LAWRENCE FAMILY MEDICINE RESIDENCY
AREA OF CONCENTRATION (AOC) DESCRIPTIONS
ACADEMIC FAMILY MEDICINE
The goal of the Academic Medicine AOC is to train residents to be leaders in Family Medicine education through
the attainment of advanced competencies in teaching, research and scholarship. Residents involved in this AOC
will be expected to develop skills in information mastery and teaching using principles of information mastery.
They will develop an understanding of core concepts underlying strategies used in medical teaching and
demonstrate the ability to evaluate and provide feedback to learners regarding clinical skills and competencies.
Regarding research, they will understand core issues relative to research with human subjects and demonstrate
an ability to successfully plan and submit an IRB proposal in addition to demonstrating an ability to design and
complete a research study. Additional competencies include the ability to write and submit a proposal for
presentation (oral or poster) at a local, regional or national meeting, the ability to prepare and submit a
manuscript for publication, and demonstrating an understanding of elements needed to plan and evaluate a
teaching session using GNOME. The above will be achieved through combined study, individual effort, and
practice with peers under supervision.
Resident limit: This AOC is not limited.
ADVANCED MATERNITY CARE
The Advanced Maternity Care AOC is an integrated OB fellowship that will train residents in high risk and
operative obstetrics, promoting continuity of care and a family-centered model of care. Objectives of the AOC
include a goal of 120 vaginal deliveries as well as surgical competency in cesarean sections, tubal ligations, and
D&Cs. Residents will also be comfortable with antepartum and intrapartum management of common high risk
patients such as twins, hypertensives, and diabetics. Other skills that will be learned include basic OB
ultrasound, group prenatal visit facilitation, operative vaginal deliveries, and complicated laceration repair.
Resident limit: This AOC can accommodate up to two residents per class.
BEHAVIORAL HEALTH
While the overall mental health of patients is essential in a standard family medicine residency program, the
behavioral health area of concentration allows interested individuals time to focus on additional skills. Our
overall goals for this AOC include: 1) Provide both a broadening of the essential mental health clinical and
didactic experience as well as give opportunities for additional training in areas such as cognitive behavioral
therapy, hypnosis, relaxation training, and utilizing the extended family in primary care. 2) Have a framework of
increasing responsibilities, moving from learners to supervisors, participating in didactic training of other
residents in topics of mental health, and have opportunities to teach mental health screening in the community.
3) Participate in advocacy for greater access to mental health services on the local, state, or national level.
Resident limit: This AOC is not limited.
GLOBAL HEALTH
The Global Health AOC curriculum has been developed based on the concept that community medicine and
local provision of care are inseparable from global health, particularly in areas where patient populations have
limited resources, have a large immigrant base, and where global travel is a strong component of patients’ lives.
Global health education is an immense discipline encompassing many areas of medical and public health. This
curriculum aims to prepare resident doctors to work in the field of their choice, whether this involves direct
international patient care, public health, education, or community-based global health. Resident physicians will
be trained in the broader concepts of global health including, but not limited to, basic public health concepts,
global health policy, procedural skills useful in international patient care including bedside ultrasound, women’s
and children’s health, infectious diseases prevalent in resource-limited areas, teaching skills and professional
development. Residents will choose focuses within the global health curriculum and develop a unique set of
goals based on their personal interests and career aspirations.
Resident limit: This AOC is not limited.
HEALTH SYSTEMS LEADERSHIP
The mission of the LFMR is to provide all residents with the skills to provide medical care and medical leadership
in the emerging new healthcare system, particularly in underserved communities. The Health Systems
Leadership AOC is designed to provide additional knowledge, practical skills, and leadership competencies for
those residents who wish to extend the reach of what they can do to affect more people through leading
Community Health Centers or other healthcare organizations. The current transformation of the US healthcare
system provides an unparalleled opportunity for family medicine to assume a leadership role; the goal of the
HSL AOC is to prepare residents to lead in this effort. Residents completing the HSL AOC curriculum will be
especially well prepared to play an important role designing and implementing future healthcare delivery
models in underserved communities, and advocating for system change and healthcare reform to achieve the
“quadruple aim” for all. Specific curricular areas include performance measurement and improvement, quality
and safety, CHC operations and governance, payment systems and finance, regulatory and medical-legal
aspects, organizational culture and behavior, management skills and communication, leadership, care redesign
and population health management, project management, health systems and policy, advocacy, data driven
decision making, and personal and career management.
Resident limit: This AOC is not limited.
HIV CARE
The goal of the AOC in HIV Medicine is to train family physicians with the knowledge base and clinical experience
needed to provide compassionate, high-quality longitudinal care and treatment for patients with HIV disease. It
is expected that all residents completing the AOC in HIV Medicine will demonstrate competence in the
longitudinal and primary care of HIV-infected patients, and will meet the requirements needed to sit for the
American Academy of HIV Medicine’s (AAHIVM’s) HIV Specialist examination. Specific competencies will cover a
broad scope of HIV care, treatment, and practice – including, but not limited to, prevention; counseling and
testing; primary care management of HIV-infected patients; ART management; and HIV-related complications
and co-morbidities. It is also expected that residents completing this AOC will be able to apply the concepts of
PCMH to the care of HIV-infected patients, and serve as team leaders for an HIV-focused PCMH. Activities used
to achieve these objectives will include: supervised longitudinal care of HIV-infected individuals assigned to the
resident’s patient panel; participation in the team-based HIV Comprehensive Care Clinic; participation in HIV
case conferences and Continuous Quality Improvement (CQI) activities; engagement in community-based
outreach and advocacy activities; participation in both independent and group didactic activities (e.g. web-based
case studies, journal clubs, and formal lectures); and established electives at outside institutions.
Resident limit: This AOC can accommodate up to two residents per class.
INTEGRATIVE MEDICINE
The goal of the Area of Concentration in Integrative Medicine is to train family physicians to develop skills
outside the scope of allopathic training which may be integrated into a primary care practice. “Core” skills
expected of all residents in this AOC will include such items as the nutritional history, spiritual history,
environmental history, and stress reduction techniques. Because of the breadth of trainable skills, residents will
collaborate with IM AOC faculty to prioritize and facilitate the “elective” skills they most wish to learn. These
may include: group visits, osteopathic training, acupuncture, hypnosis, functional medicine, intensive nutrition,
herbal, and other modalities per individual resident interest and faculty approval. Additionally, residents
participating in the IM AOC will be expected to complete integrative medicine-specific scholarly activity, QI, and
community medicine projects. Residents will utilize information mastery principles while serving in the role of
consultant for professional colleagues regarding integrative medicine questions of a non-urgent nature. Finally,
residents in the IM AOC will engage in a self-wellness plan and be integrally involved in the leadership of the
resident wellness program.
Resident limit: This AOC can accommodate up to two residents per class.
SPORTS MEDICINE
The primary goal of the Sports Medicine AOC is to foster the advancement of the resident’s knowledge base and
clinical skill set in the area of musculoskeletal medicine. It is available to interested residents who wish to
further their training in Sports Medicine, supplementing their abilities as a primary care physician. It also aids in
the preparation of those who are interested in pursuing a Sports Medicine Fellowship. Residents in this AOC will
join primary care sports medicine physicians and orthopedic surgeons in the office to learn diagnostic and
therapeutic techniques. They will develop a feeling of confidence in handling common orthopedic problems
encountered in the family physician's office. Under supervision by our Sports Medicine Certified Family Medicine
faculty, residents work with faculty and athletic trainers at Lawrence High School, Greater Lawrence Technical
School and Merrimack College. They will also participate in sideline medical coverage, mass participation
coverage, injury clinics, rehabilitation, counseling, sport related concussion evaluation/management, preathletic screening services for schools and corporations. Residents in this AOC will apply this knowledge to their
patients and can elect to work as a team physician for local high school sports teams.
Resident limit: This AOC can accommodate up to two residents per class.
WOMEN’S HEALTH
The Women’s Health AOC provides both a broadening of the essential women’s health clinical and didactic
experience as well as gives opportunities for additional procedural training in areas such as early pregnancy
ultrasound, STD testing, colposcopy, and manual vacuum aspiration for miscarriage management. Additional
training opportunities are available in Pediatric and Adolescent Gynecology, STD diagnosis and treatment,
options counseling, contraception, and uro-gynecology. It has a framework of increasing responsibilities, moving
from learners to supervisors, participating in didactic training of other residents in topics of women’s health, and
having opportunities to teach women’s health courses in the community. We anticipate residents in this track
will apply the concepts of PCMH to the care female patients, serve as team leaders for a Women’s Health PCMH
session, be a resource for staff and clinicians on your clinical team, serve as a resource to clinicians and residents
by email during your 3rd or 4th year for issues related to women’s health, and co-teach longits on a Gyn topic
with faculty instructor. We expect residents to complete a trainer course and serve as an instructor for Sexuality
education or ALSO, participate in women’s health advocacy on the local, state, or national level, and complete a
WH specific QI and/or research project. Residents will maintain active membership in the Association for
Reproductive Health Professionals (AHRP).
Resident limit: This AOC can accommodate up to two residents per class.
(Note: Addiction Medicine AOC, Geriatrics AOC available for interested residents, in development.)