Frequently Asked Questions
Here are answers to questions we often hear. If you don't find your question and answer or need more information, send an e-mail to firstname.lastname@example.org.
Does this residency program prepare me for a career other than at Kaiser Permanente?
Yes. With Kaiser Permanente, you will work in a primary care clinic that covers broad-spectrum outpatient family medicine. You will be supervised by faculty with varying backgrounds who maintain active practices in area clinics. You will also have rotations in hospitals, community primary care clinics, and specialty clinics with different affiliations, affording you the opportunity to see a wide range of clinical settings. This program will prepare you for a practice in urban, rural, and international settings, and academic and community practices. And it offers opportunities for personal growth with leadership, teaching, innovation, and informatics. Graduates from our program have gone to various locations and types of practices.
What is the relationship like between family medicine and specialty medicine?
In a word, it is excellent! Kaiser Permanente Washington is built on the family medicine model. The specialists who work here understand both the role of family medicine and how they can best assist. Specialists are readily available by e-mail, phone, and in person to help us learn and care for our patients. Our mutual goal is to provide the highest quality care at the point of contact, so it is in everyone's interest that the family physician be able to identify and treat most common issues and refer only for true specialized procedures and care. And when those referrals are necessary, our patients have quick access.
What does the obstetrics training involve?
Obstetrics is one of the strengths of our program. Obstetrics training includes a combination of longitudinal obstetrical training rotating on labor and delivery (105 12-hr shifts) and the care of continuity obstetrical patients from the residency clinic. Residents graduate with approximately 80-100 deliveries. Residents work primarily with family medicine attendings from Kaiser Permanente. They also have close working relationship with the Kaiser Permanente obstetricians and midwives. All residents in the past 15 years have graduated with competency to practice OB independently, 30% practice OB following graduation, and none have felt the need to pursue an OB fellowship following graduation.
What are the differences between Capitol Hill and Burien residency clinic training sites?
Each clinic cares for a unique patient population that is representative of the community served. Capitol Hill cares for a diverse urban population that is located in the heart of Seattle. Burien cares for a diverse population that lives at the periphery of Seattle and has a higher mix of cultural diversity and lower socioeconomic status. The Capitol Hill clinic is co-located with the Kaiser Permanente Washington Consultative Specialty Center and Urgent Care Center. Burien is a small to moderate size primary care clinic. Residents from both training sites share the same curriculum of inpatient and outpatient rotations. Please feel free to inquire for more information about either of these sites. The Capitol Hill Campus Match number is 1811120C0; the Burien Medical Center Match number is 1811120C1.
Are there enough residents in each class to share the load and provide support?
Because of the small size of the program and the ability to bring most residents back routinely for weekly didactics, the residents typically develop close bonds with their shared experiences. A monthly Balint group meeting provides opportunity for formal discussion of provider-patient relationships among peers. Informally, this happens in hallways, offices, homes, and cafes. Every resident is assigned a "buddy group" (made up of an R1, R2, and R3) to ensure readily available support from the beginning, but our residents certainly don't feel limited to this, and our small class sizes ensure that everyone quickly gets to know one another well. There are very few rotations that are solely dependent on resident presence. This allows our program the flexibility to cover for each other and minimize the impact on fellow residents if someone becomes ill or requires a leave of absence.
Are there opportunities for teaching?
We work with medical students in our family medicine clinic, at Seattle Children's Hospital, and in obstetrics rotation. Senior residents on inpatient medicine teach junior residents. Additionally, seniors play a key educational role for the new residents during orientation and the initial shifts in clinic, OB, and medicine. Furthermore, R3s serve as co-preceptors for their resident colleagues in clinic during the last 6 months of residency. There is also a teaching curriculum that prepares our residents for the above teaching. As a result, many of our graduates go on to teaching careers following graduation.
What is it like to work in a hospital system that is not dependent on residents?
This is an ideal training center for motivated, independent learners. Residents are not required to take every admission that comes in just because someone has to. Instead, the majority of cases will be selected for their learning and teaching value. Residents here enjoy one-on-one interactions with attendings who are chosen by residents for their skill and interest in teaching. Another benefit of this model is that the residents are not dependent upon each other. If someone is ill or needs to take a leave of absence, the other residents do not have to shift over to cover additional services. Additionally, residents can leave most services to deliver a continuity obstetrics patient without having to arrange coverage.
Where have recent graduates gone to practice?
Recent grads have gone on to practice in a variety of settings, including rural practice, urban clinics, inner- city underserved, community health centers, health maintenance organizations (HMOs), academics, and fellowships. Some graduates have specialized their scope in urgent care, occupational medicine, leadership, or health administration. Our full-spectrum training program that is the only residency in a system caring for 800,000 patients is designed to ensure that graduates have the ability and the confidence to excel in whatever practice environment they choose. The vast majority of graduates have chosen to stay in the greater Seattle area and Washington, but our graduates are practicing all over the nation.
Are there limitations working in an HMO?
The Kaiser Permanente-model HMO, otherwise known as an integrated group practice, is an ideal setting for family medicine because the family physician and the patient are at the center of a large system of support. The family physician provides the majority of care for most patients, coordinates additional care with specialists if needed, and makes decisions about testing, referrals, treatment, follow-up, hospitalizations, and so on. There are no significant restrictions to diagnostic and treatment options. This is possible because of the quality of the family doctors within the system. It's also possible because of the use of evidence-based medicine and best practice guidelines, created and periodically reviewed by committees of Kaiser Permanente Washington, which serve as examples of gold-standard care for doctors in the clinic. Our formulary also is managed by a committee made up of clinicians. Rarely will providers need (or want) to prescribe outside the formulary, but in those cases exceptions can be made.
What sort of patient population do you serve?
The Family Medicine Residency's patient population reflects the richness of both their settings in and near Seattle. Patients represent the entire spectrum of racial, cultural, age, and socioeconomic diversity. Among our clinic patients, 30 percent are of a race other than white, 26 percent have government-subsidized insurance, and 12 percent speak a language other than English in their home. Interpreters are readily available for the wide range of languages spoken. Medicare, Medicaid, and Apple Health (a state-funded insurance program for the working poor) are all honored in both the inpatient and outpatient settings. Patients are made aware of a resident's particular interests and language skills through biographical leaflets. Each resident is the primary provider for a panel of 400-500 patients that they care for throughout residency.
Do you offer part-time or shared positions?
We do not offer part-time or shared positions. Occasionally part-time arrangements have been made for residents with special needs. This requires prior approval of the American Board of Family Practice and is considered on a case-by-case basis. It is not available for the first year. The part-time schedule must include 24 months of continuing care by the resident for her or his continuity panel of patients, with availability to that panel equivalent to that of other (full-time) residents.
Does it really rain all the time in Seattle?
In Seattle, it rains frequently during the winter, but not heavily. We get 37 inches of rain annually, placing Seattle 44th on the list of U.S. cities for rainfall, behind such notables as Chicago, San Francisco, New York City, Houston, and Miami. On the other hand, it is quite often cloudy, though locals do not usually let that get in their way. Seattle is a surprisingly outdoorsy city considering its reputation for rain.