spend one month rotating to various outpatient mental health facilities both at the Belleville residency clinic and at Scott Air Force Base. This is an excellent opportunity to learn about mental health, including pain management, and the numerous resources available in the community. As part of this four-week rotation, each resident designs a 15-minute presentation on a behavioral health topic of interest to them.
Residents spend time working with Scott Air Force Base and St. Elizabeth Hospital's radiologist reviewing a variety of radiologic studies in both the inpatient and outpatient setting, as well as participating in interventional radiology procedures when able. There is also a series of radiology modules to complete and an end of rotation test.
One month is spent working with a private physician in a local rural underserved area, focusing on the unique decision-making and patient care that takes place in the rural setting. Also during this month, residents do a project assessing community needs and planning a simple intervention to be implemented and followed up during the third-year community medicine month.
Four weeks are set aside for residents to complete an elective or research project of their choice. During this elective month, residents continue to see clinics two to three half days per week in the Family Medicine Clinic.
The sequence of rotations will vary with each resident.
PGY-3 residents have clinic three to four half days per week at the Belleville Family Health Center. Continuing into the third year, residents take care of a panel of three to five nursing home residents at Belleville Health Care and Rehab. Call is only on the two family medicine inpatient service rotations; there is no random call.
In addition, third-year residents are expected to be available to attend the delivery of their OB continuity patients and follow mother and newborn for their hospital stay. Residents will present a 15-minute lecture discussing a current clinical guideline and a brief chart review of some of their patients.
Residents spend two four-week blocks as the senior resident supervising the actions of the second-year resident overseeing the service's ICU patients and the two interns seeing the team's general medical patients. There is increased emphasis on providing education to more junior residents. In addition, seniors will give one or two ten to 15 minute morning report lectures covering common inpatient topics to the teams before rounds. Call is every fourth night.
One month is spent in a general pediatric clinic including well child visits, acute illnesses, hospital follow-up, and long-term treatment. Residents will work one-on-one with pediatric attending physicians.
Residents spend one month working in various sports-related areas. Three times a week is spent in our sports medicine clinic and one to two times a week in OMT (osteopathic manipulative treatment). During the rotation, residents may elect to spend time in a physical therapy office learning the rehab skills necessary after sports injuries. Residents have the option to work with local high school and college teams during sporting events as well as at events like local marathons. Residents will have an end-rotation quiz as well.
One month is spent working with community agencies learning about the types of social services that are available to patients and their families. Residents also focus on their preventive medicine skills and implement their intervention that they proposed during their PGY2 rural medicine month.
Residents have two blocks of medical "selectives"- subspecialty rotations including, but not limited to, pulmonology, nephrology, gastroenterology, or cardiology- and two blocks of free electives to be used as the resident desires. Some residents have used the time for additional clinics, others to gain more procedures, still others to do more specialized rotations like allergy/immunology.
Residents spend a block learning the components of private practice including billing and coding, quality-improvement projects and contract negotiations. Residents maintain their continuity clinic during this block.
Given that the vast majority of family medicine residency graduates go into primarily outpatient-based practice, third-year residents have a block of primarily outpatient clinics, including their continuity panel, acute appointments and procedures. Emphasis is on seeing a higher volume of patients and becoming more efficient with time management during a clinic day.
Applicant interviews are an important part of the match process and are by invitation only. Applicants who will be considered for interviews must:
Interviews are held from October through January. We accept only ERAS (Electronic Residency Application Service) applications, and the deadline for submission is December 15.
To ensure a fair process for all civilian applicants, rotations will not be scheduled for students outside of our institution until an invitation to interview has been made.
Applications for military applicants are processed through the Joint Service Graduate Medical Education Selection Board (JSGMESB). Final residency training site rankings are due to the JSGMEB by the middle of October, with the board meeting during the last few weeks of November and match results released around the middle of December.
Military Applicants Only: To arrange an active duty tour, site visit, or tnterview, please complete the Rotation Request form.
Belleville Family Medicine Center patients represent all sectors of urban and rural areas, allowing a wide variety of experiences for our residents.
Our preference for treating the whole family enables our residents to see prenatal and pediatric patients and families in various stages of development, as well as geriatric patients. This demographic distribution of patients allows our residents to gain valuable experience and give continuous and comprehensive medical care.
First-year residents are assigned a small panel of patients and spend one to two half days in clinic per week. Second year residents, spend two to three half days in clinic per week and third-year residents have a panel of patients nearing 500 and are in clinic three to four half days per week.
Incoming residents have patients spaced for longer intervals to allow adequate time to handle their visits. This interval shortens slightly each year as their clinical skills advance.
The inpatient service is divided into two teams; each consisting of two PGY1s, and PGY2 responsible for ICU patients and a senior PGY3. To balance patient care and resident education, a cap has been placed to limit the number of patients admitted to each team. Typically a cap of seven patient admissions per 12-hour shift and a community coverage cap of 20 patients per 24-hour shift.
Formal lectures are held once a week. Residents are excused from their rotations and required to spend five hours in these didactic sessions. The topics range from case presentations, procedural instructions to formal lectures.
In addition, at the beginning of inpatient rounds there is a short morning report where senior residents and faculty discuss with junior residents differential diagnosis and treatment plans for common inpatient complaints.
All residents take the family practice in-service exam each fall and results are given with the answer book at the completion of the exam for further learning opportunities. During all rotations, there is time for formal and informal one-on-one learning and teaching points with your preceptor.
Call is every fourth night on inpatient services (eight months during first year, two months during second year and two months during third year). Second years have four weeks of home call as a backup for the inpatient team.
OB call is every seven to 14 days during the outpatient months during the first and second year with third year having no call except two inpatient months. There is also an OB night float system during the second year.
The surgery call schedule is arranged with the surgeon, which ranges from q5-7.
Nontraditional sites are utilized as environments for residents to gain experience. These community agencies deliver assorted and comprehensive services to various populations with health care needs.
These populations include the underprivileged/underserved, geriatrics, childbearing, HIV/AIDS patients and the terminally ill.
Our program is a joint program with the United States Air Force family practice residency program. Typically, each class will consist of eight military residents and six civilian residents.
Civilian and military residents take all the same rotations, call, schedule and didactics. Our faculty is also comprised of both military and civilian faculty, allowing us to create an even greater pool of talented teachers.
Other than the uniforms and an occasional military-specific lecture or activity, our lives as residents are not marked by our military status. There are truly no divisions among the residents or the faculty and we consider ourselves one residency. The civilians are not expected to participate in military activities/requirements.