Our Family Medicine Center is a 16,700 square foot outpatient center on the campus of the Long Beach Memorial Medical Center. Located in the Buffum Medical Pavilion, it serves as the base for all of our continuity patient care. Here residents and faculty share one practice, seeing patients side-by-side as they take advantage of our 32 exam rooms. We see around 30,000 patient visits per year.
In addition to routine, office-based patient care, we are able to provide all of the outpatient procedures which are an everyday part of family medicine, including video colposcopy and other gynecologic procedures (IUD, cervical biopsy/ECC/EMB, Nexplanon), minor surgical and dermatologic procedures, bedside ultrasound (including OB, MSK, vascular and abdominal), casting and splinting, spirometry, arthrocentesis and joint injections, etc. In addition, we have a regularly scheduled gynecology clinic as well as a busy primary care sports medicine clinic.
The residents’ patient care is supervised at all times by full-time faculty members, with volunteer faculty members contributing from time to time. Consultation is also available from our psychologist, Dr. Wendy Linderholm, and from our on-site social worker.
Westside Neighborhood Clinic is a non-profit, community-based organization, located (predictably) on the west side of Long Beach, which serves as Memorial Family Medicine Residency Program’s community medicine site. Each second and third year resident spends four weeks providing care to the largely underserved patient population that resides in the immediate and surrounding neighborhoods. In 2014 we successfully merged WNC with The Children’s Clinic, a multi-site FQHC based in Long Beach, allowing WNC to become a FQHC. With this have come Westside’s first electronic health records and a broader array of services available to our patients. In 2015 we re-established our working relationship with the City of Long Beach’s homeless clinic.
The range of services at WNC includes prenatal and postnatal care, general acute and chronic care, family planning, immunizations, health education, nutrition and family counseling. A component of the clinic’s mission statement is the commitment to educate health care professionals in service to low income, culturally diverse communities. To this end, the clinic hosts family medicine residents, medical and nurse practitioner students, and medical assistant trainees in a multicultural, multidisciplinary training setting.
Long Beach Memorial Medical Center
Celebrating over 100 years, Long Beach Memorial Medical Center has been recognized as a major regional provider of medical and surgical services. Long Beach Memorial consistently achieves national accolades for its quality care, including being named as one of the U.S. top 125 hospitals by Consumers’ CHECKBOOK; named Top 100 Hospitals Cardiovascular by Thomson Reuters; and named one of “America’s Best Hospitals” for Orthopedics by U.S. News & World Report magazine. Our state-of-the-art electronic medical record system ensures our patients receive the best, safest possible care.
Long Beach Memorial Medical Center has 420 general acute care beds and 61 ICU beds. There is also a level one trauma center and separate adult and pediatric emergency departments with a total of 54 beds. LBMMC also has a 42-bed acute rehabilitation hospital which offers cardiac, neuro, trauma and orthopedic rehabilitation services.
Miller Children’s Hospital
The largest children’s hospital in California, Miller Children’s and Women’s Hospital is located on the campus of the Long Beach Memorial Medical Center and serves as the pediatric teaching hospital for Memorial Family Medicine residents. Miller Children’s features eight Centers of Excellence across more than 30 pediatric sub-specialties. In 2009, we celebrated the opening of a state-of-the-art inpatient pavilion which includes a new surgical center and expanded NICU, and we are now in the process of creating a new and expanded PICU.
A major feature of the block curriculum is the Family Medicine Inpatient Service. This service comprises residents and family medicine attendings and provides comprehensive patient care in a family medicine model. Thus patients are cared for in the medicine, surgery, pediatrics, maternity care, rehabilitation and emergency department arenas by the same inpatient team, striving for continuity between the hospital and the Family Medicine Center. Our integrated electronic medical record (EMR) facilitates the transfer of information and coordination of care.
Our pediatric rotations are based at Miller Children’s and Women’s Hospital, the largest children’s hospital in California, on the Long Beach Memorial campus. The patient care and educational resources offered to make the pediatric training (and patient care) here unsurpassed.
All blocks are 4 weeks in duration.
- Family Medicine Inpatient Service (4 blocks)
- Obstetrics – White Memorial (7 weeks)
- Pediatrics Outpatient
- Pediatrics Inpatient
- Family Medicine Inpatient Service (10 weeks)
- Pediatrics Inpatient (2 weeks)
- Emergency Medicine
- Pediatric Emergency Medicine (2 weeks)
- Outpatient Surgery
- Westside Clinic
- Sports Medicine
- Behavioral Medicine
- Health Systems Management (2 weeks)
- Elective – 2 weeks
- Family Medicine Inpatient Service (6-7 weeks)
- Gynecology – Harbor UCLA
- Community Medicine
- Westside Clinic
- Pediatric Emergency Medicine (2 weeks)
- Outpatient Pediatrics
- Electives – 16 weeks
In addition to each resident’s continuity practice in the Family Medicine Center, certain elements of medical education lend themselves more to a longitudinal format rather than a block experience. Among the experiences taught in a longitudinal manner are:
House Calls Service: A part of training here since 1983, the House Calls Service involves one resident at a time going out on home visits with one of the full-time faculty, both to provide in-home assessments of the resident’s own patients and to provide ongoing care for a panel of home-bound patients in the community.
Point of Care Ultrasound: Beginning with our maternity care curriculum, and expanding with the start of our sports medicine fellowship in 2014, we have been steadily increasing our use of ultrasound in the outpatient setting. We have now developed a comprehensive POC ultrasound curriculum to ensure that our residents will be adept in bedside ultrasound including AAA screening, DVT evaluation, abdominal ultrasound, soft tissue ultrasound and ultrasound-guided paracentesis.
Bioethics: The bioethics curriculum is a new curriculum that will involve workshops, resident participation in the hospital bioethics committee, involvement in hospital bioethics consults and completion of a comprehensive bioethics course.
Quality Improvement: Each R2 partners with an R3 to complete a QI project. The project is then presented at the end of each academic year at a local or regional conference. We also have monthly QI meetings that address quality measures, adverse event reporting and patient safety issues. Our residents have developed their own quality committee that addresses QI and patient safety issues and they also sit on quality committees at the hospital level.
Group Visits: Since 2006 we have been holding monthly group visits for patients with diabetes in our practice. This has been an opportunity to develop one element of the future of family medicine and demonstrate how our patients can learn from and teach one another. These visits are multidisciplinary, with participation from residents, students, nursing staff, social work, and behavioral and medical faculty.
Wellness: The wellness of our residents, faculty and staff are a priority in this residency. We have a wellness curriculum that has been developed by the residents. It involves monthly wellness activities, snacks for the resident room, workshops on compassion and emotional intelligence, monthly Balint groups, formal debriefing sessions, quarterly resident/faculty get-togethers and monthly resident social activities. This curriculum is being expanded so will have new components in the upcoming year.
Behavioral Medicine: We have started a weekly behavioral medicine clinic in our FM office. The clinic is staffed by a psychiatrist, faculty physician, faculty psychologist, therapist and social worker. The goal is to provide better access to mental health services to our patients and an excellent behavioral medicine curriculum for our residents.
Family Medicine Health Policy Curriculum
In response to the rapid pace of change in the health care delivery market and to growing interest among our residents, Long Beach Memorial Family Medicine has offered a Health Policy curriculum since 2008. Designed to complement the longitudinal Health Systems Management curriculum, the Health Policy curriculum exposes our residents to a range of issues facing family physicians and their patients within an increasingly complex delivery system.
The curriculum seeks to address health policy on both the theoretical and the real life level. Didactics are scheduled covering current topics affecting health policy, led by full-time and volunteer faculty as well as guest presenters from MemorialCare and outside organizations. In addition, residents are given opportunity to participate in advocacy activities, both locally and in Sacramento and Washington, DC. These include attendance at events with elected representatives in the Long Beach area; participation in state and federal, issue-focused advocacy (through CAFP and AAFP); and advocacy training and events sponsored by our state and national academies and by MemorialCare. These activities are addressed in greater detail in our new Health Policy Area of Concentration.
Mission Statement – Diversity and Community Engagement
We are committed to promoting diversity and inclusivity among our residents, faculty, staff, and clinic. We aim to advance diversity through:
- discussion and education to create an environment of respect of varied backgrounds – both of our patients and of each other,
- recruitment of a diverse workforce,
- active engagement through service and social justice to address health inequity in our community.
Contact for questions for URM residency applicants:
Odrin Castillo, DO, MPH – Director of Diversity and Community Engagement
Email: [email protected]
Our residency program promotes diversity, equity, and inclusion, and advocates for communities of color through these initiatives:
This committee, comprised of faculty and residents, meets quarterly to regularly review clinic and residency policies. The primary objective of this committee is to ensure that we as a program are promoting clinic policies that ensure health equity, and promoting and advocating for diversity in our residency program.
The Doc is In
We’ve been working with high school students on the “Doc is In” program since 1996. Located in North Long Beach, Jordan High School has a magnet school for students interested in science and health care careers.
Residents in all three years have the opportunity to participate as groups of residents adopt a class for the school year. Regular monthly sessions cover information and activities which relate to health issues most pertinent to teens. In addition, the residents serve as role models and sources of information on careers in health care. This activity won an award as the subject of the residents’ display at the 1997 Annual Scientific Assembly of the American Academy of Family Physicians.
Cabrillo Jaguars Football
We have served as the team physician for the Cabrillo High School varsity football team since its first game in 1999. At least one faculty member and one or more residents attend each game as the on-the-field docs, adding to our hands-on sports medicine experience while providing some needed community support. It has also become one core element of our Sports Medicine Fellowship. Through our sports coverage activities have grown to include other local high schools and colleges Cabrillo will always be our first. Go Jaguars!
Neighborhood M.E.D. (Medical Enrichment through Diversity)
Since 2014 our residents have run a mentoring program for college students in the Long Beach area from disadvantaged backgrounds who are interested in health care careers. Over the course of the school year, and after a competitive application process, 16 students are each assigned a resident mentor and go through group and individual activities, both to expose them to clinical medicine (simulation lab; procedures; in-office shadowing) and to help them prepare for the application process for their next level of education. We also open this program to exceptional local high school students from disadvantaged backgrounds who are planning to attend a four-year college.
Reach Out and Read
Supported by grants from the Memorial Medical Center Foundation and Target, our office participates in this literacy advocacy program that integrates children’s books and advice to parents about the importance of reading aloud into well-child visits for pre-school aged children. The goal is to equip parents with tools and knowledge to ensure that their children are prepared to learn when they start school.
As a part of the community medicine curriculum, residents are given the opportunity to go to fifth-grade classrooms in local schools as part of the Tar Wars program. Tar Wars is a pro-health, tobacco education program and poster contest the ultimate goal of which is to discourage tobacco use among our nation’s youth. Residents become teachers for one hour as they present this fun, image-based lesson, which focuses on the short-term effects of tobacco use, the reasons people use tobacco, and the images that tobacco companies use to market their products.
The Tar Wars program offers an opportunity for school personnel, health care providers, educators and community members to join together and address the issue of youth-targeted marketing and youth access to tobacco. It also gives each resident valuable experience working with and educating children while experiencing firsthand the excitement and enthusiastic participation of the fifth graders.
The first Saturday of each month, our faculty and residents have the opportunity to join the UCI School of Medicine’s Flying Samaritans to Valle Redondo, Mexico (about 30 minutes past the border) to care for the local community’s underserved population. Additionally, we have now begun working with the Flying Samaritans group at Cal State Long Beach. These clinics have become a central element of our Global Health area of concentration.
An Lanh Lestonnac Free Clinic
1-2 times a month, our 2nd and 3rd year residents have the opportunity to serve as preceptors for 1st and 2nd year medical students from UC Irvine and Western University at this free clinic in Garden Grove, CA. Patients that come to this clinic are 100% uninsured, and this clinic provides the community with a vital health care resource for this vulnerable population. This volunteer clinic gives residents a chance to hone their teaching skills, provide mentorship to new medical students, and care for a deeply underserved population.
As a part of our work with the Westside Neighborhood Clinic, our residents spend two half-days per week working with the City of Long Beach’s homeless clinic. Half of this time is spent in the LB Public Health Department and, since 2016, the other half is spent going out to provide care in the community.
Since 2016, our program has been collaborating with The Center, an organization that has been providing a variety of health, social, advocacy, legal, and service programs to the LGBTQ community in the Greater Long Beach area for over three decades. Our collaboration serves both our program and The Center’s needs. We receive state-of-the-art training to provide high quality and culturally humble care to members of the LGBTQ+ community. In turn, we are able to serve as providers of care for this substantially underserved population, addressing everything from culturally-competent preventative care to transgender care across the spectrum. Most recently, we have started a monthly transgender hormone replacement therapy clinic, where our residents can rotate to receive additional training in initiation, maintenance, and titration of HRT. We will also be starting a biweekly evening clinic at The Center in the 2020-21 academic year in order to provide on-site care to this patient population and decrease barriers for access to quality primary care.
Six Areas of Concentration
An area of concentration (AOC) provides a resident with additional training opportunities above and beyond the core training in family medicine. We offer the following six AOCs:
Faculty Director: Odrin Castillo, D.O.
The Community Medicine Area of Concentration is a longitudinal curriculum designed to broaden the resident’s understanding of providing medical care to vulnerable populations in a community setting. This includes the study of social determinants of health, health disparities, and barriers to care for our patients at the individual, community, and systemic levels. With these factors in mind, our goal is to explore, design, and implement effective interventions to promote health and prevent disease for our most vulnerable patients.
This track is designed to provide extra training on multiple aspects of community medicine, specifically: social determinants of health, health equity, public health, community needs assessment, and community engagement. After completion of this track, residents should have a deeper understanding of the needs of vulnerable populations, and have the knowledge and experience to be a physician leader in the community.
On completion of the curriculum in this Area of Concentration, each resident should be able to:
- Understand the importance of social determinants of health and how they contribute to disparities in health
- Analyze specific health disparities and learn how to implement community-based projects to address these disparity
- Better understand the community resources available to low-income/underserved patients
- Learn the basics of how a community clinic operates
- Teach medical students and residents about urban underserved medicine, social determinants of health
- Continuity clinic at Lestonnac Free Clinic
- Precepting at the An Lanh Student Run Clinic
- Involvement with Neighborhood MED Pipeline Program
- Participation in the Diversity and Health Equity Committee
- Attending the APHA National Conference or National Health Disparities Conference
- Attending Community Collaboration Events
- Experiencing didactics on Community Medicine
Faculty Director: Brooke LaDuca , M.D.
Global health is a rapidly expanding field of medicine and residents and students are expressing increased interest in global health training. We have always offered our residents the opportunity to participate in international rotations, and now we have the Global Health Area of Concentration to add structure to the experience.
The sites that we have included are locations that our residents and/or faculty have participated in medical care.
- Catalina Island, CA
- The Himalayas
- Nome, Alaska
- Papua New Guinea
Faculty Director: Jeffrey Luther, M.D.
Health policy is a wide-ranging field garnering more and more interest among new and established physicians, and family medicine is at the forefront, both locally and nationally. The Health Policy AOC is a dedicated “track” that spans the entire length of residency and seeks to equip physician leaders to continue to advocate for their patients and specialty throughout their careers.
The curriculum for this AOC includes the following:
- Complete the 3-week fellowship on health policy at George Washington (offered twice per year, in September and April). Stipend offered for registration and housing expenses.
- Participate in health policy lectures and journal clubs, covering such topics as social determinants of health, health care disparities, health care advocacy, etc.
- Design and implement a project within our practice and/or community that addresses health care disparities.
- Attend CAFP’s annual All Member Advocacy Meeting: includes training and a day lobbying in the Capitol.
- Option to attend AAFP’s annual FM Advocacy Summit: Advocacy training, update on issues and a day on Capitol Hill.
- Attend MemorialCare’s Lobby Day in Sacramento.
- Attend the annual conference on health disparities and do poster presentation on your project.
Faculty Director: Odrin Castillo D.O.
The LGBT Medicine Area of Concentration is a longitudinal curriculum designed to broaden the resident’s understanding of providing medical care to LGBT patients. LGBT medicine is a new, rapidly evolving field of medicine, born of necessity in the context of health disparities between LGBT and non-LGBT patients.
This track focuses on three broad learning objectives:
- Initiation, titration, and maintenance of gender-affirming hormone therapy;
- Sexually-transmitted disease prevention and treatment;
- Preventive and primary care in LGBT patients of all ages.
Residents in this track, through supervised patient care, didactics, conferences and community outreach, will gain medical experience caring for LGBT patients and advocacy experience working with LGBT community leaders. After completing this track, residents should feel prepared to provide acute and primary care for LGBT patients, and to have a nuanced understanding of LGBT status as a social determinant of health.
On completion of the curriculum in this Area of Concentration, each resident should be able to:
- Provide culturally- and medically-competent primary care of LGBT patients
- Understand the different health care needs of LGBT patients
- Identify key health disparities and barriers to care impacting the health of LGBT patients, and design and implement targeted interventions aimed at health equity
- Initiate, titrate, and troubleshoot gender-affirming hormone replacement therapy in transgender patients
- Understand the basics of the most common types of gender-affirming surgery (mammoplasty, phalloplasty, metoidoplasty, vaginoplasty) and the after-care for each
- Know how to initiate treatment for HIV and know when referral is necessary
- Know the most common STDs in the LGBT population, as well as how to diagnose and treat these diseases
- Teach medical students and other residents about the most essential topics in LGBT medicine
Faculty Director: Rose Swords, M.D.
The Maternity Care area of concentration is designed to prepare the family medicine resident to practice low-risk obstetrics in the community upon graduation. It requires more intensive training in maternity care and includes the following components:
- One additional month of an obstetrics elective to be done in the 3rd year of residency
- Participation in weekly fetal strip rounds with the inpatient OB team
- A higher required number of total deliveries prior to graduation (75 total deliveries including ten continuity patients)
- Two maternity care topics to be presented during 2nd and 3rd year at our family medicine noon conferences
- Completion of required reading on maternity care topics
- Development of ob ultrasound skills
Faculty Director: Joshua Snodgrass M.D. CAQSM
Primary Care Sports Medicine is a growing sub-specialty that showcases some of the best attributes of family medicine: comprehensive care, point-of-care procedures, and community involvement. The Sports Medicine AOC is a dedicated “track” which features a longitudinal curriculum that spans all 3 years of residency training.
Highlights of the Sports Medicine AOC include:
- Increased collaboration with local sports medicine and orthopedic specialists
- Event coverage at Cabrillo HS
- Pre-participation physicals at the high school and collegiate levels
- Training room and event coverage at Cypress College
- Training room and event coverage at Long Beach State
- Case abstract presentation at a national conference
- Additional opportunities to present and train medical students and junior residents