Program Director's Message

Welcome and thank you for your interest in the Saint Joseph Family Medicine Residency!

Our program was founded in 1975 to serve our community, with a particular mission to care for the poor and vulnerable. We serve a diverse urban underserved population and pride ourselves on providing excellent team-based medical care to many patients who struggle to find care elsewhere, including a large Spanish-speaking and undocumented immigrant population from around the Denver metro area.

We offer robust clinical experiences and cultivate leadership and teaching skills that allow our graduates to excel in a wide variety of practice settings, from rural critical access hospitals to urban federally qualified health centers to academic family medicine. One of my favorite aspects of my job is watching residents grow from new interns to senior residents who are compassionate physicians ready to advocate for their patients and provide them with outstanding full-spectrum care.

Most of all, I am thrilled to be a part of our fun, bright, engaged, and caring community of residents, faculty, and staff. I hope you will consider joining us!

Elin Kondrad, MD

Accreditation

Saint Joseph Hospital made history by opening its doors in 1883, establishing staff by 1892, and graduate medical education by 1893. In 1904, we received the first national recognition for hospitals when our physician education program was recognized by the American Medical Association (AMA). And in 1914, the AMA added Saint Joseph Hospital to the first exclusive list of accredited teaching hospitals.

Just as we are committed to providing patients with the highest quality care available, we continue to be committed to providing resident physicians with a high-quality education. Our residency program is accredited by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME is a private, non-profit council that evaluates and accredits medical residency programs across the United States. We are proud to be fully accredited by ACGME.

Curriculum

PGY 1

  • FM Inpatient Service (FMS) approx. 6 weeks
  • Internal Medicine 1 month
  • Intensive Care Unit 1 month
  • Obstetrics 2 months
  • Pediatric EM @ Denver Health 1 month
  • Pediatrics - Inpatient @ Children's Hospital 1 month
  • Newborn 1 month
  • Geriatrics 1 month
  • General Surgery (Outpatient) 2 weeks
  • Emergency Medicine 2 weeks
  • Behavioral Health 2 weeks
  • Clinic orientation 2 weeks
  • Elective 1 month
  • 1-3 half days per week of continuity clinic
  • Longitudinal Curriculum: Community Medicine, Medical Spanish, Long term nursing home care

PGY 2

  • Career Development Selective 1 month
  • FM Inpatient Service approx. 6 weeks
  • FM - Night Float Two 2 week blocks
  • Internal Medicine 1 month
  • Intensive Care Unit 1 month
  • Obstetrics 1 month
  • Orthopedics 2 weeks
  • Pediatrics - ambulatory subspecialty 1 month
  • Rural Medicine 1 month
  • Surgical Procedures 1 month
  • Elective 1 month
  • Emergency Medicine 2 weeks
  • Clinic Intensive 2 weeks
  • 2-4 half days per week of continuity clinic
  • Longitudinal Curriculum: Community Medicine, Medical Spanish, Long term nursing home care

PGY 3

  • Dermatology 1 month\
  • Trauma 1 month
  • FM Inpatient Service approx. 6 weeks
  • FM - Night Float 2 weeks
  • Clinic Intensive 1 month
  • Gynecology 1 month
  • Management of Health Systems 2 weeks
  • Pediatric Outpatient 1 month
  • Sports Medicine 1 month
  • Electives 3.5 months
  • 4-5 half days per week of continuity clinic
  • Longitudinal Curriculum: Community Medicine, Medical Spanish, Long term nursing home care

Our curriculum is designed to fully prepare residents for any setting after graduation. Our rotations and training represent a balance of foundational family medicine, including outpatient, inpatient, obstetrics, pediatrics, geriatrics, and procedures.

Saint Joe’s is a particularly excellent program for those considering full-spectrum practice in the future. Our more intense rotations, while challenging, will expand your knowledge and skills. In comparison, other rotations are more relaxed and allow for more decompression and personal time. All rotations are structured to maximize learning opportunities and respect the resident’s time and efforts. Lastly, our ample flexibility and elective opportunities allow residents to cater training to their specific interests and goals.

Collaborative Training

Saint Joseph Hospital hosts four residency programs: FM, IM, OB/GYN and General Surgery. While it may not be true everywhere, at Saint Joe’s we strongly value this collaborative training. We work and play well together; benefit and learn from each other. Residents rotate with the other specialities which creates meaningful relationships and deeper understanding. The hospital and residency clinics are teaching institutions to the core, which means residents enjoy consistent autonomy from patients, attendings, specialists and staff. As a busy hospital, there are plenty of patients and procedures for all of us. Lastly, we support each other on all levels, from the residents to the highest levels of leadership.

Select Rotation Information

  • Family Medicine Service (FMS): Full-spectrum (newborns, OB, adult, ICU) family medicine inpatient service at Saint Joseph hospital staffed by our residency faculty.Internal Medicine: Work with internal medicine residents on an adult inpatient service at Saint Joseph Hospital staffed by Kaiser Permanente hospitalists
  • Intensive Care Unit (ICU): Work with internal medicine residents on a multidisciplinary team in the ICU at Saint Joseph Hospital. Staffed by National Jewish and Kaiser Permanente intensivists.
  • Obstetrics: High-risk and low-risk labor and delivery, triage, and postpartum experience staffed by Kaiser Permanente and OB/GYN faculty.
  • General Surgery: Hybrid inpatient/outpatient rotation in which residents work with surgery residents doing consults, operations, and pre-op/post-op visits. Residents also work with FM faculty doing outpatient procedures such as skin biopsies and vasectomies.
  • Rural: Spend a month of 2nd year in rural Colorado (housing provided) learning rural medicine.
  • Career Development: Work with a mentor to design a 2 week elective for self-exploration, goals and values identification and to try out different career possibilities.
  • Acute Care Orthopedics/Trauma: Spend 2-4 weeks at Winter Park or Snowmass mountain clinics learning high altitude medicine and how to take care of acute orthopedic injuries.

Community Medicine Curriculum

  • During PGY1, residents have protected time to orient themselves to the community we serve. Highly motivated residents may find time to establish and continue a partnership into PGY2 with a community organization of their choice.
  • Third year residents have approximately one half day per month blocked to work with one of our community partners. Some of our partners:
    • Urban Peak Youth Shelter Clinic: work with one of our faculty providing clinical care to homeless teens and young adults
    • Career Coach Mentoring: mentor 10 th or 11 th grade students at a local high school who are interested in health careers
    • Metro Caring: assist in keeping shelves stocked or participate in food and education projects at a local hunger prevention organization
    • Lardon Hall: provide care for a patient population with developmental and intellectual disabilities

Spanish Language Training

This training improves Spanish proficiency among providers and staff at all levels in order to improve patient care and interactions for our large Spanish-speaking population. Training includes:

  • Monthly 90 minute multilevel Medical Spanish classes for all residents
  • Four day pre-orientation intensive Medical Spanish course for new interns
  • Optional: Spanish language acquisition and immersion! Residents may apply for funding to take a two week medical Spanish immersion in Guatemala or Costa Rica (or do virtual classes if travel restricted)

Electives

In addition to the wide range of existing elective rotations, residents can create their own rotations tailored to meet their educational needs. Some examples include international and rural rotations as well as integrative medicine. Residents have progressively more time for electives each year of training with a great deal of flexibility in their third year.

Didactics

Didactics are taught on a daily basis through our noon conference series. Our core didactic curriculum is based on an 18-month cycle, meaning you will get exposed to each topic at least twice during residency. We also offer academic half-day sessions in our simulation lab (or in the great outdoors) on a number of topics, including:

  • Wilderness medicine
  • Obstetric emergencies
  • Hospital procedures
  • Family planning training
  • Casting and splinting workshop

Our didactics includes a balanced mix of family medicine and specialty perspectives, including teaching from our colleagues in OB/GYN, medicine and critical care. There are a number of scheduled recurring talks, including:

  • Journal club
  • Sports medicine
  • OMT
  • Community medicine
  • Meaning in medicine
  • Family medicine morning report
  • Behavioral health
  • Practice management
  • Palliative medicine
  • Complementary and Integrative medicine

Our noon conference series also includes dedicated time for team-based quality improvement conferences. You will also have access to didactics in a number of other specialties during your rotations, including Pediatrics, IM/ICU and ECG conferences.

Health Equity and Social Justice at the Saint Joseph Hospital Family Medicine Residency

We recognize that our diverse patient population is at risk for poor health outcomes secondary to inequities in our health care system and systemic racism in the world. We also recognize the opportunity to address health equity as a core part of our residency curriculum. Included in this is our program’s approach to teaching and practicing anti-racism, our intention to promote and become a more diverse and inclusive community, and our work in leadership and advocacy. Our work in the realm of social justice and health equity encompasses five broad categories. These are:

Population and patient panel management, with a particular focus on addressing health disparities

  • Introduction to concepts of population health and panel management, and learning to use population health tools available in the electronic health record
  • Identifying and addressing disparities in care among various patient groups on panels (i.e. African American patients, Latino patients, older adults, etc.)
  • Using a team-based approach to address care gaps and health disparities
  • Regularly incorporating how health disparities have large downstream effects in daily didactic teaching
  • Reinforcing and teaching skills that help to prevent burnout and promote our residents to work in low resource settings post-residency

Advocacy and Leadership

  • Introduction to different forms of advocacy in medicine starting first year that continues into a longitudinal community medicine curriculum
  • Directly engaging in graduate medical education changes that affect all 4 residencies at an annual institution review
  • Learning how to advocate on a larger scale (i.e. writing a letter to local legislators, testifying on bills)
  • Partnering with the Colorado Academy of Family Physicians in their Doc of the Day Program to provide medical services and learn advocacy during the legislative session

Community Engagement

  • Orienting our new residents to the communities we serve via intentional dedicated time to observe and experience some of the cultures in the community
  • Partnering with different programs and institutions (i.e. foodbanks, high schools with high percentages of BIPOC students, and nurse partnerships that support first time mothers) in the surrounding communities with a longitudinal experience beginning in the first year of residency
    • Highly motivated residents may find time or utilize elective time to engage further with the community partner of their choice in PGY2
    • PGY3 residents have approximately one-half day per month blocked to work with one of our community partners

Addressing Diversity and Inclusion within our residency program and in the clinic

  • Continually striving to recruit and retain residents and faculty with diverse perspectives and experiences
  • Annually dedicate an academic half-day on Implicit/unconscious bias training for resident and faculty physicians
  • Partnering with community organizations to encourage URM youth to consider and pursue health careers to better serve communities in the future
  • Participating in the SJH GME residency-wide physician mentoring program for BIPOC residents

Curriculum

  • Our longitudinal didactic curriculum includes exposure to the following topics: anti-racism and anti-sexism in medicine, care management and community health workers, care for the LGBTQ+ community, immigrant care, public health, and global health
  • Promoting our providers to constantly improve their Spanish language proficiency and utilization of interpreter services in a patient centered manner. This consists of:
    • Monthly medical Spanish classes
    • Four-day intensive medical Spanish course during orientation for all incoming PGY1 residents of any speaking proficiency level
    • Financially supported Spanish language acquisition and immersion. Residents may apply to take a two-week medical Spanish immersion experience in another country, or locally if desired
    • Feedback from intermittent direct faculty observation on patient-centered communication skills while using interpreter systems

Quality Improvement

At Bruner Family Medicine, we are committed to being a Patient Centered Medical Home (PCMH). This requires us to routinely evaluate ourselves and continuously improve in the areas of quality of patient care, quality of patient communication, and team-based care practices. We believe that this structure of primary care is a model for the future and really puts the patient at the center of everything we do.

As a physician at Bruner Family Medicine, you will learn about PCMH principles and have the opportunity to practice team-based quality improvement (QI) from the first days in clinic. You will participate in our team meetings, which are focused on various QI projects as they relate to preventive medicine and chronic disease management for our patients.

Your first year is primarily focused on learning QI tools and processes used in the clinic. During your second and third year, you will be encouraged to take on a leadership role and help direct the team through project creation, developing SMART goals, and implementing successive Plan-Do-Study-Act (PDSA) cycles. You will have the opportunity to present your QI work as one of the required scholarly activities for residency, and have a working knowledge of QI that can be applied in your future career no matter where you find yourself practicing medicine.

Examples of quality improvement projects that residents have presented at various conferences:

  • Sutton S, Kellogg L, Burke K, Gamble N, Taylor A, Keane M, Matergia M. "Improving Access to Isotretinoin for Acne Treatment in an Urban Underserved Family Medicine Residency Clinic: a Quality Improvement Initiative" Rocky Mountain Research Forum. May 2022. Denver, CO
  • Harland, R, Davis, AM, Hainz, R, Kondrad, E, Olsen, B. “ Creating Culture: Quality Improvement in Attitudes around Diversity, Inclusion, and Discrimination at a St. Joseph Family Medicine Residency.” Rocky Mountain Research Forum. May 2022. Denver, CO
  • Taylor A, Kellogg L, Phillips G, Mayeda D, Gill S, Matergia M." Cervical Cancer Screening Quality Improvement." Rocky Mountain Research Forum. May 2022. Denver, CO
  • Teska B, Taylor A, Hulen K, Burnett B, Hill K, Matergia M. "TheClinicBinder.com: Four Years of Lessons Learned." Rocky Mountain Research Forum. May 2022. Denver, CO
  • Harland R. "Increasing the Number of Underrepresented Minority Residents at a FM Residency in Denver, CO." STFM Conference on Medical Student Education. Oral Presentation. Virtual. Feb 2021