Medical Residents and UB

“Medical Residents and the State University of New York at Buffalo

Jacobs School of Medicine and Biomedical Sciences”

The FIRST medical resident will be going through the chiropractic elective starting December 19, 2011 with me at my clinic in Buffalo, NY.  This chiropractic elective is the first chiropractic elective in a medical residency program in the United States. This program has been designed to offer firsthand observational knowledge of chiropractic practice to family practice residents at the University of Buffalo Medical School.  For those of you that may be unfamiliar with how medical education works, the medical residency program starts after medical school is completed. The residency programs offer training in a specialty and are involve paid positions.  The medical residents receive hands-on and supervised training and the residencies are available to any graduate of medical school.  This is designed to give in-depth training in a specific branch of medicine.  There are wide varieties of medical residencies, some of the most popular being family practice, anesthesiology, dermatology, emergency medicine, neurology, pediatrics and surgery.  Some of you may also be familiar with the term fellowship.  The difference between a residency and a fellowship is that the fellowship FOLLOWS the residency program with the fellowship being a subspecialty of the residency program.  

Now, I want to be perfectly clear on where I stand, personally, with all of this medical school stuff.  I am involved at this level because chiropractic principles and concepts deserve to be taught to medical professionals.  However, the goal is not to train medical providers how to be chiropractors and certainly not to train chiropractors to be medical physicians.  Chiropractic has a unique approach to healthcare and patients deserve to have that option when they discuss their health with their primary care physicians.  There are only two ways to educate the medical community.  The first is to educate practicing medical providers by co-treating patients and the second is to educate medical students and residents.  Family medicine providers need to understand what chiropractic is and what a chiropractic patient looks like, the same way they need to understand a cardiac patient or a podiatric patient.  It all comes from education and teaching them how to recognize the signs of biomechanical and nervous system dysfunction in the human body.  We chiropractors are perfectly suited to be the portal of entry with musculoskeletal conditions and the hub of referral and co-management.  Our profession is unique in that we treat past the maximum medical improvement model and care for our patients long-term.  That is the major caveat of chiropractic care and the bonus is that we do it without drugs or surgery. Therefore, what will I want to teach the medical resident starting on December 19?

There is a process and I want to start slowly and work up to more complex chiropractic principles.  I want to expose him/her to the chiropractic examination process and will do that for two reasons. first I want him/her to see that what we do from a screening level is not much different from what he/she would do.  Second, I want him/her to see that there is A LOT more that can be discovered from a physical examination and interview.  This is critical because he/she is going to graduate from the residency program and move to practice somewhere in the United States, most likely.  When that happens, he/she is going to need to know how to handle musculoskeletal conditions and why just because the patient doesn’t return to him/her doesn’t mean the condition is resolved.  He/she will be exposed to acute and chronic patients as well as wellness and maintenance patients.  That is also important because he/she will get to observe chiropractic techniques in each of those patient categories and how they can be different.  I don’t have any fancy equipment in my office; simple chiropractic ergobenchs and a single F&D table.  Although I do use modalities and therapeutic exercise, I believe in the hands-on approach to chiropractic care.  That is the reason that we have the chiropractic elective and that is the reason that I receive referrals from medical providers on a daily basis.  If there was not something unique about chiropractic, providers would send patients to PTs or pain management specialists and skip chiropractic.  The chiropractic elective is about putting the emphasis on chiropractic as a distinct healing profession that offers a significant benefit to healthcare without the use of drugs or surgery.  I will be posting more information in the next several weeks.