Texas Institute for Graduate Medical Education and Research

Make a difference during your residency!

The Texas Institute of Graduate Medical Education and Research (TIGMER) is proud to announce the development of a new community-based family medicine residency program in San Antonio following the Teaching Health Center model. This program will allow residents to train on the front line of health care - providing service to those with the greates health care needs. This program is made possible through a partnership with CommuniCare Health Centers and The Center for Health Care Services.
CommuniCare is a Federally Qualified Health Care Center with over a dozen outpatient clinical sites in San Antonio and neighboring communities. They offer an array of services including pediatric medicine, family medicine, senior care, women's health, dental, behavioral health, minor surgery, and WIC services. Specialty services are offered at some locations in conjunction with our partners for vision care, hepatitis care and general surgery. CommuniCare provides integrated primary care delivered by highly-trained healthcare providers, utilizing state of the art diagnostic equipment and electronic health records.
The Center for Health Care Services (CHCS) is the community mental health center for Bexar county. Its mission is to improve the lives of people with mental health, developmental disabilities, and substance abuse challenges. CHCS has primary care and mental health care programs for children and adults and persons with intellectual disabilities. CHCS also provides crisis management and substance abuse treatment programs. 

More than a decade ago, Bexar County began implementing serious changes to care for the mentally ill and keep its citizens safe. The reforms expanded training for mental health and law enforcement professionals, established health treatment options and post-trial services, and importantly, focused on a collaborative approach that diverted mentally ill individuals to treatment instead of prison. As a result, overcrowded jails have been reduced in size, taxpayers’ dollars have been saved and lives have been changed for the better.

The CHCS Restoration Center  is an integrated mental health service center that is now the first stop for police when they have arrested someone who is mentally ill. The Restoration Center provides support to mentally ill offenders, such as substance abuse treatment programs and job training, to help them recover, and keep them from becoming “frequent fliers” through hospital emergency departments and the criminal justice system. The Center for Health Care Services also partners with nonprofits like Haven for Hope to reduce the broader causes of homelessness in the San Antonio community, giving individuals the hand they need to lead productive lives.

The new TIGMER Community-Based Family Medicine Residency Program is unique and innovative in its approach to training and patient care. Residents will incorporate training in primary care with a focus on mental health which is a major component of family medicine.

We take pride in the fact that this program will train residents to provide community-oriented, patient-focused, high-quality primary care. We focus on providing healthcare to underserved populations and improve access to medical treatment. We are adressing the needs of the community and see our model as part of the solution for improved community health - one patient at a time.

What is a Teaching Health Center?

Traditional residency programs are sponsored by hospitals and funded through Medicare payments to the hospitals. Hospital administrators are able to decide what residency positions to offer based on what will provide the greatest benefit for the hospital. As a result, there is in many regions, a shortage of primary care physicians and a surplus of specialty-trained dotors and no formal mechanism for the federal government to direct Medicare dollars to meet the healthcare needs of the community.

In 2010, the Teaching Health Center Graduate Medical Education (THCGME) program was established as a component of the Federal Patient Protection and Affordable Care Act (ACA). This program established a mechanism to fund primary care residency programs through Federally Qualified Healthcare Center and Rural Health Centers. These programs would focus on ambulatory primary care training for residents who would spend more of their time in the clinic setting providing services for underserved communities.

Residents still complete the required inpatient rotations at affiliated hospitals, but there is a primary focus on ambulatory care that is patient centered and community-based. Completion of a THCGME program prepares a resident for private practice or continued service to FQHCs where student loan repayment is often an attractive option.

The THCGME program was an unmitigated success. (See link to article below). Unfortunately, the federal appropriations for the program ran out in 2015 and congress is still debating how to continue funding this excellent program. In the mean-time, state and local funding sources have stepped up their efforts to continue funding residency training at Teaching Health Centers.

The TIGMER Community-Based Family Medicine Resisency Program is made possible through the Texas State GME Expansion Grant Program, a major grant from The Center for Health Care Services and support from CommuniCare and the University of the Incarnate Word School of Osteopathic Medicine.
TACHC Website
AATHC Website
AAFP Article
Academic Medicine Article