University of New Mexico Health Sciences Center

Introduction | Mission | Goals & Objectives
The Community | The Curriculum | Longitudinal Experiences
Block Rotations | Conferences & Meetings | The Facilities
Faculty | Facilities | Contact Information

Mario Pacheco, M.D., Director NNMFPRP

Welcome

It is a privilege to have this opportunity to welcome you to our website and share with you a few thoughts on the Northern New Mexico Family Practice Residency Program (NNMFPRP) located in Santa Fe, New Mexico.  The NNMFPRP graduated its first class of residents in June 1998.  Our program is a “1+2 Residency Program” that combines the best components of a one-year University-based internship in Albuquerque with a two-year Community-based residency in Santa Fe.  I believe that this one year in a traditional medical education setting forms a critical foundation for the successful continuation of the residency program.  St. Vincent Regional Medical Center, a not-for-profit community hospital, and La Familia Medical Center, a federally qualified community health center, provide the core clinical settings for this non-traditional program in Santa Fe during the second and third years of training

Of the many strengths of our program, it is my opinion that the following characteristics distinguish the NNMFPRP from many other training programs:

• Santa Fe is a beautiful place to live.  With a population of 64,000, it is the oldest continuously inhabited capital city in the United States.  This sense of history is enhanced by its multicultural heritage of Native Americans, Hispanics, and Northern Europeans. Unique architecture and four –season climate, with predominantly blue skies and sunny weather, makes Santa Fe an exceptionally appealing site to begin one’s career.
• Our mission is a noble one.  The NNMFPRP is dedicated to improving primary care access for uninsured, rural and immigrant patient populations.  Our continuity clinic is at a well-established community health center that delivers approximately 30% of the babies born in Santa Fe’s only community hospital.  Over 80% of our graduates choose to remain in New Mexico after graduation.  Of those who have left New Mexico, all have worked in under-served settings.
• Our curriculum is flexible, allowing ample opportunity for individual residents to tailor their educational experience to their special needs, interests and talents.  It is a training environment that values the precepts of individualized adult -learning.
• Our residency utilizes one-on-one teaching, especially in the hospital when one resident is on call with one attending.
• Our residency provides protected time for residents to engage in a community project of their choice.  The community medicine experience includes specific training in health policy advocacy at the New Mexico State Legislature, as well as extensive involvement with the New Mexico Department of Health.

 I hope that you find this web site helpful in choosing the residency program that is best for you.  

If you have any other questions about the Northern New Mexico Family Practice Program, please feel free to explore further or contact me directly  at Mario.Pacheco@stvin.org.

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Northern New Mexico Family Practice Residency Program

INTRODUCTION

The family physician fills a special role in medicine: meeting the challenge to bridge economic, cultural, and language barriers to provide accessible, appropriate, and effective care. The needs of patients, particularly the poor, cannot be adequately served by traditional hospital or office-based healthcare systems. Physicians in family practice residency training are encouraged to provide clinical care within the context of the community in which they live. Begun in 1973 in response to a critical need for physicians in the rural areas of the state, the University of New Mexico (UNM) residency in family practice incorporates a unique combination of tertiary care training with broad experiences in rural settings. “1+2” programs in Las Cruces, Roswell, and Santa Fe evolved in the mid-90’s to decentralize training of physicians from tertiary care sites into community settings like those in which they will be practicing.  Current 1+2 Training Programs remain in Santa Fe and Roswell. Las Cruces and UNM offer complete three-year programs.

Santa Fe’s Northern New Mexico Family Practice Residency Program began in 1996 and is jointly sponsored by UNM, St. Vincent Regional Medical Center and La Familia Community Health Center. It is designed as a longitudinal- and block-based residency experience. The program is accredited by the Accreditation Council for Graduate Medical Education (ACGME), and fully meets the expectations of the American Board of Family Practice. The continuity site is at La Familia Community Health Center.  Additional training occurs at St. Vincent Regional Medical Center, the Santa Fe Indian Hospital, the offices of local physicians, and in rural settings.

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MISSION

The Northern New Mexico Family Practice Residency Program is dedicated to improving access to primary care physician services in Northern New Mexico by training Family Practice physicians in a community based setting directed by the collective wisdom of the community, local health care providers and national standards for the delivery of quality care. Excellence in clinical skill building is enriched by specific training in public policy, precepts of adult learning, wellness as an interdisciplinary concept and options in health care delivery.

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GENERAL GOALS AND OBJECTIVES

1. Maintain a curriculum that is both in compliance with RRC-FP standards as well as flexible in addressing the specific needs of each resident as well as the marketplace.
   • Meet the American Board of Family Practice expectations regarding the skills each residency graduate should attain in 36 months of training.
   • Assess the community needs and incorporate appropriate clinical and social interventions into the specific curriculum.
   • Maintain a curriculum that incorporates concepts of adult learning and wellness.
2. Support an environment, which encourages optimum interface with the community, establishing specific community tasks and responsibilities to be met by individual residents.
   • Incorporate interdisciplinary learning.
   • Assign each resident to an independent community project in which the resident works directly with its constituents, establishes specific responsibilities, clinical/educational outcomes and evaluation mechanisms.
   • Expose each resident to a variety of practice environments, including community health centers, Indian Health Services, managed care and hospital-based settings.
3. Promote and support activities that encourage clinical effectiveness.
   • Quality Improvement Activities.
   • Train residents in a setting in which they do not have to compete with other specialty residents for educational resources.
   • Teach skills to enhance communication with patients, staff and peers as an essential requirement for functioning effectively as a competent physician.
4. Demonstrate and practice cost-effective health care in concert with current and developing health care policy, as well as specific patient need.
   • Incorporate practice management material into the resident training curriculum.
   • Incorporate a communication between the financial office and the practicing physician whom provides continuous feedback regarding clinical services and financial compensation.
   • Provide patient education and illness prevention as a primary characteristic of cost-effective health care delivery.
5. Promote family practice education and primary health care delivery that is family centered and incorporates a biopsychosocial orientation.
   • Each resident provides inpatient and outpatient care for patients in all life cycles, including obstetrics.
   • Provide care that incorporates the medical, cultural, environmental and psychological needs of the under-served community, in addition to providing skills for effectively dealing with the family structure as a fundamental component of care.
6. Assume accountability for medical education leadership and the promotion of community health education with effective community collaboration.
   • Develop and maintain LFMC as a model community site and central educational center for family practice training in the Santa Fe area.
   • Maintain balance between educational and clinical missions.
   • Engage the health education community in the development and implementation of appropriate community activities.
7. Achieve excellence in community-based family medicine education through a program, which successfully provides dedicated practitioners to under-served areas.
   • Maintain an administrative structure that emphasizes rural outreach and encourages appropriate site development.
   • Pursue all areas of support for developing rural opportunities for family practice training.
   • Train family physicians to serve as role models and teach future family physicians in training.
   • Support research, writing and publication of efforts to serve the under-served.

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THE COMMUNITY

Nestled at an altitude of 7,000 feet in the foothills of the Sangre de Cristo Mountains, Santa Fe with a population of 64,000 is the oldest continuously inhabited capital city of the 50 states. This sense of history, along with its multicultural heritage of Native American, Hispanic, and Northern European, unique adobe architecture, and four-season climate with predominately blue skies and sunny weather, makes the city an increasingly appealing site to begin one’s career. The world-renowned Santa Fe Opera highlights a performance-packed summer of cultural events while the Santa Fe Ski Basin, just minutes from downtown (Google map), and caters to winter sports enthusiasts. Each season provides an invigorating selection of outdoor sports and recreation.

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THE CIRRICULUM

First-year training occurs at the University of New Mexico facilities in Albuquerque along with residents from the Albuquerque-based program as well as those training for placement in Roswell. Transfer to Santa Fe takes place at the end of Year 1.  The second and third years in training are spent in community settings in Santa Fe and outlying areas.

The curriculum is predominantly rotational in nature, combined with some longitudinal educational experiences. The continuity clinic provides a longitudinal patient base for each resident.  The intention is to immerse the resident into a successful community clinic setting, which reflects a holistic approach to health care.

The block rotations and longitudinal experiences for this training program are outlined on the next page.

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LONGITUDINAL EXPERIENCES

• Family Practice Clinic–2-4 clinics/week
  
• Inpatient Family Practice Service (for resident’s continuity patients)
  
• Geriatrics—nursing home rounds and lecture series
  
• Behavioral Medicine: continuity clinic precepting and lectures
  
• Rural Community Project
  
• Bioethics; Spirituality and medicine; cultural competency
  
• Weekly problem-based learning sessions
  
• Rural Clinics

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BLOCK ROTATIONS OVERVIEW

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CONFERENCES AND MEETINGS

EDUCATIONAL ACTIVITIES
The resident participates in the teaching programs and in the educational activities under the guidance and direction of the program director or his designee. The following outlines structured educational activities, including time, place and individual responsible for the forum. It does not, however, limit the breadth or opportunities for training.

Every Tuesday (except first Tuesday of the month)
12:30 – 1:30    Noon Medical Lecture

Every Tuesday and Friday
8:00 – 8:30     Morning Report*
Resident Case-Presentations

Every Wednesday (except 5th Wednesday)
12:30 – 2:00     Problem Oriented Learning Sessions*
Resident/Faculty Presentations & Lectures

Fourth Wednesday of every month
1:45 – 2:45     Resident Meeting*

Second Wednesday
2:00 – 4:30     Behavioral Medicine*
LFMC Behavioral Medicine Department

Fourth Wednesday
3:00 – 4:00     Women’s Health Journal Club*                                                              

First and Third Wednesday
1:45 – 2:45     Journal Reviews*                                           
                                   
3:00 – 4:30     Resident Support Group*                        

Fifth Wednesday of any month
12:30 – 1:30   Resident/Provider Meeting*                                                   

First Thursday of every Month
7:30 – 9:00am    Bioethics Committee Meeting                          

First Friday of every Month
9:00- noon     Nursing Home Didactic/Practicum *               

*Requires 80% Attendance.

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THE FACILITIES

La Familia Medical Center is a community health center treating the underserved in Santa Fe County.  Under the guidance of a local and autonomous board of directors, which includes patients if the health center, La Familia offers a wide range of community services and outreach.  Current staff includes nine board-certified family physicians, 2 family nurse practitioners, and two dentists.  The clinic offers a strong and nationally recognized health education program for its patients.  Limited laboratory services are available on site.  Other laboratory and diagnostic imaging services are contracted to local providers.  La Familia Medical Center has been the primary continuity clinic since the inception of the Northern New Mexico Family Practice Residency Program.

St. Vincent Regional Medical Center is a non-profit, community hospital with 268 beds and more than 200 physicians representing 22 medical specialties.  The largest hospital north of Albuquerque and south of Pueblo, Colorado, St. Vincent admits more than 10,000 patients annually.  Additionally, 11,500 are treated as outpatients and 5,000 other patients come to same-day surgery each year.  The emergency department and adjacent Fast TRACK treated more than 80,000 patients last year, making it the second busiest acute care facility in New Mexico.

The Santa Fe Indian Health Services Hospital is an additional rotational training site.  This institution provides care in its own clinic and acute care hospital, providing the resident with a unique opportunity to care for the Native American population in an environment which respects the cultural, spiritual and health practices of its clientele.  Santa Fe Indian Hospital is the site for a required GYN and surgical rotation.

Women’s Health services Family Care and Counseling Center is a private nonprofit organization with a community board, whose clinical services are supplemented by federal, stage, local and private grants.  The family physicians provide full spectrum family practice services, including obstetrics.  WHS provides a Women’s health rotation to all family practice residents.

Other training activities of Northern New Mexico program reach beyond the confines of the clinic or hospital setting.  Dedicated to community interaction, specialty rotations are provided in the offices and clinics of community practitioners and experiences in rural areas are required.

Rural continuity experience sites include:

• Pojoaque Primary Care Clinic
  
• Angel Fire Free Clinic
  
• Pecos Valley Medical Center
  
• Santo Domingo Pueblo
  
• San Felipe Pueblo
  
• Cochiti Pueblo
  
• Shiprock; (Navajo Nation) Crownpoint
  
• HCNNM  (Las Vegas and Española, New Mexico)
  

These clinical experiences allow residents to practice in more rural communities over the course of their 2 years in Northern New Mexico.

In addition, each resident is required to identify, design, and implement a community project during his or her two years in Santa Fe.  The public health department and community practitioners provide support and training for these activities.  The central offices of the NM Department of Health are located in Santa Fe.  In combination with a very active district health office that serves the Northern region of NM, educational resources for population-based health education make the Santa Fe site especially rich for public health education.

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THE FACULTY

MARIO PACHECO, MD, Program Director and past founding director of the residency program, was born and raised in northern New Mexico. He is a graduate of the University of New Mexico School of Medicine, where he also completed a residency in family practice and a fellowship in Health of the Public. He has worked at La Familia Medical Center since October 1989 and is a former member of St. Vincent Regional Medical Center Board of Trustees. Dr. Pacheco served as the medical director for the Pecos Valley Medical Center from 1992 to 1994 and medical director for the Health Promotion Bureau of the New Mexico Department of Health from 1994 to 1995. Dr. Pacheco spent 2000-2001 on sabbatical serving as a Robert Wood-Johnson Fellow in Washington D.C. Following his return to his native New Mexico; he spent a year serving as a public health officer prior to returning to his position as Program Director for the Northern New Mexico Family Practice Residency Program. He is married to Diana Gonzales-Pacheco, has a daughter, Cecilia, and a son, Gabriel.

KURT KASTENDIECK, MD is the Assistant Director for the La Familia Continuity Clinic. He is a native New Mexican from Grants, completed College and Medical School and Internship at the University of New Mexico. Following his graduation from the 1 + 2 Northern New Mexico Family Practice Residency Program in Santa Fe, Dr. Kastendieck spent 2 years providing full spectrum care in Raton, NM. In 2002 he returned to Santa Fe and joined La Familia. In 2003 Dr. Kastendieck assumed the role of residency program site director at La Familia Medical Clinic. Kurt’s main interest in Family Practice is procedures including colonoscopy, upper endoscopy, exercise treadmill tests, coloscopy, and vasectomies. Since back at La Familia, Kurt had enjoyed the balance of being able to practice full spectrum family medicine and spending time with his family. Dr. Kastendieck and his wife Loretta, a Physician Assistant at La Familia, have three young children—Holly, Luke, and Julie.

KAREN ARMITAGE, MD, , completed a residency in pediatrics at the University of New Mexico. She is the District Health Officer for the northern region of the state with special interests in public health issues and health of communities. She facilitates the community projects for the family practice residents and loves what she does.

JOHN BRAY-MORRIS, MD, received his medical degree at NYU and completed residency in Family Medicine at the University of Rochester. He has international medical experience in Zambia and Sierra Leone. He comes to New Mexico from the Navajo Health Foundation, Sage Memorial Hospital in Ganado, Arizona where he was a full time member of the medical staff.

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NEAL DEVITT, MD, graduated from Harvard University and Rush Medical College before completing his family medicine residency at Lutheran General Hospital in Des Plaines, Illinois. Dr. Devitt began practicing at La Familia Medical Center in 1984. He is Past-President of the New Mexico Chapter of the American Academy of Family Practice.

PAULA DEVITT, RN, CDE, is the health educator for La Familia Medical Center. She is a graduate of North Park College in Chicago, Illinois. Her interests at La Familia include lay health educator programs in diabetes health education, breast and cervical cancer prevention, and prenatal care outreach.

ROGER GILDERSLEEVE, MD, is a graduate of the University of New Mexico, Northern New Mexico Family Practice Residency Program (Santa Fe). Dr. Gildersleeve graduated in June of 2005. He is employed by La Familia and works closely with the residents of the program as attending physician. After the Navy, Dr. Gildersleeve graduated with honors in Russian Literature. He completed his medical training at UT. Dr. Gildersleeve and his wife Erin share three beautiful children: Cara, Noah, and Sabra.

GARY HARRIS, MD, , is a graduate of the University of Nebraska College of Medicine. He completed his internal medicine residency at Wilford Hall USAF Medical Center and pulmonary fellowship at Southwestern Medical School in Dallas, TX. After 9 years in the Air Force and 25 years at the University of Texas Health Science Center in San Antonio he retired and joined LFMC to develop the Healthcare for the Homeless project.

SUE KATZ, MD MPH, Medical Director of La Familia and a member of the staff of La Familia since 1990. She is involved in quality management activities at the community health center. Dr. Katz graduated from the School of Medicine at the University of California, San Francisco, where she also earned an MPH degree. Her residency was completed in family practice at the University of New Mexico. Bike riding, signing, and eating chocolate are her special interests.

JAMES D. LUTZ, MD, is a graduate of the University Of New Mexico School Of Medicine. He completed his residency training in the Northern NM Family Practice Residency program in Santa Fe, NM. He worked previously as an engineer and received his Master’s Degree in Engineering from Texas A&M University. He has lived in New Mexico since 1986 and is happy to be in Santa Fe. He has two children and he enjoys hiking, biking, and playing the guitar in his spare time.

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ALAN MARX, NP, PA Former Associate Medical Director at LFCM, Alan has had the privilege of being one of many providing care for the Santa Fe community since 1990. Alan received a BSN from Creighton University in 1984 and a Nurse Practitioner/Physician’s Assistant certificate from the University of North Dakota in 1989. He received a Master’s of Science in Nursing at Case Western Reserve in 1996. His work experience includes practicing as a registered nurse in primary care since 1984. He advocates for primary health care as a way to provide health for all in a comprehensive and humane manner.

KRISTINE PARKE, MD, is Board certified in family practice. Dr. Parks completed residency training at Greater Lawrence Family Practice in Lawrence, Massachusetts. Dr. Parke’s interests include obstetrics and internal medicine.

LUIS RIGALES, MD, is a graduate of the University of New Mexico School of Medicine. He completed his residency at the Salinas Family Practice Residency Program in Salinas, California. He is fluent in Spanish. Dr. Rigales joins LFMC from La Clinica de Familia Community Health Center in Las Cruces. He is a native New Mexican, married with two boys and enjoys spending time outdoors with family.

FEN SARTORIUS, MD, graduated from McGill University in Montreal, Canada, and completed his residency in family practice at the University of New Mexico. He has a Certificate of Added Qualifications in geriatrics and facilitates the geriatric curriculum for family practice residents. He is in private practice in Santa Fe.

JUSTINA TROTT, MD, is a graduate of the University of Pennsylvania. She is a board certified internist specializing in women’s health. As Director of Women’s Health services Family Care and Counseling Center in Santa Fe, she provides a required specialty rotation to the family practice residents. In addition, she facilitates a regularly scheduled ongoing support group for the PGY II & III family practice residents. Dr. Trott is an active participant in the curriculum and training experience for the Family Practice residents.

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Mario Pacheco, MD
Program Director
St. Vincent Regional Medical Center
455 St. Michael’s Drive
Santa Fe, NM 87505
Phone: 505-995-3985
Fax: 505-820-5813
email: mario.pacheco@stvin.org

Deborah Weiss, MPH
Program Coordinator
St. Vincent Regional Medical Center
455 St. Michael’s Drive
Santa Fe, NM 87505
Phone: 505-820-5596
Fax: 505-820-5813
email: deborah.weiss@stvin.org

Rose Gonzales
Program Assistant
St. Vincent Regional Medical Center
455 St. Michael’s Drive
Santa Fe, NM 87505
Phone: 505-820-5695
Fax: 505-820-5813
email: rose.gonzales@stvin.org

Updated: November 10, 2006