Make a difference during your residency!






About Community Based Family Medicine:

The Texas Institute of Graduate Medical Education and Research (TIGMER) continues to develop on our new community-based family medicine residency program based in San Antonio. This program follows the Teaching Health Center model and allows for residents to train on the front line of health care, providing services to those with the greatest health care needs. We take pride in the fact that this program will train residents to provide community-oriented, patient-focused, high-quality primary care. We focus on providing healthcare to underserved populations and improve access to medical treatment. We are adressing the needs of the community and see our model as part of the solution for improved community health - one patient at a time. This program is made possible through a partnership with CommuniCare Health Centers and The Center for Health Care Services.

The Family Medicine Residency Program is a postgraduate training program accredited by the American Osteopathic Association. Only graduates from  Colleges of Osteopathic Medicine, approved by the Commission on Osteopathic College Accreditation (COCA) will be accepted into the program at this time. The program has proudly achieved the status of "Initial Accreditation" with the Accreditation Council on Graduate Medical Education (ACGME). The program is currently seeking Osteopathic Recognition as the next step. 

The length of the residency program is three years. The program provides residents with advanced and concentrated training in Family Practice and Osteopathic Manipulative Medicine and will prepare them for the examination provided by the American College of Osteopathic Family Physicians (ACOFP). This training program has been designed in compliance with the AOA Basic Standards for Family Practice and the ACOFP.

Upon successful achievement of the program, the physician will be prepared to provide comprehensive osteopathic primary care to diverse populations in multiple clinical settings. The program offers the resident with well-structured training in both cognitive and procedural domains, which will provide primary responsibility for patient care in the inpatient and outpatient settings. This training will offer extensive didactic and clinical experiences. Utilization of osteopathic principles and practices relating to family medicine will be incorporated into the training program. 

In addition to a busy rotation schedule, our residents have other opportunities to add to their skills, through conferences, research and work with medical students.
Conferences are woven into our everyday schedule, allowing residents to consider and debate a broad range of topics.
Residents are required to engage in scholarly activity that allows them to pursue areas of interest to them.
Residents also have the opportunity to mentor medical students who are based in San Antonio or stationed here briefly as they work on their clerkship requirements or electives.
Graduates of the residency program will have multiple opportunities to begin their career at a South Texas FQHC with options for medical student loan repayment.
Our residents receive consistent feedback and evaluation from a variety of sources.


What is a Teaching Health Center?

Traditional residency programs are sponsored by hospitals and funded through Medicare payments to the hospitals. Hospital administrators are able to decide what residency positions to offer based on what will provide the greatest benefit for the hospital. As a result, there is in many regions, a shortage of primary care physicians and a surplus of specialty-trained dotors and no formal mechanism for the federal government to direct Medicare dollars to meet the healthcare needs of the community.

In 2010, the Teaching Health Center Graduate Medical Education (THCGME) program was established as a component of the Federal Patient Protection and Affordable Care Act (ACA). This program established a mechanism to fund primary care residency programs through Federally Qualified Healthcare Center and Rural Health Centers. These programs would focus on ambulatory primary care training for residents who would spend more of their time in the clinic setting providing services for underserved communities.

Residents still complete the required inpatient rotations at affiliated hospitals, but there is a primary focus on ambulatory care that is patient centered and community-based. Completion of a THCGME program prepares a resident for private practice or continued service to FQHCs where student loan repayment is often an attractive option.

The THCGME program was an unmitigated success. (See link to article below). Unfortunately, the federal appropriations for the program ran out in 2015 and congress is still debating how to continue funding this excellent program. In the mean-time, state and local funding sources have stepped up their efforts to continue funding residency training at Teaching Health Centers.

The TIGMER Community-Based Family Medicine Resisency Program is made possible through the Texas State GME Expansion Grant Program, a major grant from The Center for Health Care Services and support from CommuniCare and the University of the Incarnate Word School of Osteopathic Medicine.
TACHC Website
AATHC Website
AAFP Article
Academic Medicine Article

Block Schedules​​

PGY 1 Block Schedule
There are 12 blocks in an academic year with each rotation being 4 weeks in length (with the exception of Inpatient Medicine which is 3 months)

Rotations and Locations:
CommuniCare Health Centers
  • Family Medicine
  • Outpatient OB/GYN
  • Outpatient Pediatrics
  • FM and OB Continuity Clinic
The Center for Health Care Services
  • Behavioral Medicine
CHRISTUS Health System
  • Inpatient Pediatrics*
  • Inpatient Medicine*
  • Emergency Medicine*
Baptist Health System
  • Inpatient OB/GYN
Kerrville VA and Audie L. Murphy San Antonio
  • Geriatrics and Palliative Care

Continuity Clinic = 1 half day per week for PGY 1 residents

*denotes possible changes



PGY 2 Block Schedule
There are 12 blocks in an academic year with each rotation being 4 weeks in length (with the exception of Inpatient Medicine which is 3 months)

CommuniCare Health Centers
  • Family Medicine
  • Outpatient OB/GYN
  • FM and OB Continuity Clinic
The Center for Health Care Services
  • Behavioral Medicine
CHRISTUS Health System
  • Inpatient Pediatrics*
  • Inpatient Medicine*
  • Emergency Medicine*
Baptist Health System
  • Inpatient OB/GYN
  • Inpatient Sugery
Kerrville VA and Audie L. Murphy San Antonio
  • Geriatrics and Palliative Care

Continuity Clinic = 2 half days per week for PGY 2 residents

PGY 2 residents will have one block for an elective rotation in a specialty of their choosing.

*denotes possible changes

PGY 3 Block Schedule
There are 12 blocks in an academic year with each rotation being 4 weeks in length (with the exception of Inpatient Medicine which is 2 months)

CommuniCare Health Centers
  • Family Medicine
  • Outpatient OB/GYN
  • FM and OB Continuity Clinic
The Center for Health Care Services
  • Behavioral Medicine
CHRISTUS Health System
  • Pediatric Emergency Medicine*
  • Inpatient Medicine*

Continuity Clinic = 4 half days per week for PGY 3 residents

PGY 3 residents will have 5 blocks available to complete electives in any specialty of their choosing.

Additionally, a PGY 3 resident will complete a rotation in Practice Management.

*denotes possible changes

Mission, Vision and Objectives


Mission

The mission of the CommuniCare Family Medicine Residency is to provide excellent clinical training while providing the highest quality health care to our patients.

Vision

The vision of the CommuniCare Family Medicine Residency is to become the best Osteopathic Family Medicine Residency Program in the Southwestern United States through excellent patient care, continuous quality improvement and outstanding graduate medical education.
General Objectives of the Residency Program:

  1. Train residents to provide quality clinical care in a wide range of clinical venues
  2. Expose trainees to the subspecialties medicine in order to obtain a broader understanding of the scope of patient care.
  3. Introduce trainees to ambulatory continuity of care medicine
  4. Create in trainees a proficiency level of excellence in medicine
  5. Develop an organized approach toward the diagnosis of disease.
  6. Apply the principles of evidence-based medicine to the care of patients
  7. Integrate osteopathic concepts in the diagnosis and treatment of patients.
  8. Develop an awareness of health care economics and practice cost containment
  9. Recognize the basis of and the need for humanistic values in clinical medicine
  10. Stimulate participation in the educational process of residents and students
  11. Develop a methodical; approach to reading, interpreting and applying the medical literature.
  12. Promote health well-being and preventative medicine
  13. Provide healthcare to the underserved population in South Texas.

Specific Objectives of the Residency Program:

At the completion of the training program, the graduate shall:

Accurately identify potential medical problems.
  • describe the medical problems presented;
  • define information in the patient record which aids in said description;
  • elicit and record appropriate history which defines the problem;
  • perform and accurate physical examination to identify and confirm the problems.
Accurately diagnose problems.
  • describe potential etiologies for each presenting problem;
  • identify signs and symptoms for each problem;
  • prioritize findings with respect to potential etiologies;
  • rank potential disorders by likelihood based on presence or absence of findings.
Confirm the diagnosis of the problem.
  • describe the diagnostic resources for each disorder;
  • generate a diagnostic plan to appropriately confirm the disorder;
  • perform diagnostic procedures where appropriate;
  • properly interpret results of testing, recognizing the relative sensitivity and specificity of the tests;
  • understand cost effective diagnostic planning
Competently treat the problems.
  • define the needs and circumstances of the patient;
  • describe the conventional and alternative therapies for each problem;
  • generate treatment plans which are cost effective;
  • monitor response to treatment, including appropriate follow-up testing if needed;
  • determine efficacy of chosen treatment.
Communicate effectively.
  • use standard English effectively;
  • use accepted medical terminology appropriately;
  • develop listening skills for patient, family, and ancillary providers;
  • effectively and sensitively respond to patient questions and fears or concerns;
  • record data and plans clearly and completely in progress notes, summary reports, history and physical reports, and procedure reports;
  • develop prompt responsiveness to requests for information or explanation;
  • demonstrate reasonable facility in use of computer network information and record keeping systems.
Demonstrate professionalism.
  • be characterized as competent, approachable, empathetic, conscientious, and cooperative;
  • develop sensitive yet definitive leadership capabilities when dealing with house staff, students, or ancillary staff;
  • demonstrate honesty, reliability, and morality;
  • develop a commitment to the medical community and the advancement of medical care in the population.
Develop strong work habits.
  • demonstrate ability and commitment to use of continuing medical education tools, such as journals, computer-assisted instruction, and involvement in conference activities both as learner and instructor;
  • recognize personal limitations and obtain appropriate assistance where necessary;
  • perform all record keeping activities promptly and thoroughly;
  • understand requirements of operating in the managed care environment, and how to maximize efficiency;
  • recognize the medico-legal aspects of care, and manage risks appropriately.

Resident Benefits and Compensation

Compensation and Benefits, Stipends
Current information on compensation, benefits, and stipend amounts will be posted on the website annually once confirmed by Human Resources. (www.uiw.edu/hr).

Vacation
PGY-1 year – 10 days paid vacation per contract period.  “Vacation” is defined as time off for a vacation or personal time.
Vacation Leave request require the Program Director’s approval.  Unused Vacation Leave does not accrue and expires at the end of the contract.

Sick Leave
5 days paid sick leave days total per contract period.  “Sick” leave is defined as time off for illness.  Sick Leave requests require the Program Director’s approval.  Unused Sick Leave does not accrue and expires at the end of the contract.

Family and Medical Leave
When it is anticipated that an extended leave is necessary for medical/personal reasons, the Resident must discuss with the Program Director.  The Resident may also be entitled to benefits under the Family Medical Leave Act (FMLA), and other federal statutes.  Other medical or personal unpaid leave may be granted with the approval of the Program Director, consistent with the AOA’s/ACGME regulations, as applicable, only after the Resident has exhausted all of his or her applicable leave benefits.  Makeup time and /or repeat of training is determined by the Program Director.

Counseling and Psychological Support Services
Employee Assistant Program (EAP)