Patient Handbook

Family Medicine Residency Program (FMRP)

PROGRAM OVERVIEW

VISION: As the model Army Family Medicine Residency Program, we strive to be the home of choice for patients, residents, students, faculty, and staff that develops Soldier Family Physicians with the values and abilities to provide outstanding patient care and excel in accomplishing the Army’s mission.
 
MISSION: The CRDAMC Family Medicine Residency trains Family Physicians in a supportive team environment, provides evidence-based and patient-centered care to Soldiers, Retirees, and their Families, serves the Army and medical communities, assures wellness for all members of the team, and develops the AMEDD’s future leaders.
 
LEARNING ENVIRONMENT: The FMRP provides a collaborative and rigorous learning environment that engages students, residents and staff in a dynamic partnership to foster the development of well-rounded Family Physicians through a safe and collegial atmosphere emphasizing evidence-based practice, selfless service, excellence, and professionalism. We assure the safety and quality of patient care provided by our residents today and our graduates in their future practice.
 
GOALS
Goal 1: Patients. Provide outstanding patient-centered care.
Goal 2: Education. Deliver quality education anytime, anywhere.
Goal 3: Outreach. Serve the local community, provide new knowledge to the medical community, and promote our program to students.
Goal 4: Wellness. Promote and facilitate physical, psychological, and spiritual wellness, for team members.
Goal 5: Leadership. Develop leaders and mentors.
 
PATIENTS FIRST, LEARNING ALWAYS

CLINIC OVERVIEW

The Family Medicine Residency Clinic (FMRC) would like to welcome you and thank you for choosing our center for health services. We provide health care services to Soldiers, Retirees, and their family members.
 
The clinic is on the first floor of Carl R. Darnall Army Medical Center at Fort Cavazos.
 
When you enrolled in TRICARE Prime, you were given a Primary Care Manager (PCM) by name. The Patient Appointing Service (254)288-8888 will always attempt to give you an appointment with your PCM. When your PCM is unavailable, your appointments will generally be with a member of your PCM's team.

Clinicians

The FMRC is proud to offer full-scope primary care – providing newborn, infant, pediatric, adolescent, women’s health, adult, obstetric, and geriatric care to 7,000 patients.  Our patients range from the newest babies born at CRDAMC to World War II veterans and their spouses.  One of the many benefits of the FMRC is the practice of family medicine in which your primary care provider can care for you and your whole family.  This even extends to pregnancy care – the same physician can care for a woman before, during, and after her pregnancy, including managing her labor and delivery, caring for her and her newborn in the hospital, and as an outpatient after delivery.
 
In fulfilling our mission to provide patient-centered, evidence-based, and compassionate healthcare to our patients, the clinic also is proud to support the Family Medicine Residency Program's mission to train resident physicians in the specialty of family medicine. CRDAMC provides an outstanding environment to train physicians and other healthcare providers of the future. The clinic staff includes family physicians, physician assistants, nurse practitioners, clinical psychologist, clinical pharmacologist, nurses, and medics. The teaching faculty are all board-certified family physicians, many of whom have advanced training in other areas such as sports medicine, geriatrics, obstetrics, osteopathy, and research. The resident physicians provide care under the supervision of the teaching staff. The clinic also provides learning opportunities for medical students, physical therapy interns, and physician assistant students.

Relay Health

We are pleased to offer you a new and convenient way to connect with our clinic. Using the Internet, you can now communicate with your provider and nurse online through the Relay Health messaging service.
 
The Relay Health service is a safe, secure, and confidential way to communicate about your non–urgent healthcare needs. It's very easy to use, and incorporates stronger security measures to ensure your privacy. By using the Relay Health service, you will be able to communicate with our clinic when it's most convenient for you. All you need is access to a computer with an Internet connection.
 
Interested? If so, please take a few minutes to sign up now by following the instructions below (there is no fee to register for this service):

1. Visit www.relayhealth.com and click Register.
2. When prompted, select your provider. NOTE: To ensure security, our clinic must accept your application before your registration will be completed. Please allow 24 hours following registration for our office to process your registration.

To learn more about the Relay Health service, visit www.relayhealth.com. If you have any questions about Relay Health, please feel free to contact Relay Health Customer Support at 1-866-RELAYME (1-866-735-2963).

Our Facility

On April 3, 2016 we moved into a new, larger state of the art hospital.  We are excited to train in a beautiful space and for the opportunity to improve our residency even more.   While there are 2 other residencies in our facility (Emergency Medicine and Psychiatry), we remain an essentially unopposed residency program with a community hospital culture.

Welcome

Greetings from the Great Place!  We are so glad that you took the time to look at all our residency program has to offer.  As the Army’s newest Family Medicine Residency established in 2000, we have already established a tradition of training extraordinary Army Family Physicians ready to excel in all that they do!

Our Location

Located in the Hill Country of Central Texas, Carl R. Darnall Army Medical Center provides health and healthcare for a very large and diverse patient population.  The local communities are growing and offer great schools, parks, restaurants and shopping.  As the largest military post in the world, the Fort Cavazos installation also offers abundant recreational opportunities, facilities, family events and activities.

For the outdoor lovers, there are local lakes, rivers, hiking and biking trails. Fort Cavazos is uniquely situated a short drive from an eclectic mix of vibrant culturally diverse cities, as well as the Gulf Coast.  Austin, Dallas, and San Antonio provide opportunities to experience music, art, festivals, professional athletics, amusement parks, waters, and numerous fun things to do.  From the experience of a rodeo to fine art, you name it, you can find it here.  We love living here!

Our Foundation

The foundation of our residency program is the people.  We have awesome residents, faculty, and staff.  Our team is very fortunate to have a highly trained and dedicated core faculty group.  Our core faculty members are full-scope Family Physicians with additional training in Geriatrics, Sports Medicine, Faculty Development, Point of Care Ultrasound, Hospital Medicine, and Family Medicine Obstetrics.

Our Faculty

Our teaching team also includes a clinical psychologist and clinical pharmacist.  The faculty can provide training in OMT, acupuncture, exercise stress testing, and Cognitive Behavioral Therapy (CBT), and all residents are trained in primary care procedures (minor skin procedures, vasectomy, colposcopy, first trimester ultrasound, intrauterine device and contraceptive implant insertion).  We offer 1:1 OMT teaching clinics for interested residents.

Additionally, we have faculty members with a MPH, on the Institutional Review Board (IRB) and successful in research/publications, and highly involved in the American Academy of Family Physicians (AAFP) and Uniformed Services Academy of Family Physicians (USAFP).   We have vast experience in military and operational medicine.  The bottom line is that our faculty members have a diverse and relevant skill set that they readily share for resident education.

Our Culture

The program is further rooted in a culture of excellence. Our residency clinic is recognized by the NCQA as a Level III Patient Centered Medical Home (PCMH) which is the highest level.  We are dedicated to scholarly activity and patient safety/quality improvement.  We achieved a 100% board pass rate since 2014.   We are proud to offer multiple resources to help you develop into the best Army Family Physician that you can be.

Extra Curriculars and Events

We work hard to become great doctors and Army officers, and we also make sure to leave time for family and fun!  Since COVID restrictions have eased, the residency sponsors numerous annual events including a dining out, holiday party, annual retreat, hails and farewells, and the graduation dinner and roast. We are resuming “Officer Call,” casual get-togethers to unwind after a good week.  We play sports together every week.  Typically, this is on Thursday mornings and we play a unique sport called Bucketball (just ask when you get here) as well as Army Combat Fitness Test (ACFT) training. We are a family and love the camaraderie that our residency offers.

“Rotations” http://www.crdamc.amedd.army.mil/FMRP/rotations.aspx. 
CRDAMC Family Medicine Residency Rotations
 
First Year Rotations – 4 week blocks

FM Clinic/ Health System

Family Medicine Inpatient

Family Medicine Inpatient

Family Medicine Inpatient

Labor & Delivery

Orthopedic Clinic

Cardiology Inpatient1

Medical ICU1

Pediatrics Inpatient2

Newborn Nursery

Emergency Medicine

C4/General Surgery

GYN Clinic

C4: Combat Casualty Care Course (Fort Sam Houston, TX)
Second Year Rotations – 4 week blocks

FM Upper-Level Orientation

Family Medicine Inpatient

Family Medicine Inpatient

Family Medicine Inpatient

Labor & Delivery

Sports Medicine

Psychiatry

Dermatology

Pediatrics Clinic

Pediatric ER2

Geriatrics4

Procedures Clinic

Elective

 
Third Year Rotations – 4 week blocks

Transition to Practice/ Military Unique

Family Medicine Inpatient

Family Medicine Inpatient

Cardiology Clinic4

Labor & Delivery

Sports Medicine

Research Elective

Urban ER2

Pediatrics Clinic

Trauma5 (away rotation)

Selective

Elective

Elective

1. Central Texas VA Medical Center, Temple, TX     2. McLane Children’s Hospital, Temple, TX            3. Baylor Scott & White Memorial Hospital, Temple, TX          4.Baylor Scott & White satellite clinics in Fort Cavazos area                                                              5. Brooke Army Medical Center, San Antonio, TX
 
Selective Experiences: ENT, Ophthalmology, Urology, Plastic Surgery, Pulmonology, Gastroenterology, Neurology, Pain Medicine, Radiology, other Adult and Pediatric Subspecialties
Electives: the above, Operational Medicine electives, plus many more!
 
Longitudinal Experiences

Continuity Clinic Each resident has an assigned panel of patients.  Appointment lengths gradually shorten during residency	PGY-1: 1-2 half days per week PGY-2: 1-3 half days per week PGY-3: 1-4 half days per week
FM Morning Report Conference	30 minutes, Mon-Fri mornings – case-based presentation of a focused clinical question and answer
FM Noon Clinic Conference	30 minutes, Mon & Wed – round table discussion on interesting cases, ECGs, and board questions
FM CME Conference	One half day per week, Thursday mornings, includes Didactic lectures Simulation workshops (bimonthly) Wellness events (quarterly)
Geriatrics Curriculum	Continuity nursing home patients at Texas Veterans Home assigned to PGY-2s and -3s, seen monthly Didactics for PGY-2s and -3s4 hours per month at nursing home Geriatrics rotation Empaneled patients over 65
Practice Management	1-2 Morning Reports/month, FM clinic rotation, and Transition to Practice month
Military Unique Curriculum	1-2 Morning Reports/month, quarterly cadaver labs, semiannual simulation events, Trauma and Transition to Practice rotations, electives, Soldiers on your panel of patients
Quality Improvement/Patient Safety Curriculum	Attend QI/PS committee meetings, hospital root cause analyses, etc., during PGY-2 and PGY-3 years Monthly Patient Safety Conference Periodic didactics during CME QI projects
Scholarly Activity Curriculum	Dedicated research time during PGY-2 FM Upper Level Orientation and PGY-3 Research block Periodic didactics during CME Scholarly activity projects (publications, presentations, posters, etc.) Opportunity to present at local, regional, national, and international conferences

Residents receive training in ACLS, PALS, ATLS, ALSO, NRP, STABLE, and TCCC prior to graduation.
“Contact Us” http://www.crdamc.amedd.army.mil/FMRP/contact2.aspx
 
FAMILY MEDICINE RESIDENCY PROGRAM – TO SCHEDULE A ROTATION CONTACT:
usarmy.cavazos.medcom-crdamc.mbx.family-medicine@health.mil

Tricare Prime Remote

TRICARE Prime Remote (TPR) is a managed care option available in remote areas in the United States. By law, you can only use TPR if both your sponsor's home and work addresses are more than 50 miles (or one hour's drive time) from a military hospital or clinic.

CRDAMC Area of Responsibility:

The Carl R. Darnall Medical Center (CRDAMC) provides primary care to Active-Duty Service Members assigned to Fort Cavazos and Soldiers in the local area in transient status (Leave, TDY, etc) within CRDAMC’s Area of Responsibility.  Care extends to Tricare Prime Remote (TPR) Soldiers requiring specific assistance with military centric care and documentation that cannot be performed by their network civilian Primary Care Manager (PCM) such as physical examinations and physical profiles.

Soldier Responsibilities

Physicals Commissioning, Retirement, and SHPE. (No PHAs) 

1. Contact the Soldier Medical Readiness Clinic (SMRC) at 254-285-6232/6266 or send a message using the MHS Genesis Patient Portal to the SMRC inbox "USA Ft. Cavazos MIL Readiness Scheduling." 

Eligibility

Soldiers assigned to Tricare Prime Remote (TPR) who work in remote locations in any county within CRDAMC’s Area of Responsibility. If uncertain, refer to the Pick your MTF document to help you determine which MTF covers your assignment location. More information can be found at the AR Medical Management Center site: https://www.milsuite.mil/book/groups/ar-mmc.

TPR Services Provided

Medical Readiness Evaluations: Profiles and Convalescent Leave Extensions

• Profile type: Medical Profile (PDF Fillable)
• Profile type: Behavioral Health Profile (PDF Fillable)

1. Packet must be completed and signed by your civilian medical provider.
2. Obtain copies of your medical documentation related to your profiled condition only.
3. Examples include, radiology, labs, progress notes, hospital discharge records and doctors’ notes.
4. Submit packet and medical documentation following these instructions: MHS Genesis Patient Portal Walk Thru
5. You will be contacted by the scheduling nurse for a virtual appointment with the Provider.

Fit for Duty Evaluations (Medical/Behavioral Health)

1. Command Prepares a Fit for Duty Memo (Template)
2. Submission by the Service Member are uploaded to MHSG MHS Genesis Patient Portal Walk Thru
3. Command submissions to the following: usarmy.cavazos.medcom-crdamc.mbx.tricare-prime-remote-program@health.mil

PCS Documents

1. DA 5118 – CONUS Reassignments or
2. DA 4036 – OCONUS Medical and Dental
3. Uploaded to MHSG MHS Genesis Patient Portal Walk Thru

Contacts

TRICARE East Region-Humana Military
1-800-444-5445
TRICARE East Region Website

TRICARE West Region-Health Net Federal Services
1-844-866-9378
TRICARE West Region Website