Spokane Residency Curriculum

Family Medicine -- A 4-week block rotation in year one focuses on introducing faculty, staff, and clinic logistics, practice management policies and procedures, review of basic clinical policies and procedures, and the opportunity to build a patient base. During year 2 and 3 this is two 4-week block rotations focusing on the ambulatory care setting. Residents participate in clinics conducted in the family practice center specifically geriatric assessment, gynecology, nutrition, and psychiatry clinics. Procedures, continuity of care, and practice management are also emphasized.

Cardiology -- Time is spent with a cardiology group consulting on inpatients at DMC, in the cardiac intensive care unit, and through step-down units to patient discharge. Outpatient cardiology is emphasized with experience in outpatient evaluation of heart disease and treadmill interpretation. FMS Medicine/chief call is taken during this rotation.

Electives -- This time may be used to pursue medical/surgical interests, research, to experience and gain skill in an outpatient specialty or experience an additional rural clerkship. Subject to faculty approval, electives have ranged from a managed care rotation, to a procedural month, to a subspecialty rotation.

Emergency Medicine -- The R1 is supervised by board certified emergency physicians at Providence Sacred Heart Medical Center (PSHMC), trauma center for the Inland Northwest. The resident completes eighteen shifts divided between Pediatric ER and Adult Acute Care ER areas, 1 day of continuity patient care in the FPC.  Board Certified Emergency Physicians at DMC supervise second year residents. The resident completes 15 ER shifts, one full day at the family practice center each week, and has 6 days off. Board Certified Emergency Physcians at DMC supervise second year residents.  The resident completes 18 ER shifts, one day at the family practice center each week and has 6 days off.

ENT/Dermatology -- The time on this rotation is in private physicians' offices learning to manage routine outpatient problems in ENT and Dermatology. There is no call with this rotation.

Family Medicine -- During the 9 weeks in the R2 and R3 years, the resident will gain experience in neurology with physicians at the VA; procedures such as vasectomy, colposcopy, LEEP, circumcision, lesion removal, specialty clinics such as Geriatrics, Nutrition, Psychiatry, and practice management.  Home visits and precepted nursing home visits are also scheduled during this rotation.

General Surgery -- On this block rotation (4-weeks as R1 and 4 weeks as R2) residents work with general surgeons. Emphasis includes inpatient management, OR assisting, postoperative care, and time spent in the attending surgeon’s office. Call is from home two nights each week and one weekend per four weeks.

Gynecology -- This aspect of the curriculum is taught longitudinally in the family practice center and with a focused rotation in a private ambulatory care setting, which includes some surgery and inpatient experience. Additional experience is gained during the Rural Clerkship, GYN clinic, and some electives.

ICU -- The ICU at SHMC is busy and provides a concentrated learning experience. The R1 functions on the team with an R1 from the Internal Medicine or Transitional Residency Program and a senior Internal Medicine resident. The ICU team is expected to attend all in-house cardiac arrests, as well as the usual ICU duties. 

Family Medicine Hospital Service -- This rotation occurs in the R1 (12 weeks), R2 (8 weeks) and R3 (8 weeks).  Each second and third year resident has the opportunity to serve as a chief resident, teach and supervise R1s. All admissions from the Family Practice Center are managed on this Hospital Service by a team consisting of 2 R1s, an R2 and an R3. There is a faculty member on call with the team for teaching and assistance. Daily rounds at SHMC and DMC are conducted with the FMS faculty member on call for the week. R1s are on call for 8 nights with a Senior and each Senior covers 6 nights.  Night call is taken from home.  Senior call for this Service from other rotations totals about 17 nights per year.

Medicine Subspecialty -- This 4-week rotation is primarily an oupatient experience with selected community sub specialists in nephrology, endocrinology and pulmonary medicine. Resident is available to take Family Medicine Hospital call from home. 

Obstetrics -- One of the strong components of our curriculum is obstetrics. Emphasis is placed on the management of low risk labor and delivery during the R1 year. Patients are primarily private patients of family physicians and obstetricians at Deaconess and Sacred Heart Medical Centers. Under the supervision of the attending physician, the resident actively participates in admitting patients to labor and delivery, being available for deliveries, and assisting senior residents in managing high-risk patients. Each resident is involved with approximately 60 to 80 deliveries per year. Didactic lectures occur regularly during the week. Working closely with private obstetricians and perinatologists, senior residents manage pre-term labor, pregnancy induced hypertension, pre-eclampsia, etc. Emphasis is hands-on experience with operative obstetrics, including C-sections and tubal ligations. The senior residents supervise the R1s and provide hands-on education.

Ophthalmology -- This outpatient experience emphasizes evaluation and management of outpatient problems in the office setting.

Orthopedics -- Supervised by orthopedists, emphasis is placed on fracture care, pediatric problems, evaluations, sprains, strains, sports medicine, and physical therapy. The resident also attends the FMS Orthopedic Clinic. Call is taken from home with the attending orthopedists and averages every 4th night.  Sports Medicine experience is gained at Champion Sports Medicine, trainers and physicians with Gonzaga and Whitworth Universities and Rogers High School and as team physicians with the Spokane Indians baseball team.  Additionally, residents are required to participate in preparticipation physical exams with Whitworth University, Spokane Indians baseball team, and other local schools.

Pediatrics -- Inpatient Pediatrics training takes place at Providence Sacred Heart Medical Center, which serves as the pediatric referral center for the Inland Northwest. The pediatrics' team is composed of five FMS residents and one to two medical students. Rounds are teaching and guidance in managing critically ill children. Didactics are provided daily by the pediatric hospitalists and guest speakers. Call averages every fifth night in-house. The Outpatient Pediatric experiences utilizes a busy pediatric office for acute and scheduled visits. Additional time is spent in a developmental assessment clinic, specialty clinics at Providence Sacred Heart Children's and Shriner's Hospitals.  Call consists of rotating through the coverage of the FMS Hospital Service, which is home call. 

Podiatry – Emphasis is placed on assessment and hands-on treatment of plantar fascitis, bunions, corns, toenail problems, orthotics, flat feet, and shoe recommendations during time spent in a Podiatrist's office and the Podiatry Clinic at the family medicine center.

Rural Clerkship -- To stimulate interest and acquaint residents with the medical needs of rural communities, R2s complete a rotation at the Rural Training Track site in Colville or in rural Goldendale, Washington. Call depends on the individual site, but averages every fourth night. This rotation may be used by R3s to gain further rural experience, and is often used to preview a future practice site. Rural location of this rotation is dependent on faculty approval.

Sports Medicine – Includes evaluation and diagnostic teaching, athletic physicals, and developing management skills for acute and chronic sports injuries. Time is spent with the team physicians and trainers for Gonzaga University, Whitworth University and Rogers High School and participation as team physicians for the professional hockey and baseball teams in the community enhances this educational component of the curriculum.

Urology -- This one-week focused experience is to develop skill in managing routine outpatient problems.

Last Updated Sunday, July 17 2011 @ 05:03 PM PDT|783 Hits