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Southwest Illinois Residency

Saint Louis University's family medicine residency program has been serving the community of southern Illinois since 1997.

The Saint Louis University Family Medicine Residency Program is the only fully-integrated civilian/military residency that is military and community-based. 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 HSHS St. Elizabeth's Hospital and SIHF Healthcare, faculty and residents experience diverse outpatient clinical care of underserved, uninsured, and military communities, comprehensive obstetrical care, inpatient medicine with ICU privileges, and a wide variety of in-house specialties available for consultation.

Program Highlights

  • 14 residents per class in a community-oriented primary care with the resources of a major academic medical school.
  • Unopposed residency at HSHS St. Elizabeth's Hospital.
  • Integrated resident/faculty group practice at the SIHF Healthcare clinic.
  • Diverse patient population.
  • Rich academic resources of SLU School of Medicine and the U.S. Air Force.
  • Focus on resident wellness with integrated wellness curriculum.
  • Close working relationships with academic and socially-committed faculty.
  • Procedure workshops held throughout the year: Nexplanon, Botox (for migraine prophylaxis), etc.
  • Half-day weekly for conferences, inpatient didactics daily.
  • Educational allowance for books and conferences.
  • Affordable city or rural living with proximity to vibrant entertainment and recreational activities of St. Louis.

Frequently Asked Questions

How do the military and civilian residents interact?

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 draw from 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 (although if a civilian would like to take a fitness test, you too can earn a half day off!)

“It's weird for the first two hours of orientation at SLU’s campus - military residents have begun duties already so they will be hanging out, laughing, and wearing uniforms. By the first afternoon, the civilians are in on the fun. After that, I can’t say I notice a difference other than I get to pick what I wear to work every day.”

What is your on-call system?

As interns, each of your four inpatient blocks will encompass one week of night float and q4 “short call” with sign out at 6pm (completion of clinical duties may occasionally extend until 9pm).

Interns will also have two blocks of OB on which they will spend half the rotation on night float and the other half on days. On outpatient rotations, you will cover an average of two random shifts per month on the OB deck or FMIS teams.

Second years will have 2 weeks of night float and two weeks of q4 short call on each of their two inpatient rotations. They will also have two blocks on which they spend two weeks of OB senior night float and home call as back up for the inpatient teams for each block. Average of about one weekend 24-hour OB senior shift per month.

Third years will take q2-4 short call on their two inpatient months.

 “This year we made a much-anticipated adjustment. We sat down with the faculty and created a night float system, eliminating the 28-hour shift from our inpatient service.” 

What is the demographic distribution of the practice's patient population?  

Our 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.

“One of the big draws for me was that I would get to serve two very different populations in residency. In the civilian clinic and hospital, we are exposed to nearly everything from both pathological and preventative medicine standpoints. Then we tack on a group (the military) with many of the same attributes plus a younger, athletic population that really enhances your preventative, gynecologic, and musculoskeletal learning experiences.”

What is the outpatient clinical load for each year of residency?

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 about every 6 months as their clinical skills advance. 

What is the inpatient clinical load?
The inpatient service is divided into two teams, each consisting of two PGY1s, one PGY2, 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. A team census typically averages from 10-15 patients.
What types of procedures are residents allowed to do? 

Our residents are trained by family medicine faculty in a variety of procedures including colposcopy, joint injections, dermatological biopsies, cryosurgery, colonoscopy, suturing, and other minor surgery. In addition, many of the preceptors are willing to teach procedures specific to their practice. 

“Another strong point in my education has been my exposure to procedures. Between sports medicine, Gynecology, and a dedicated procedures month I was exposed to a ton of different procedures and got signed off to perform several independently. Our occasional afternoon workshops offer other great opportunities such as using Botox for migraine prophylaxis. Personally, I’ve benefited hugely from time spent on musculoskeletal ultrasound. If you want to learn something here, the faculty are here to help.”

How much obstetrical experience is involved?

There are three four-week blocks, two inpatient and one outpatient, during the first year. Residents also take OB call during their outpatient rotations (usually one to three shifts per month to give our inpatient coverage a break). During the second year, there are four weeks of OB night float. Management of prenatal patients occurs in all three years in both an inpatient and outpatient setting. Each resident is expected to graduate having cared for 15 continuity OB patients providing prenatal care and performing the delivery. There is ample opportunity for additional continuity patients if desired. Residents may make the OB experience as demanding as they wish and have the opportunity to learn advanced obstetrical care, including C-sections.

We also have fellowship-trained FM-OB faculty that are experienced in providing care to high-risk patients, allowing a richer learning experience and the opportunity to develop greater skill in a demanding field.

“If OB is your thing, you’ll find yourself pleased once you get here. Even if it’s not, you’ll learn a lot. Catching babies is great, but the continuity experience of picking up an expectant mother early on in her pregnancy and walking with her up to delivery and into motherhood is an experience that has tremendously grown on me. Additionally, having the support of our FM-OB fellowship trained faculty (we currently have 3) allows us to safely care for our higher-risk mothers.”

What do you do for didactics?

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 and formal lectures to procedural workshops. We are currently focusing on ensuring a greater proportion of this material is interactive to encourage participation and drive resident investment in their learning.

Apart from these formal didactics, 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. Pharmacy Friday’s are always a highlight with our St. Elizabeth’s clinical pharmacists.

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.

“Since I arrived here two years ago, our Wednesday afternoon didactics have really grown. Chief residents are largely responsible for organizing these, and we have been lucky to have chiefs that have turned a necessary evil into an interactive learning environment. The faculty, workshops, guest speakers, and resident-driven content is an area in which we are making consistent growth.”

Can you leave the area for an outside rotation?

Arrangements for outside rotations can be made through the program director when additional educational experiences are desired. The outside rotation must meet the requirements of the Residency Review Committee and the program.

What affiliations does the program have?

The  residency is sponsored by the Saint Louis University School of Medicine. The outpatient clinic operations are managed through Southern Illinois Healthcare Foundation. We are the only medical residency program in the O’Fallon, Illinois, community.

What other community agencies are used for rotations?

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. Recent resident projects have included breastfeeding for new mothers, as well as a new dad’s class.

How can I schedule a rotation with your residency?

We consider outside rotator requests on a case-by-case basis. To request a rotation, send your medical school transcripts (unofficial is fine), requested rotation dates, and why you want to rotate with us to slu.belleville.familymed@gmail.com.

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 during interview season (October through January).