A magazine for friends of the Warren Alpert Medical School of Brown University.

Family Medicine’s New Frontier

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A combined residency program and major telehealth grant better prepare doctors for the future.

After six years of courtship, Brown’s family medicine residency programs in Pawtucket and Warwick, RI, officially tied the knot last year.

“It’s been a marriage made in heaven,” Chair of Family Medicine Jeffrey Borkan, MD, PhD, says of the unified program. The 48 family medicine residents train at safety-net clinics, academic centers, and community hospitals across the state, caring for vulnerable populations.

The programs first collaborated in 2014, when Borkan and residency directors facilitated a “matchmaking” between Kent Hospital, which sponsored the Warwick residency, and the new Thundermist Health Center for outpatient training. Things got serious four years later when Memorial Hospital in Pawtucket shut its doors and Kent became the sponsoring institution for both residency programs.

Fadya El Rayess F’07, MD, MPH, director of the Pawtucket residency, now leads the combined program. “We actually had a lot in common,” she says. “Both residencies were geared toward providing residents with the broad clinical and procedural skillset needed to provide excellent care for underserved communities.”

Both sites offer “cradle-to-grave” care, El Rayess says, including medication assisted treatment (MAT) and transgender care. Angela Jacavone RES’21, DO, chief resident in Warwick, says they learn reproductive health, dermatologic, and orthopedic procedures, as well as osteopathic manipulative treatment at her site. “That ability to really hone in on what you’re interested in and [program leaders]being so open to what you want to do is really valuable,” she says.

Pawtucket chief resident Katrina Roi MD’18 RES’21 says her site’s interns now rotate at Kent, in addition to The Miriam, Hasbro Children’s, and Women & Infants hospitals. “We are getting training that will help us succeed in a broad range of settings after graduation, wherever we end up,” she says.

The pandemic jump-started another longtime department goal. Last year it received a $2.4 million award from the Health Resources and Services Administration to develop telemedicine to address the opioid crisis using MAT and expand care for underserved communities.

“We anticipated rolling it out really slowly,” Borkan says. “Then the COVID pandemic hit and we learned how to do telemedicine on the fly.”

“All of our second- and third-year residents became quite adept at providing [telemedicine]to patients,” adds El Rayess, who is leading the five-year project. “We had a huge impact on the community we serve in terms of providing outreach and keeping people safe at home.”

For the project’s rural component, Brown is collaborating with Mount Desert Island Hospital in Maine, which uses telemedicine to reach the large geographic area it serves. El Rayess says the Maine team already provides virtual MAT for their patients and will help train Brown residents in rural medicine.

“This is one of the top family medicine residencies in the country, and the HRSA grant is designed to encourage innovation,” Borkan says. “It will help us transform and adapt to meet current and future
challenges together.”

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