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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.

CommuniCare Health Centers

CommuniCare Community Health Center is a federally qualified health center with twelve outpatient locations in and around San Antonio. Their full-service primary healthcare system serves in both Bexar and Hays counties and offer an array of services including:

  • Pediatric medicine
  • Family medicine
  • Senior care 
  • Women's health
  • Podiatry
  • Dental
  • Behavioral health
  • Minor surgery clinic
  • WIC services
  • Vision care (provided by the UIW School of Optometry)
  • Pediatric speech therapy 

Care is delivered through multiple clinic locations utilizing integrative primary care practice, highly trained healthcare providers, state of the art diagnostic equipment, and electronic health records. CommuniCare strives to be a ‘one-stop shop’ for healthcare for the communities they serve.


Residents will be based at the West Clinic on Barclay Street for their continuity clinic(s). They will also rotate through other CommuniCare sites, for their outpatient pediatric and OB/GYN rotations, to understand the unique aspects of each specific community. Each clinic site has office space dedicated for the residents, computer facilities for both electronic health records and information retrieval for study and research. Each clinic has a break room with kitchen facilities including refrigerator and microwave. Food service is not provided at the clinics, although vending machines are available and most clinics have restaurants and grocery stores in the nearby vicinity. Each clinic has its own security system and residents must utilize their ID badge to gain access to the facility.

Communicare works with a number of affiliated hospital partners in the area. Residents will be assigned to teaching services with hospital partners. In many cases, the residents will work alongside residents from other programs at these hospitals and will benefit from their inpatient didactic programs. Residents will be fully oriented to the policies and procedures for each hospital prior to beginning their rotation at that location.

Dr. Bridget Thackeray, Site Director
CommuniCare Hospital Partners
CommuniCare Clinic Locations
The Center for Health Care Services 
Where Hope & Healing Begin

For fifty years, The Center for Health Care Services has been improving the lives of people with mental health disorders, substance abuse challenges, and developmental disabilities in Bexar County. The Center believes in creating environments that inspire and promote respect for one another, and empowering people to live independent, productive lives. The mission of the Center is to share hope and support recovery with a full spectrum of innovative services that promote healing and help people live life to their full potential. CHCS' Five Centers of Excellence include Adult and Children's programs, Community and Transformational Services for the homeless population, Long Term Care Services for the Intellectually/Developmentally Disabled, and Restoration Services for crisis and substance use disorders. The Center is commited to staying at the leading edge of providing effective health care by using the latest evidence-based treatment.

The Center for Health Care Services has been recognized as a national leader for their Diversion Program which began in 2002. By providing appropriate care and treatment for mentally ill individuals, CHCS diverts over 4000 people each year from incarceration and even more from unneccesary emergency department visits. This adds up to a savings of over $5 million annual for the local justice system and the emergency medical facilities. More importantly, this program directs patients towards hope and healing.

The Center for Health Care Services is also a primary care provider. Following a true approach to integrated healthcare, the CenterCare Clinic at The Restoration Center offers primary care services to people receiving counseling, therapy and recovery assistance for substance use and mental health disorders. The Clinic improves health in our community by treating adults with common, chronic and complex conditions. The care team of experienced providers includes primary care physician assistants and nurse practitioners, as well as staff specialists in benefits coordination, care coordination, and medication management.

CenterCare providers offer continuing and comprehensive health care to consumers and their families throughout the course of life. In addition to diagnosis and treatment for a broad range of conditions or illnesses, providers also offer preventive care including:

  • Routine checkups
  • Health risk assessments
  • Immunizations
  • Screening tests
  • General Healthcare Maintenance
  • School Physicals
  • Well Women Exams

CenterCare providers often manage chronic diseases by partnering with other medical specialists to offer coordinated medical care.



Dr. Ruth Morgan, Site Director
The Center for Health Care Services Website

Baptist Health System

Core Inpatient Rotation

 Mission Trail:
•Inpatient Medicine (PGY 1-3)
•ICU (PGY-2)
•Emergency Medicine (PGY 1-3)

North Central:
•NICU (PGY-2)
•Inpatient Pediatrics (PGY-1)
•Pediatric ER (PGY-3)

  
Medical Center:
•CommuniCare patient OB/deliveries
•General Surgery (PGY-2)

Northeast:
•General Surgery (PGY-2)
  

Metropolitan Methodist Hospital

Core Inpatient Rotation

Inpatient Obstetrics
(completed PGY-1 year)

The San Antonio Orthopedic Group

Core Outpatient Rotation

Orthopedic Surgery (PGY-1)

Elective Rotation

Pain Management (PGY-2 or 3)

Sports Medicine Associates of San Antonio

Core Outpatient Rotation

Sports Medicine (PGY-2)

Fellowship

Sports Medicine (in development)

Audie L. Murphy VA Hospital - San Antonio

Core Inpatient/Outpatient Rotations

Geriatrics (PGY-2)

Outpatient VA (PGY-2 and 3)

Kerrville VA Hospital

Core Inpatient/Outpatient Rotations

Geriatrics and Palliative Care (PGY-1)

Outpatient VA (PGY-2)