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Integrative Medicine Residency

Maine Medical Center Family Practice Residency Program
Complementary and Integrative Medicine Project

Specific Aims

Use of complementary and alternative medicine (CAM) is widespread in the United States. Education in traditional medical schools and residencies has not kept pace with this shift in the health care paradigm. Patients with a virtually limitless array of medical problems seek the care of family physicians, who are often the first point of contact in the traditional medical system. To provide optimum health care to patients and the community, family physicians need education in CAM.

The main purpose of the 30-month project described in this proposal is to design, implement, and evaluate an educational program in CAM for family practice residents at Maine Medical Center (MMC). The project will focus on development of a curriculum that describes the principles, safe use and appropriate referral for selected CAM therapies as well as effective communication with patients about their personal choices in complementary and alternative health care. In carrying out this project, we will build attitudes, knowledge and skills among faculty, residents, and staff of our residency program, build collaborative relationships with community practitioners of CAM, and promote an environment that is conducive to the integration of conventional medicine with complementary modalities.

The teaching and learning strategies of this project will include didactic presentations, an experiential component, and curriculum development. The four main goals of the project are to:

1. Develop, implement, and evaluate a CAM curriculum for Maine Medical Center family practice residents, which will serve as a model institution-wide and for other family practice residency programs.

2. Engage a physician, fellowship-trained in integrative medicine, as a faculty expert to provide in-house expertise and formal training in CAM for faculty, residents, and patients. Develop skills, knowledge and attitudes of four physician residency faculty leaders in four areas of CAM: acupuncture, manipulative therapies, herbal remedies/homeopathy, and mind-body interventions.

3. Facilitate collaborative relationships between local CAM providers and family practice residents and faculty, both for patient care and for education.

4. Promote an environment conducive to establishing partnerships between physicians and patients regarding the integration of conventional medicine with CAM therapies.

We will begin our project by convening a multidisciplinary Advisory Committee (AC) to identify community CAM resources, review and approve the overall CAM curriculum, plan educational workshops, and plan for dissemination of our project results within our institution and nationally. The AC will monitor overall progress on the project, ensuring that we meet our goals.

We will use an established curriculum subcommittee process to design, implement, and evaluate a resident curriculum in CAM. In addition to identifying knowledge, skill and attitude objectives, learning experiences, and suitable faculty, we will be looking for sources of reliable information about CAM therapies so physicians can counsel patients appropriately. We will publish our curriculum along with identified resources on both the MMC Intranet and the Internet. In our resident training, we will emphasize the importance of integrating conventional medicine with complementary and alternative approaches while acknowledging patients' belief systems. We will incorporate resident learning experiences longitudinally in teaching conferences and at our outpatient residency practice sites, Family Practice Centers (FPCs), during patient care as well as discretely during a month-long orientation to residency and in a block rotation. During and immediately after the first year of implementation, we will evaluate our curriculum and modify it as necessary.

If CAM is to be integrated into the Maine Medical Center Family Practice Residency Program (MMCFPRP), we need instructors who can effectively teach and model the use of such approaches. We will engage an Integrative Medicine fellowship-trained physician to be our faculty expert. This physician will be responsible for providing mentoring in CAM for faculty and residents, direct patient care, and liaison with community CAM providers. The faculty expert will conduct research in CAM therapy or education and will enlist institutional support for CAM. Four physician faculty members have agreed to be the faculty leaders for this project. We will support them as they pursue more in-depth study of their selected CAM modality through an appropriate course or conference. The faculty leaders will then be paired with a CAM practitioner with whom they will spend time seeing patients in order to maintain and enhance their newly learned skills. Along with the faculty expert, they will serve as role models, teachers and curricular resources for our program.

 


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