Mission

Provide world-class graduate medical education to produce board-certified, deployment-ready family physicians capable of serving all patient populations.

Vision

Premier Full Spectrum Medical Education, Patient-Centered Trusted Patient Care Always

Aims

• Our graduates will be COMPETENT and QUALIFIED physicians, who are board-certified family physician capable of providing continuity and comprehensive care to the individual and family as an integrated unit, in any military or civilian medical system.
• Our graduates will propagate our special through MENTORSHIP by cultivating family physicians who focus on teaching all medical learners the unique skills of family medicine that can be applied to work in any clinical setting.
• Our graduates will perform as LEADERS, they will lead patient care teams and be able to assume responsibility for directing a team approach to health management.
• Our program will ensure an optimal CLINICAL LEARNING ENVIRONMENT by creating/maintaining quality initiatives to enhance resident wellness and engagement. Faculty will serve as role models preparing graduates to deliver excellent technical and humanistic care with quality and patient safety as a priority throughout their careers.

Tuesdays

• Fracture Rounds: 12 - 12:40 p.m.

Fridays 

• Didactic and team based learning academies: (PGY-2s/PGY-3s) Friday Mornings 8 - 11:30 a.m., (PGY-1s/Med Students) Friday Afternoons 1 - 4:30 p.m.
• Prescheduled rotation of either: Team Jeopardy, Balint, Inpatient Team Morbidity and Mortality Conferences, or Resident/Faculty Meetings from 12 - 1 p.m.

Weekly

• Medical Student didactics: Monday or Tuesday afternoon

 Monthly

• Active Duty Service Member Medical Care Team Review: First Friday of each month from 7:15 - 8 a.m. 
• Hospital Grand Rounds: Third Wednesday of each month 12 - 1 p.m.

First Year (PGY-1) 

The first year of internship is a critical period in medical education, marking a transition to increased professional confidence and a shift away from feeling like an imposter. The year is structured to provide a foundation in outpatient and inpatient medicine with exposure to the full-scope of Family Medicine. The year is divided into 12 four-week blocks with 4 one-week blocks around the holidays, featuring various rotations:

• Adult inpatient medicine at the Mike O'Callaghan Military Medical Center (MOMMC) (four months)
• Obstetrics/gynecology (Ob-Gyn) (three months): One month on labor and delivery at MOMMC, One month downtown at Sunrise Hospital, One month in an Ob-Gyn clinic
• Pediatrics (two months): One month downtown at Sunrise Children's Hospital and One month at MOMMC in the newborn nursery and clinic
• Outpatient Procedure focused month in Family Medicine Residency Clinic (two weeks)
• Orthopedics/sports medicine/radiology at MOMMC (one month)
• Geriatric (two weeks) clinic and inpatient consult experience at MOMMC
• Four weeks are allocated for elective, research or towards an area of concentration (AOC) rotation

After completing the in-house Labor and Delivery and Ob-Gyn clinic rotations, residents will follow pregnant patients from initial discovery of pregnancy through delivery and post-partum, fostering strong relationships with these families.

Second Year (PGY-2)

The second year of the Air Force family medicine residency will involve more challenging and rewarding responsibilities, including mentoring medical students and interns. The year is divided into 12 four-week blocks with 4 one-week blocks around the holidays, featuring various rotations:

• Inpatient medicine (16 weeks): working with Family Medicine staff and night float at MOMMC, Sunrise Nursery/Late term NICU, and ICU medicine at University Medical Center hospital.
• 2 weeks in Sports Medicine
• 2 weeks in MOMMC Peds clinic
• 4 weeks in Family Medicine procedure clinic
• 4 weeks of elective time tailored to individual resident interests
• Required subspecialty blocks (typically 2 weeks each) include:
  • Nephrology
  • Mental Health (4 weeks)
  • Dermatology
  • Endocrinology
  • Urology (Selective)
  • Cardiology
  • Pulmonary
  • Surgical subspecialties such as Otolaryngology (Selective)
  • Pediatric Emergency Medicine at Sunrise Children's Hospital (4 weeks)
  • Evidence Based Medicine
  • MOMMC Emergency Department (4 weeks)
  • Family Medicine Geriatrics Clinic

Third year (PGY-3)

The third year of the Air Force family medicine residency is meant to prioritize the outpatient continuity clinic, completing scholarly work and to tailor their electives towards their own learning goals to best prepare them for their transition to in garrison medical practice and deployment medicine. The year is divided into 12 four-week blocks with 4 one-week blocks around the holidays, featuring various rotations:

• Inpatient Medicine (6 weeks): working with Family Medicine staff and night float supervisor at MOMMC, and Trauma at University Medical Center
• 4 weeks in Family Medicine procedure clinic
• 4 weeks in Sports Medicine
• 4 weeks in a volunteer Community Medicine Clinic for underserved patient population
• 4 weeks readiness selective such as rotation at Yosemite National Park Medical Clinic
• 2 x 4 week blocks for elective or AOC rotation
• 4 weeks of selective surgery or medical subspecialty rotation
• Required subspecialty blocks (typically 2 weeks each) include:
  • Adult ED at Sunrise
  • Trauma ED at UMC
  • Neurology
  • Nephrology
  • Endocrinology
  • Cardiology
  • Pediatrics

Humanitarian Opportunities

Residents can participate in humanitarian missions to underdeveloped countries.

Leadership

Three residents serve as chiefs, and one paid Continuing Medical Education (CME) trip is allowed. All residents and interns have the opportunity to supervise medical students and lead their clinical care teams. All residents will have the opportunity to supervise interns.

Procedural Skills

The program emphasizes developing residents' procedural skills. Opportunities to complete POCUS certification, Acupuncture certification during residency are available. By graduation, residents should be proficient in various family medicine procedures. Credentialing is offered in advanced procedures like colonoscopies, colposcopies and Cesarean sections (the latter is not mandatory).

Area of Concentration (AOC):

Nellis FMR allows residents to craft the educational experience that is in line with their passion and will best prepare them for their future careers within the broad scope of family medicine. Residents have the option of developing an Area of Concentration (AOC), which is 200 hours dedicated to a specific concentration within the very broad scope of Family Medicine. AOCs may include completion of a scholarly project on that topic, presenting a journal club article to classmates on the topic, and possibly attending a CME in that field. There are numerous examples AOCs from prior residents, but each AOC is tailored by the resident and their team chief to meet all required criteria and work seamlessly into the resident’s regular required rotation schedule. Examples of prior resident AOCs are Wilderness Medicine, Flight Medicine, Sports Medicine, Obstetrics, Transgender medicine and many more.

Family Medicine Rotation Schedule

New accrediting body guidance has allowed the Family Medicine program to offer a full range of clinical opportunities that are unique to individual residents. All residents have the opportunity to choose (core selective medical subspecialty and surgical subspecialty rotations) and elective clinical or research rotations. These unique experiences allow residents to personalize their training and dive deeper into areas of interest.

• Medical Selective Options: Cardiology, Pulmonology, Endocrinology, Neurology, Dermatology, Nephrology, and Pediatrics (outpatient clinic-based).
• Medical Elective Options: The above selectives, and many other options including: Point of Care Ultrasound, Sports Medicine, Procedures, Obstetrics, Gastroenterology, Rheumatology, allergy & immunology, infectious Disease, Emergency Medicine, Integrative Pain Medicine, Transgender Medicine, Research, Faculty Development, and Initial Flight Medicine Training.
• Surgical Elective Options: General, Vascular, Urology, Ophthalmology, Otolaryngology, Orthopedics, and Plastics.

Weekend Call Nights

Occur 5 p.m. - 6 a.m. Saturday and Sunday evenings. On average R2s will be scheduled for 4 Weekend night calls and PGY-3s are scheduled for 2 weekend night calls. The resident will be post-call on Monday.

Jeopardy Call System

Residents on an in-house rotation may be required to cover another resident’s call or clinic in the rare instance of family emergency, illness, excessive fatigue, or any situation where the resident is not available/fit to work. Resident selection will be based on their currently scheduled shifts and calls in order to adhere to accrediting body work hour requirements.

The Military Medicine/ Health Systems Management is a continuity curriculum over the three years of residency. It provides the Family Medicine resident with an exposure to professional, administrative, and business practices related to health care delivery in the Military Heath System as well as the global health care system. Residents will develop the skills and expertise expected of military family physicians to fulfill their leadership and administrative roles within the organization and the community.

Resident activities will include participation in hospital committee(s), writing official Air Force documents (Officer Performance Report, Memoranda for Record, Medical Evaluation Board, and awards), and completing all military unique documentation such as quarters, profiles, Annual Review In Lieu Of and Initial Review In Lieu Of for their Air Force and other sister service patients assigned to be seen within the Family Medicine Residency Clinic. Each resident will be expected to manage care for our military patient population through our clinic Airman Medical Readiness Optimization (AMRO) Program in coordination with our Chief Flight Surgeon, Chief Medical Officer, nurse case managers, Physical Evaluation Board Liaison Officers (PEBLOs) and squadron commanders. Each resident will also be given an exposure to and requirement to understand and optimize patient care quality metrics (Healthcare Effectiveness Data and Information Set- HEDIS, Access to Care- ATC and Relative Value Unit- RVU) and implement basic principles of patient safety and quality improvement. Nellis offers multiple opportunities for interactions with the "line side" and is a base utilized for multiple international combat exercises, houses the Air Force Special Tactics Pararescue Personnel (PJs), and has multiple platforms stationed here and more that come on temporary orders!

Life-saving Certification Classes

Basic Life Support, Advanced Life Support, Pediatric Advanced Life Support, Advanced Trauma Life Support, Fetal Heart Monitoring Course, Advanced Life Support in Obstetrics, Neonatal Resuscitation, STABLE neonatal course.

Board Certification Testing

Completed in April of PGY-3 year as long as the resident has met all ABFM requirements

Optional Courses

• Acupuncture
• Advanced Wilderness Life Support
• Military Medical Humanitarian Assistance Course
• Military Tropical Medicine Course
• Initial Flight Medicine Training
• Expert Field Medical Badge, Air Assault, and other operational courses (pending availability)

Simulated clinical inpatient and urgent care cases have been incorporated into both the intern and senior resident academies, including team-based learning and just in time procedural simulations. We offer optional Objective Structured Clinical Exams (OSCE) throughout residency on an as needed basis for enhanced resident learning opportunities.

Residents are given didactics and real world opportunities to build on their military leadership skills within the clinical and administrative realm. Though only 3 third-year residents are selected as chief residents, each third-year resident is given a leadership role in some aspect of the program. All residents are given exposure to the scope of responsibility and demands of being a clinic Medical Director or Flight Commander, as well as opportunities to practice "soft leadership skills" as assigned members of hospital committees and health care teams.

Research

The fully embedded Clinical Investigation Program (CIP) at Nellis Air Force Base offers unparalleled research and teaching opportunities for residents and faculty. Since its establishment in 2012, building on research initiated in 2010, the CIP has grown into a Regional hub, empowering Eglin and Scott bases to bolster their research portfolios. The program's success is evident in the numbers: 83 clinical trials, 46 exempt studies, and 63 quality improvement, performance improvement, and evidence-based practice projects conducted. Over 270 scholars from three Air Force Family Medicine residencies have participated, with the program securing more than $20 million in grant funding. This work has resulted in 591 publications and 561 regional and national presentations, making Nellis a leader in scholarly activity within the Air Force. The CIP's collaborative environment and extensive resources position participants for success in advancing military medicine.

Scholarly Activity

Residents are required to complete a research project or scholarly activity project to be presented to the residency prior to graduation. The forms of research expected to be completed by residents include:

1. A Help Desk Answer “HDA” completed during the evidence-based medicine rotation in PGY-2/ early PGY-3 year.
2. A quality improvement project that meets standards of American Board of Family Medicine for board certification
3. An additional Scholarly Activity, which can be any of the following options:
   • Area of Concentration as designed by the resident and approved by team chief and Program Director

In the PGY-1 year, residents will attend a research training session. The Team Chief and research coordinator will help each resident determine the best scholarly activity plan to meet all requirements. Research time is available and will be scheduled and monitored by the research coordinator and Team Chief. Study start/end dates should be agreed upon by the resident and research coordinator. The end date should not extend beyond winter of the PGY-3 year. Given this schedule, each third-year resident is encouraged to present their study at any of the spring scientific assemblies, especially Uniformed Service Academy of Family Physicians. Travel funding will be prioritized accordingly. All residents will present their research no later than the scheduled annual department research symposium in the spring of the PGY-3 year.

Each resident is required to submit a Patient Safety Report (PSR) during their residency. Each residency class, at a minimum, will complete a joint Quality Improvement project that meets American Board of Family Medicine standards for board certification. Residents are encouraged to participate in other Process Improvement (PI) and Quality Improvement (QI) projects within the family medicine residency clinic and the medical center. Residents will work with Faculty or other medical group staff to vet these PI/QI projects before initiating.

Emphasizing professionalism lies at the heart of Accreditation Council for Graduate Medicine Education priorities, crucial not only in medical practice but also as a military medical officer. Faculty and residents must exemplify it daily, promptly reporting/addressing any breaches without fear of retaliation or retribution. Resident conversations with advisors should regularly integrate professional development, forming an integral part of individual learning plans. Additionally, designated multidisciplinary training events specifically target professionalism enhancement over the three years including patient hand-offs, transitions of care, simulation training, etc...

• University Medical Center (Trauma ED, MICU)
• Sunrise Hospital and Medical Center (Inpatient Pediatrics, Pediatric & Adult ED, NICU and OB Labor and Delivery)
• Volunteers in Medicine of Southern Nevada (VMSN) (Community Medicine Free Clinic)

OB Rotations Specifically

• PGY-1 Year at MOMMC Labor and Delivery/ OB clinic and Sunrise Labor and Delivery
• PGY-2 Year Night Rotation at Sunrise Labor and Delivery
• PGY-3 Year residents are able to use elective rotations to increase their number of deliveries and OB centric procedures
• *All continuities are delivered at MOMMC, unless labor and delivery is on divert in which case patients are encouraged to go to SUNRISE Labor and Delivery where are residents are able to go and deliver them.

The first set of applications for rotation will be accepted between November 1st and January 15th.  After January 15th, the program director will review all applications and make assignments for rotation dates with responses back to each of you no later than January 31st.  Any applications received thereafter will be collected through that month, and decisions will be emailed out within the first week of the following month.

Las Vegas is definitely more than bright lights and the Strip. There is truly something for everyone in this town. For those on active duty training (ADT) rotations, a rental car request through Air Force Institute of Technology will facilitate your ability to explore this town. The hospital is located on a separate gated area from main base where billeting is located, which is another advantage to a rental car.

Wear of military uniform will be expected throughout your rotation whether a sponsored Active-Duty Training or as a TAA (Training Affiliation Agreement). The uniform of the day is Airman Battle Uniform for the entirety of the week. You will need proper gear for group Physical Training (PT). Wear of the white coat is not required for inpatient and Labor and Delivery duties. Full-service dress is needed only for interviews.

The program places a strong emphasis on fairness in the interview and evaluation process for applicants. During rotations, interviews typically occur towards the end of the rotation and involve the program director and key faculty members. Each interviewee not completing a full rotation receives the same set of questions to maintain consistency and ensure equal access to discussion topics. The aim is for both the program and applicants to gain insight into each other, preserving time for questions as an integral part of the interview. The final scoring of applicant packets heavily considers input from both residents and core faculty.

Guidance for Interviewees

Reflect on your commitment to the Air Force and Family Medicine and be prepared to discuss your life's successes and setbacks, highlighting how you've grown from these experiences. Consider what you seek in a residency program. Above all, be genuine and sincere; your character is of utmost importance!

You are welcome to schedule full interview rotations, but these are filled on a first come first served basis. We also offer 2-to-3-day interview options where the applicant will have the opportunity to shadow our inpatient team, complete their interview, and be involved in our didactics to gain insight into our educational climate. Additionally, we offer three "Wilderness Weekend" opportunities that involve the entire program. These are great options to schedule an interview while getting a deep dive into wilderness medicine education and have fun with our program. Join us for immersive weekends, where you'll hone survival skills, master backcountry medicine, and forge bonds with peers amidst breathtaking natural landscapes.

Family Medicine Residents diligently gear up for the American Board of Family Medicine (ABFM) board exam, a significant milestone in their professional development. Typically scheduled in April of their PGY-3 year, this examination represents a pivotal moment in their journey. To be eligible, graduates must satisfy all prerequisites outlined by the ABFM and remain on track for graduation within three months of the standard June 30th residency completion date. For those following a non-standard timeline or extending beyond the three-month window, an exam period is available in October. More information can be found on the ABFM website. 

• Helping to guide/ instruct/ teach rotating medical students including: chalk talks on rounds, perfecting documentation and mentoring in clinic.
• Mentoring and instructing technicians throughout clinic.
• Assisting competency of medical students and junior residents in procedures to include vasectomies.
• Consistent opportunity for patient education to include group classes.
• Lectures presented at academy.
• Journal club during academy.

By becoming certified in the following you can become an instructor in:

• Advanced wilderness life support
• Stop the Bleed
• Battlefield acupuncture
• Advanced Life Support, Pediatric Advanced Life Support, Basic Life Support, Advanced Life Support in Obstetrics, Neonatal Resuscitation Program, Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support (STABLE) , Advanced Trauma Life Support (All required certifications)
• Diversity, equity, inclusion and advocacy (DEI curriculum)
• Possible travel opportunities
• Faculty Development electives
• Bushmaster
• Presentations of research at Uniformed Services Academy of Family Physicians

Currently faculty within the residency have the following subspecialty training:

• Sports Medicine
• Point-of-Care-Ultrasound
• Obstetrics
• Faculty Development
• Acupuncture

We also have a Ph.D. Social Worker as our Behavioral Health Core Faculty, and also a pharmacist on the Family Medicine Inpatient team as adjunct faculty.

Our program prioritizes mentorship, recognizing its pivotal role in professional growth and career advancement. Each resident is paired with a faculty advisor who provides ongoing support throughout residency, supplemented by multiple mentors. We diligently facilitate connections between residents and staff physicians across the medical center, aligning them based on shared interests, career aspirations, military objectives, and considerations such as gender, ethnicity, and religious background. The presence of strong mentors has proven instrumental in assisting residents in securing desired fellowship programs, military assignments, as well as opportunities for publication and conference presentations.

• On-site Behavioral Health faculty member (PhD-level social worker) available to work with residents on professional development, communication skills, healthy coping, etc. This service is confidential (barring safety concerns) and voluntary.
• One-month dedicated Mental Health rotation in 2nd year, with a focus on residents building their own joyful and meaningful careers.
• Monthly Balint sessions are facilitated by the Behavioral Health faculty member. These hour long sessions provide a safe space for residents to discuss areas for growth in patient-doctor communication, transference, and empathy for self and others.
• Each Fall there is an all resident retreat. Each Spring each individual class will have their own separate weekend retreat. Retreats are meant to foster team bonding, personal reflection, and enjoying a well-deserved break.
• Relative flexibility in residents' schedule allows residents to attend appointments and tend to other personal tasks.