Mission

Train, prepare, and enable full scope military Family Medicine Physicians to meet health needs of our operational forces and our Military Health System

Vision

The BEST trained, ready, and agile Army FM Physicians.

Aims

1. To produce fully competent military FM Physicians who provide compassionate, comprehensive and continuous care to those serving our country, those who have served our country, and their dependents in the context of both the military and local community.
2. To graduate residents with the appropriate baseline knowledge, interpersonal skills, lifelong learning skills, procedural competence, and leadership skills to function as a full-scope family physician.
3. To provide an outstanding training environment that allows all learners the opportunity to see the breadth and value of family medicine in the MHS. 
4. To promote an environment of inquiry and scholarship in order to encourage lifelong participation in scholarly activity, lifelong learning, the application of new knowledge to practice, and teach the science and art of family medicine.
5. To provide a learning environment and culture that embraces Diversity, Equity, Inclusion, and Accessibility both in our staff cohort and patient population. This includes recruitment, selection, education, and enforcement of DEIA policies and principles.

Our residents and faculty, and other specialists contribute to our didactics. Our didactics are based on an 18-month cycle of medical topics covering the scope of FM.

• Monday - Friday, daily morning reports, and once a month we have FM-Pediatrics combined morning reports. Every Wednesday afternoon is our dedicated didactics, and they include Journal Club, Grand Rounds, scheduled CME lectures, mental health lectures, management of health systems, clinic and process improvement meetings, quarterly M&M conference and simulation labs, military unique lectures and more.
• On the last Wednesday of each rotation, our didactics take place in the morning, and the afternoon is designed for wellness, and advisee-advisor time to develop/assess competency-based medical education and professionalism.

Our academic year is divided into 13 four-week rotations.

Residents rotate through various departments both within and outside of TAMC.  Elective rotations vary per resident’s interest and needs. We also have longitudinal POCUS curriculum for our residents to attain proficiency in performing limited bedside ultrasound common to ER physicians and becoming more prevalent in FM. These include limited eFAST, ECHO, Aorta, Renal, OB, Soft tissue, MSK, DVT, and RUQ. We include longitudinal Houseless Clinic to provide compassionate, competent, and quality care for the houseless patients in various stages of life and illnesses.

First Year Required Rotations	Second Year Required Rotations	Third Year Required Rotations
Family Medicine Orientation Family Medicine Clinic (FMC) Family Medicine Inpatient Team (FMIT) Pediatrics Clinic/Ward ICU Procedures Clinic Newborn Nursery Internal Medicine Ward Labor and Delivery Selective MSK	FMIT FMC Cardiology Night Float (NF) Sports Medicine (SM) Surgery Labor and Delivery Pediatrics Sub-Specialties Gynecology Dermatology Emergency Medicine	FMIT Geriatrics Hilo ICU Labor and Delivery Selective-Adult Medicine Specialties Pediatric Emergency Medicine Night Float (NF) Psychiatry NICU Military Unique

Below are examples of elective rotations that were completed in the past. Electives are not limited to what is listed below:

• Acute Pediatrics
• Addiction Medicine
• Allergy and Immunology
• Anesthesiology
• Dermatology
• Endocrinology
• ENT
• Faculty Development
• Lifestyle Medicine
• Global Health
• Pain Medicine
• Palliative Care
• Point-of-Care Ultrasound (POCUS) Course
• Procedures Clinic
• Obesity Medicine
• Operational Medicine
• Sleep Medicine
• Tropical Medicine
• Trauma
• Wilderness Medicine

Our Chief residents develop the call schedules. Call shift for residents is Friday and Saturday night from 5 p.m. - 7 a.m., based on a rotation, divided into an equal number of shifts between the residents.

The resident will learn to manage the soldier-athlete in a combat arms unit, understand the interaction between the unit and the soldier, be able to write appropriate physical profiles to help speed the return to duty and gain appreciation of the role of the unit medical provider in unit functions during preparation for war and training environments. These military specific experiences will be done by shadowing physicians in operational positions at Schofield Barracks, undergoing mentorship experiences with the Program Director and/or Associate Program Director, and attending either Combat Casualty Care Course/Tactical Combat Medical Care Course or trauma training and exercises as coordinated by the program.

The resident will also gain familiarity with the roles and responsibilities of the Clinic Officer-in-Charge and other job duties required of the graduating military FM resident by completing an interactive project. The graduating residents will also continue to have duties in the FM clinic, seeing their own patients as well as assisting in the Attending Room. These experiences can vary each academic year.

• Advanced Life Support
• Advanced Trauma Life Support
• Advanced Life Support in Obstetrics
• Basic Life Support
• Combat Casualty Care Course
• Neonatal Resuscitation
• Pediatric Life Support
• NEXPLANON Clinical Training Program
• S.T.A.B.L.E.
• External Fetal Monitoring
• Microscopy Course
• Opioid Course
• E-Profile Course
• Ultrasound Modules

Simulation training is scheduled quarterly, using both FM Clinic and Tripler Simulation Center. Our simulation academics include outpatient musculoskeletal and point-of-care-ultrasound exam skills, tactical combat casualty care and individual critical task lists, obstetric emergencies, and outpatient procedural skills. Our curriculum is shaped by the needs of the residents on a month-to-month basis.

Leadership topics are presented during regular didactics and leadership experiences are present throughout all three years of training. During the 3rd year prior to graduation residents complete a Military month where more formal training is also taught.

To assist in more robust Research and Scholarly Activity curriculum, our residency program has assigned Research Coordinator, a core faculty member, to assist the residents in identifying opportunities, and a resident Research Chief is elected each academic year, who is responsible for maintaining the culture of SA, to include announcing and assisting with research requirements and deadlines, and one-on-one mentorship.

It's a residency requirement to complete three scholarly activity projects during residency, which include:

1. Case report
2. Review of a topic (FPIN HDA/GEM), book chapter, review article, USAFP or HAFP lecture, IRB study
3. Quality Improvement/Process Improvement Project

To meet the criteria for SA, a project must be submitted for dissemination to the larger medical community. If not accepted for presentation or publication, an opportunity to present locally will be available.

Each year we have multiple ongoing resident-led team-based PI/QI projects within our clinic that often include our nursing teams. Residents are required to participate and present at least one PI/QI project either within the residency or at our Annual Hawaii Family Medicine PI conference. QI projects are supported throughout the hospital and interdepartmental collaboration is encouraged.

• On a daily basis residents are exposed to personal situations, patients and hospital level situations, which gives them the opportunities to grow professionally and learn from faculty how to navigate complex situations.
• Regarding military professional development, residents participate in company-level activities to reinforce their military knowledge, skills, and abilities to hone their development as military officers.
• As part of the Behavioral Science curriculum, residents are given assignments and have weekly discussions about both personal and professional development, exploring their goals as physicians and Army officers, as well as who they are outside of work.

• Kapiolani Medical Center for Women & Children, on the island of Oahu (Labor and Delivery)
• Spark M. Matsunaga VA Medical Center (Geriatrics)
• Hilo Medical Center, Hilo, Hawaii (Third Year ICU)

Interested third and fourth year civilian (can rotate January thru May), and military HPSP and USUHS medical students can email us at: usarmy.tripler.medcom-tamc.list.fm-residency@health.mil for rotation opportunities.

Our priorities are given to HPSP and USUHS students. For non-active duty training for HPSP students must ensure that your school has a Memorandum of Agreement with TAMC.

All requests should be submitted four months prior to the start date. No rotations will be scheduled during the months of November and December.

Interested students will be scheduled for interviews during their clerkship rotation with us. For those students who are interested in our program but are not able to do a rotation with us, they can email: dha.tripler.tripler-amc.list.tamc-fammed@health.mil and attach their CV, personal statement, with best interview dates/times.

Program graduates take the American Board of Family Medicine board exam, offered bi-annually. Applicants are eligible to take board certification exam at any time once all pre-requisites required by the ABFM are met, which include three Self-Assessment Exams and one process improvement/quality improvement project. Most residents elect to take the board certification exam during the spring of their PGY3 year.

• Residents have opportunities and are encouraged to teach and mentor medical students who are rotating with us, and junior residents.
• Residents are also responsible to give scheduled Morning Reports, lectures, and Journal Club during didactics.
• The graduating residents also have opportunities in precepting in the Attending Room.
• Grand Round presentation opportunities to the hospital are available every month.

Interested 3rd year residents may apply for faculty development training at the Uniformed Services University of the Health Sciences. Volunteer opportunities to include rotations at a houseless clinic also provide additional teaching sessions within the community.

Our program has faculty trained in Sport Medicine, Faculty Development, and Medical Education. Additionally, our robust network of FM Physicians allows us to provide other mentorship opportunities if they do not organically exist within the program.

Our program has a Wellness Chief that reports to the program director and is responsible for ensuring regular activities occur throughout the year. These activities include organized sports, annual retreat, and celebratory events. We strive for an inclusive approach in our wellness approach and also involve our nurses and support staff in these events. Additional time for health needs is also prioritized within the program and once a month time is given to pursue personal and professional goals.