Duke University has two family medicine residencies - the Duke University Family Medicine Residency and Duke Rural Family Medicine Residency - and both are completely separate residency programs, each with their own NRMP codes and matches. You must apply to each separately if you wish to be considered for both, but you are also welcome to apply to only one if that program better aligns with your interests. Neither program communicates to the other about who has applied to their program or been offered interviews.
The main differences between the programs are the focus of the mission of their residency, as well as the location of their residency clinic. The Rural program is based out of Oxford, NC while the University program is based out of Durham, NC.
The two programs have overlapping curriculum during the intern year for rotations such as FMIS and nights where university and rural residents work together on the same team. After the intern year, the majority of rotations migrate to Oxford for the rural residents while the university residents continue to do the majority of their rotations at Duke Regional Hospital. The programs will occasionally attend the same didactics as well.
For more information about the rural residency, please visit their website.
Anything and everything! Recent graduates work in inpatient, outpatient, and obstetric settings (including both surgical and non-surgical). Almost all continue to do prenatal and pediatric care as part of their outpatient practice. Many pursue fellowship or other advanced training in sports medicine, geriatrics, reproductive health, and other fields. Some graduates are even faculty at our program!
Absolutely! Residents participate in biannual reviews of the program where concerns are discussed with the chief residents (without any faculty or support staff present), which are then brought to the program directors. Residents also provide feedback via rotation evaluations as well as two completely anonymous annual surveys (one in fall and one in spring).
The program directors close the loop at Residency Leadership Meetings (RLMs), which occur every month, during which they provide updates on any changes to plans in response to resident concerns. Our residents have also served on GME-wide committees which help to enact change for residents across Duke.
Examples of changes that have been made in response to resident feedback include our bedside rounding initiative, changes to coverage requirements for cross-cover residents, and rearrangement of the block schedule to improve wellness for incoming interns.
Residents are also highly encouraged to bring concerns up at any time to the program directors, the chiefs, or staff.
Our program is a mix of opposed and unopposed. Several core rotations, including our family medicine inpatient service (FMIS), well baby nursery, DFM/procedure clinic, and night float are all exclusively covered by our Duke Family Medicine faculty, staff, and residents.
Notable rotations that are ‘opposed’ include inpatient and outpatient pediatrics, L&D, and emergency department coverage during which residents rotate with other residents from Duke and UNC. Our residents have a collegial relationship with residents from other programs and will often become friends outside the hospital!
Residents do not do any “call” from home at Duke University Family Medicine residency. Instead, coverage for all service lines - even for OB continuity patients – is built into rotations. Below are some specific examples of how we do that:
Weekend Inpatient Coverage: The Family Medicine Inpatient Service (FMIS) is a dedicated rotation, with both the senior residents and interns working 6 days a week. A senior resident will cover a 12-hour call period from 6 AM Saturday morning to 6 PM Saturday morning and then a different senior resident covers from 6 PM Saturday morning to 6 AM Sunday morning while the FMIS residents are off. Interns do not do Sunday coverage while on FMIS and are only expected to cover alternating Saturdays while they are on FMIS.
Night Float: Our night float service covers FMIS, Duke Family Medicine OB patients, clinic after-hours calls, and the Duke Regional Hospital well baby nursery. In addition, residents admit 3 patients to either the FMIS or hospitalist service. On Saturday nights, the duties are less. Shifts are from 6 PM to 6 AM from Sunday night to Saturday morning. Each night float block is 2 weeks at a time, and residents do 2-3 blocks of night float per year.
Assist List: Residents on “assist list” cover for residents on an essential service who cannot make it to their shift. The “assist list” resident is always on a non-essential service and is notified as early as possible that they will need to cover another resident’s shift. Interns do not start assist list until the second half of their first year.
Residents do not do any 24-hour shifts.
Residents meet every Tuesday afternoon for faculty-led didactic sessions. This time is protected for residents on almost all rotations with the exception of FMIS. A list of ABFM core topics is used to create an 18-month rotating curriculum that includes lectures, workshops, and modules. Each month, residents will participate in a population health session, journal club, a resident case presentation, behavioral medicine didactics, dedicated geriatrics teaching, POCUS workshops, and wellness time with our program behavioralist Dr. Andrada Neacsiu. Speakers are both DFM faculty and outside presenters recruited for their passion and expertise in a particular topic.
In addition to Tuesday afternoon didactics, residents are also invited to participate in departmental grand rounds, primary care grand rounds, and an outpatient didactic series. The focus of the outpatient didactic series, called CLIPS, is for residents on their Duke Family Medicine rotation and covers clinical outpatient family medicine through small-group, discussion-based, and case-based learning with participation by residents, faculty, and students.
Obstetrics: The standard model of prenatal care offered at the Duke Family Medicine Center is CenteringPregnancy®, a group-based model of care. All residents receive training and are certified to be CenteringPregnancy facilitators. In addition to CenteringPregnancy, a smaller portion of patients receive traditional prenatal care through one-on-one visits. Residents spend 8 weeks on Labor and Delivery (4 weeks in first year, 4 weeks in second year), in addition to continuity deliveries of their CenteringPregnancy patients.
Because residents’ CenteringPregnancy groups are determined by when they are on the L&D service, residents do not leave their rotations to do continuity deliveries. Our residents have no difficulty meeting the ACGME requirements, and residents who are interested in OB can pursue competency to practice with electives at high volume medical centers. Prior graduates have done non-surgical OB after graduation, while others have pursued surgical FMOB fellowships in the past.
Geriatrics: In addition to seeing geriatric patients in clinic, Duke Family Medicine covers a panel of continuity patients at a local nursing home and participates in home visits. There is an additional required 4-week rotation in geriatrics that includes exposure to geriatric outpatient specialty care, inpatient consult service, and transition of care to nursing facilities.
Pediatrics: Residents rotate 4 weeks on inpatient pediatrics with the Duke Pediatrics residents at Duke University Hospital, 4 weeks in the well baby nursery at Duke University Hospital, and 4 weeks on outpatient pediatrics at WakeMed in addition to seeing pediatric continuity patients at the Duke Family Medicine clinic, where we have a disproportionally high pediatric population.
Residents can also choose to do electives in particular areas of OB, pediatrics, or geriatrics.
There are multiple opportunities for clinic-based procedural training. DFM offers gynecology, sports medicine, and dermatology procedural clinics that residents rotate through for 8 weeks of their PGY2 year and 16 weeksof their PGY3 year. Gynecology procedures include colposcopy, endometrial biopsy, Nexplanon insertion/removal, and IUD insertion/removal. Sports medicine procedures include ultrasound-guided joint injections and aspirations. Dermatology procedures include punch, shave, and elliptical biopsies, skin checks, cryotherapy, cyst removals, and toenail removals. There is also an opportunity in clinic for vasectomies. During residents’ normal clinic schedules, they may perform foreign body removal, joint injections, cryotherapy, cerumen impaction removal, I&Ds, anoscopy, management of thrombosed hemorrhoids, laceration repair, and splinting.
There are annual resident skills workshops focusing on the procedures listed above, as well as suturing, ultrasound training, circumcision, cervical exams, fetal scalp electrode and IUPC placement, and perineum laceration repairs. The use of POCUS is highly encouraged and there are dedicated Butterfly ultrasounds for the clinic and in the FMIS workroom.
Additionally, residents have the option to gain experience in providing medical or surgical abortions.
Residents in good standing in January of the second year of training are eligible for moonlighting privileges with program approval. Current opportunities include shifts with the Duke Regional hospitalist service and Duke University urgent care.
Please see our Resident Life page for more details.
The core rotation sites for our program include Duke Family Medicine, Duke Regional Hospital, and Duke University Hospital. Duke Family Medicine (aka Pickens) and Duke University Hospital (aka DUH, “Big Duke”) are on the same campus and are less than a 10-minute walk away. Residents also occasionally go to the Durham VA Medical Center for rotations which is also less than a 10-minute walk away. Duke Regional Hospital (aka DRH, “The Reg”) and Duke Family Medicine are about 15 minutes from each other by car.
Residents receive free parking placards for rotations at DUH, Duke Family Medicine, and Durham VAMC. Parking at DRH is free!
Most other sites for off-service rotations are within Durham city limits, roughly 15-30 minutes from Duke Family Medicine. The furthest residents drive is to Raleigh for their WakeMed outpatient pediatrics rotation and to Duke Raleigh Hospital for their palliative care rotation which is about 45 minutes away.