Clarkson Family Medicine Residency has a long-standing tradition
of excellence in medical education. Medical students and resident have come to The
Nebraska Medical Center for years to complete specialty and subspecialty rotations.
The development of the Family Medicine Residency Program allows students to learn
by working closely with family medicine residents. Nebraska Medicine attending
physicians have a long track record of one-on-one ward teaching as well as extensive
experience in didactics.
Nebraska Medicine medical staff believes that this extensive experience
in medical education is a major factor in the success of the Family Medicine Residency
The mission of Clarkson Family Medicine Residency Program is to train highly skilled,
enthusiastic family physicians for practice in a wide range of community settings.
Residents work one-on-one with attending physicians on clinical rotations and are
delegated increasing responsibility as the attending physician observes the resident’s
progress. This way, residents are not thrown in to crisis situations without adequate
supervision, nor are they simply casual observers while actual patient care is given
by the staff physician. As several of our faculty are former rural practicing physicians,
we realize the importance of procedural skills in the specialty of family medicine
– particularly for those physicians who will be practicing in remote arenas.
At the end of the third year of training, residents will be performing colposcopy,
LEEP, chest tube placement, thoracentesis, emergency management and stabilization
of major trauma, as well as the management of complex cases in the ICU and CCU.
It is expected that residents who choose to perform obstetrics as part of their
eventual practice will have participated in a minimum of 40 or more vaginal deliveries
and gained cesarean section experience.
The Clarkson Family Medicine Residency Program is grounded in the concept that residents
manage their own patients within the Family Medicine Center and that each resident
is viewed as the patient’s physician. Continuity of care is strongly stressed within
the residency program, with cross coverage by other residents to continue care while
the resident is off duty. Nebraska Medicine believes in the existence
of life after medicine. We provide adequate free time for residents to pursue individual
interests and believe the time is necessary for the maintenance of the residents’
Through formal sessions as well as informal dialogue, the faculty and director help
residents deal with any difficult times that may arise.
Evaluation and feedback from all individuals participating in residency training
– faculty members, attending physicians, residents, residency graduates and patients
– is essential for the continued success of the program.
At Clarkson Family Medicine Residency Program, residents are evaluated monthly by
the attending physician supervising the rotation. Physician preceptors at the Family
Medicine Center are specifically assigned to provide evaluation and feedback to
residents, as needed, regarding each patient visit. The director and other full-time
faculty also provide the resident with ongoing feedback and informal semi-annual
Equally important, residents evaluate all aspects of the residency program. Residents
submit formal evaluations of each attending physician with whom they rotate and
include recommendations for how the rotation could be improved. Residents give evaluations
on Family Medicine Center preceptors, full-time faculty members, part-time faculty
members and the program director. The teaching skills and quality of each faculty
physician is evaluated by the residents themselves, so we take resident recommendations
Finally, all graduates of the program will be surveyed on an annual basis. Input
from these practicing physicians allows us to make changes that are occurring in
the private practice of family medicine. In addition to the Family Medicine Center,
residents participate in a variety of clinical rotations.
Each resident spends a minimum of one month on a rural practice rotation. During
this month residents become a “junior partner” of a rural family practice.
This experience allows the resident a first-hand view of rural medicine and is designed
to develop the resident’s skill and confidence as a family physician.
The required rural rotation is located in West Point, Nebraska, which was carefully
selected for the broad range of clinical and surgical experiences, the quality of
the practicing physician and the quality of life in the community. Spouses are encouraged,
whenever possible, to be a part of this rotation.
Residents often look at this rotation as not only one of their most practical and
educational opportunities during their residency, but also as an opportunity to
begin exploring potential practice locations.
Three rotational months are performed in obstetrics and one additional month is
devoted to gynecology. The third month on obstetrics is usually performed during
the second year, and in addition to adding to skills in operative obstetrics, including
Cesarean sections, vacuum and forceps deliveries, a second-year resident is also serving
in a supervisory capacity of the first obstetrical rotation by a first-year resident.
The goal of the obstetrical rotation is to provide residents with skills to perform
excellent prenatal and postpartum care, labor and delivery management, recognizing
and treating pregnancy complications and developing the operative skills necessary
to perform obstetrics in practice.
Residents receive additional experience in obstetrics while functioning as an upper-level
house officer during their second and third years when they moonlight at The Nebraska
Clarkson Family Medicine residents also manage their own obstetrical patients in
the Family Medicine Center. Residents receive three years experience performing
deliveries at The Birth Place, Nebraska Medicine’s Labor & Delivery, Recovery
and Postpartum suites. Residents average two to three deliveries per month from
their Clarkson Family Medicine training, in additions to the delivery experience
they receive during their longitudinal rotations. Residents perform Cesarean sections,
with assistance from either family medicine faculty with section privileges, or
with Nebraska Medicine obstetricians, all of whom are actively involved
in the training of our family medicine residents.
Residents perform a total of nine months of required rotations in internal medicine
and related subspecialties. The rotations occur at Nebraska Medicine,
in the offices of subspecialty physicians and at rural satellite clinics. The goals
of the internal medicine rotation include the acquisition of problem-solving skills,
procedural skills and insight into the physician-patient relationship. For those
residents who plan to practice in areas without immediate subspecialty backup, critical
care will be particularly emphasized.
Six months of rotational time is required in general surgery and related subspecialties.
During the first year of the general surgery rotation, the resident is responsible
for preoperative and postoperative management and for participating in the patient’s
surgery. One of the goals of the surgery rotation is to develop strong surgical
Subspecialty rotations in orthopedics, ENT, ophthalmology and urology are performed
in the physician’s office with particular emphasis on primary care, emergency management,
sports medicine and procedural skills important to family practice.
Four months are committed to pediatric training. A Neonatal Intensive Care Unit
rotation to better prepare residents for responsibilities on the subsequent obstetrical rotations. In addition, one month
each is spent on inpatient pediatrics, pediatric emergency medicine and a pediatric
elective rotation. Some pediatric rotations are based at Children’s Hospital, a 100-bed
facility located 40 blocks west of Clarkson Family Medicine that provides pediatric
services to the Midwest region.
The goals of these rotations are to develop skills to enable our graduates to provide
care for hospitalized pediatric patients, outpatient pediatrics with emergent conditions,
recognizing illnesses that require specialty care and developing skills that are
necessary to stabilize and transport critically ill neonates and pediatric cases,
including umbilical catheterization, intubation and lumbar punctures.
Residents also manage their pediatric patients and infants in the nursery and in
the Family Medicine Center and during any subsequent hospitalizations. The resident
on the obstetrical service is also responsible for all infants delivered by obstetricians,
who do not have a pediatrician or family physician on Nebraska Medicine
staff. Many of these young families follow up at Clarkson Family Medicine for their
The major thrust of behavioral science teaching is done on a longitudinal basis
in the Family Medicine Center. A psychology Ph.D. is on faculty to provide psycho-social
guidance in the Family Medicine Center.
Special areas of behavioral science emphasis are individual and family counseling,
geriatrics, crisis intervention and drug and alcohol treatment. Residents are videotaped
during some patient encounters to further improve interviewing techniques and skills.
Additional Rotations and Electives
Other rotations that are part of Clarkson Family Medicine requirements include radiology,
sports medicine, emergency medicine, family medicine and geriatrics. Each of these
areas underscores a unique character of family medicine and the unique skills required
of family physicians.
In addition, there are four months of electives that are available to the resident.
Additional medical subspecialties such as endocrinology, burn, plastics, allergy
and immunology, infectious disease and rheumatology are available. Other elective
possibilities include further training in pediatrics, obstetrics, advance surgical
cases, a designed procedural month, additional rotations in rural practice and an
independent study and/or research month.
The full-time family medicine faculty consists of board-certified family physicians,
most of whom have extensive experience in rural private practice and in medical
education prior to joining our faculty.
Over 200 attending physicians at Nebraska Medicine and other area hospitals
serve as clinical faculty members and teach primarily on clinical rotations within
the hospital. Their specialties cover a broad spectrum of medical skills and all
of them have a strong commitment to graduate medical education.