Curricular Highlights

Women’s Health

At NewYork-Presbyterian/Columbia Family Medicine Residency Program, we pride ourselves on providing comprehensive health care to the women of our community and on training the next generation of full spectrum women’s health physicians. We believe that women’s health care should encompass all stages of a person’s life, and should be centered on the medical needs, experience, and autonomy of our patients. Within that vision, we perform prenatal care, mental health care, and medical and procedural abortions at our core medical practice. Residents can expect to be immersed in prenatal care for low and high risk pregnant patients, to deliver patients they care for, and, in many cases, to continue to care for newborn infants. They will be trained in evidence based cancer preventive services, including cervical cancer screening, endometrial biopsy, and the basics of colposcopy. With regards to reproductive management, residents are expected to reach levels of competence and comfort with all modes of reversible contraception, including placement and removal of IUDs and contraceptive implants. We also offer clinical care and training in miscarriage and abortion on an opt out basis. Graduating residents can expect to be competent managing medical abortions and early pregnancy loss, and to lay the foundation for potential future training in procedural abortions.

Yorgos Strangas, MD

Didactics

We dedicate a weekly Thursday afternoon to the family medicine didactic series which is geared towards educating residents on core topics and guidelines, as well as current practice changing updates in primary care. We have multiple ongoing series: Women’s Medicine, Behavioral Medicine, Quality and Safety Forum, and Complementary and Integrative Medicine, to name a few. Other examples of relevant sessions include Personal Finance for Physicians, wellness activities, and local Washington Heights culture and Spanish language enrichment.

Lectures are presented by faculty, residents, and alumni from our program, colleagues from specialty departments in our institution, and renowned presenters from other academic centers. We include dedicated time for learning procedures and gaining certifications in areas such as Nexplanon placement and naltrexone administration. We reserve time for focused workshops on important topics such as racism in medicine and advocacy, as well as training sessions for specific licenses such as buprenorphine management.

Residents are front and center in planning and implementing all of our didactic programs. Their input is highly valued and they are drivers of how their learning is structured. We emphasize collaboration between faculty and residents, innovative delivery methods, interactive formats, and recognize that our learners may have a variety of ways in which they absorb information. Family medicine conferences provide an ongoing opportunity for all of us to expand our knowledge and skills together.

Marion Richman, MD

Family Medicine Inpatient Service

The inpatient service within the Family Medicine Residency Program at NewYork-Presbyterian Hospital is dedicated to providing quality medical care to our patients within the urban underserved communities of Washington Heights, Inwood, and the Bronx within New York City. Our patients range from young adults to individuals over 100 years old. Collectively, they display the complex interplay between multiple comorbidities and social determinants of health. Our service is run exclusively by family medicine and includes one full-time family medicine hospitalist, one rotating family medicine attending, two senior residents (one covering days and one covering nights), and two interns (both covering days). On average, the daily census consists of 11 patients with each intern carrying 5-6 patients per shift.

Our service cares for approximately 1,000 patients per academic year. The cases assigned to family medicine are identical in terms of acuity and teaching value to those assigned to the internal medicine teaching service. Residents are immersed over the course of their training in a rigorous evidence-based curriculum that discusses and considers the most current peer-reviewed literature and how it impacts our medical management. The varied and engaging formats of learning include case-based review, clinical question rounds, radiology rounds, biopsychosocial rounds, narrative medicine, and consultation with Columbia’s world-renowned subspecialists. Residents can expect to achieve competency in managing acute and chronic manifestation of the following conditions both in the inpatient as well as the outpatient settings: acute coronary syndrome, congestive heart failure, atrial fibrillation, COPD and asthma, end stage kidney and liver disease, GI bleeding, infection and/or sepsis from any source, electrolyte and acid-base derangement, stroke, dizziness, and syncope.

Aside from the quality medical care we aim to provide, we are cognizant of the systemic racism and other interrelated social determinants of health that heavily impact our patients’ lives. We are invested in understanding our patients’ needs within the communities they live in through an interdisciplinary approach with our social work and nursing colleagues and are committed to addressing injustice through advocacy within and outside of the hospital system.

Hima Ekanadham, MD and Joanne Dempster, MD

Research and Scholarly Activity

The Residency Required Research Project (R3P) aims to equip residents with necessary knowledge and skills to critically appraise literature as well as to design and implement scholarly research work. Each resident develops practical skills and thorough understanding across all states of research design and implementation. Every resident works with faculty mentors to design and implement a research project that focuses on an aspect of family medicine or community health. R3P work begins in the PGY-1 year and is completed prior to graduation. Residents’ work is supported via didactic training, group discussions, and regular supervision. Some of the recently completed projects focused on: vaccination uptake rates, lifestyle modification, care utilization, as well as resident wellness and burnout. Results of the residents’ R3P work have been disseminated via national and regional conferences as well as peer-reviewed publications.

Nataliya Pilipenko, PhD, ABPP and Urmi Desai, MD, MS

Quality Improvement

person giving speech

Quality improvement is a requirement of all family medicine residency programs and is important to graduates’ future practices. Our residents have longitudinal protected time for quality improvement projects and education throughout the three years of training. Our residents, faculty, and practice staff at the Farrell Community Health Center are divided into three teams for their clinical care. Each team completes a quality improvement project each year, lead by the second and third year residents on the team.

First year residents learn the basics of QI by participating in the project implementation and by completing the quality improvement modules through the Institute for Healthcare Improvement. Our current QI projects are to improve the rates of childhood vaccination, to increase the rate of screening for food insecurity, and to increase the rates of urine microalbumin testing for diabetic nephropathy.

Urmi Desai, MD, MS and Heather Paladine, MD, MEd

Outpatient Medicine

Drs Chacko and Diaz

The Herman "Denny" Farrell, Jr. Community Health Center is the ambulatory hub of Family Medicine at NewYork-Presbyterian Hospital and where resident and attending physicians provide compassionate care to families in upper Manhattan including the Washington Heights, Inwood, Harlem, and Bronx communities. We are a Patient Centered Medical Home with a robust interdisciplinary team including social work, mental health providers, a registered dietician, community health workers, pharmacists, and more. Our resident physicians care for patients under the preceptorship of expert clinical faculty from the Center of Family and Community Medicine. The members of the Farrell team work collectively to advocate for our patients and care for the community. We offer extraordinary training for generations of future physicians to develop longitudinal relationships with patients at every stage of life through the biopsychosocial model, promote health and wellness, and use evidence-based medicine to treat chronic diseases.

Family medicine was established as part of the NewYork-Presbyterian Hospital/Columbia University Irving Medical Center's Ambulatory Care Network (ACN) over twenty years ago to meet the underserved health needs of our community. At Farrell, we provide comprehensive care for the entire family, including routine well-baby and well-child care, gynecology and prenatal care, care of those with complex acute and chronic medical conditions as well as in-office procedures. We strive to reduce disparities in health care both within the individual patient-physician relationship and by connecting patients to NYP’s world-renowned specialists. We strive for exceptional patient care through advocacy, quality improvement, and population health initiatives.

Sharon Chacko, MD and Daniela Diaz, MD

Community Medicine Month

At the NewYork-Presbyterian/Columbia Family Medicine Residency Program, we are aware that we provide primary care not simply to individuals, but to families and to a larger community. Every year, one month of the interns’ schedule is dedicated to a community medicine block. The goal of this time is to increase interns’ understanding of patients in the context of the Washington Heights community early in their residency. They participate in guided explorations through the neighborhood surrounding our health center and undergo intensive Spanish language instruction during this time as part of the larger longitudinal Spanish curriculum. Crucially, this month is also dedicated to intentionally developing the language of structural competence, and interns receive instruction regarding social determinants of health and how existing systems perpetuate health care disparities.

Silvia Cunto-Amesty, MD, MPH, MSEd, Rebecca Leeds, MD , Molly Warren, MD, and Ana Esteban-González, MD, MSEd, CI

Community Medicine and Advocacy Track (CMAT)

At the NewYork-Presbyterian/Columbia Family Medicine Residency Program, we offer the Community Medicine and Advocacy Track for our residents, beginning intern year and spanning all three years of residency. This is a new track, offered to interns for the first time in 2020. The CMAT will be offered to two residents per year. This track allows residents to explore the fundamentals of community health, social determinants of health, and the impact of these and race/ethnicity/class on health and health disparities. Residents will learn ways to incorporate the use of community medicine in advocacy frameworks into their day-to-day primary care practice and develop skills to increase awareness and understanding of health disparities and strategies to work effectively towards minimizing bias. The CMAT includes interactive learning modules through a curriculum that we have created and which must be completed by graduation. The CMAT also offers experiential learning activities and the opportunity to create and implement longitudinal community and advocacy plans for patients, families, and communities. We are a dynamic group, enthusiastic about creating community within our own family medicine residency, and we expect that residents who join the track contribute to the growth and development of the CMAT.

Silvia Cunto-Amesty, MD, MPH, MSEd

Integrative Medicine Track (IMT)

At the NewYork-Presbyterian/Columbia Family Medicine Residency Program, we offer an Integrative Medicine Track for our residents beginning intern year and spanning all three years of residency. Established in 2014, this track allows residents to explore the fundamentals of integrative medicine (IM), learn ways to incorporate aspects of IM into their day-to-day primary care practice, and develop methods for self-care and wellness. The IMT includes 180 hours of interactive learning modules through the University of Arizona's Integrative Medicine in Residency (IMR) curriculum that must be completed by graduation. The IMT also offers exciting and fun experiential learning activities and the opportunity to create and implement longitudinal IM care plans for patients. Residents who are part of the track develop annual personalized wellness and self-care plans. In addition to experiential activities, the IMT cohort joins together once monthly for check-ins with the track supervisor and the IM fellow. We have a fantastic community of integrative medicine residents and faculty and we'd love for you to be a part of it!

Pooja Shah, MD

Musculoskeletal Education

At the Farrell Community Health Center, we offer a full-spectrum teaching clinic dedicated to musculoskeletal issues, acute pain and chronic pain syndromes, and sports medicine injuries. Residents can expect to be immersed in musculoskeletal care for all age groups and will be trained in evidence-based methods of evaluation and treatment of common musculoskeletal and rheumatologic conditions. We will focus on improving procedural skills by offering our patients pain-relieving interventions, such as corticosteroid joint injections and trigger point injections. Furthermore, we value a holistic view of the musculoskeletal system of the body, as we believe all facets of the mind and body can influence pain and daily function. Frequently, we will incorporate integrative approaches into our patient's visits and post-visit care. We have also started an OMT (osteopathic manipulative treatment) session and curriculum where MD and DO residents receive exposure and training in providing manipulative treatment to patients with musculoskeletal pain.

Pooja Shah, MD, and Juliana Berenyi, DO