Residents spend four months on inpatient obstetrics & gynecology rotations, principally working on the labor & delivery unit at Baylor Scott & White Medical Center - Hillcrest. Residents are supervised by both obstetricians and family physicians, and care for both low- and high-risk cases. All residents receive certification in Advanced Life Support in Obstetrics. Optional training towards achieving competency in performance of C-sections is also available.
Inpatient Adult Medicine
Residents spend eight months of training on the inpatient adult medicine and family medicine services caring for a broad scope of adult medical illness in the inpatient setting. By the end of PGY-1, residents are comfortable admitting and managing patients from the emergency department and participating in the management of patients in intensive care. By graduation, residents will each have cared for over 100-200 critically ill patients. They will have in-depth experience managing a wide variety of adult medical illnesses and performing the associated procedures necessary to facilitate such care. All family physician faculty have ICU privileges at both hospital training sites, and all of the adult patients needing critical care on the medicine services are cared for by residents and faculty attendings with specialist support as needed.
Inpatient Pediatric Medicine
Inpatient pediatrics includes low- and intermediate-level newborn care and care of the hospitalized child and adolescent. Residents develop proficiency in newborn examination, management of illness in the newborn period, and care of the sick neonate. Additionally, residents care for an array of illness that commonly occur in children and develop skill in managing the social and parental dilemmas that accompany those illnesses. Procedural experience including circumcision training and lumbar puncture is also incorporated. There are five and a half months of inpatient pediatrics; both family physician and pediatrician attendings supervise.
Emergency Care - Adult & Pedi
The emergency care rotation includes four-weeks of general emergency care training at Providence Health Center and two weeks of dedicated pediatric ED care at Hillcrest. The goal of the emergency care rotation is to help prepare the resident to care for patients of all ages with acute episodic illness, acute traumatic injuries, and the emergent presentation of serious and life threatening illness and injury. This rotation facilitates the development of procedural skills germane to the practice of full spectrum family medicine including (but not limited to) laceration repair, lumbar puncture, acute fracture management, intubation and central line placement.
Family physicians routinely perform preoperative evaluations, manage medical problems in the perioperative period, and address complications of surgery. In addition, they frequently assist with major surgeries and in some settings, perform them. Residents spend one month learning the fundamentals of general surgery and lower endoscopy. The goal of the surgery rotation is to prepare resident physicians to care for patients in the preoperative and postoperative settings, and to develop the surgical skills needed in full-spectrum family medicine. Additional optional training towards developing competency in performing uncomplicated surgical procedures and colonoscopy is also available.
Behavioral Health Consultation Clinic
Problematic health-related behaviors and mental illness are ubiquitous in ambulatory and inpatient medicine. Our program challenges residents to become experts at recognizing mental illness, optimizing treatment plans, and promoting mental health. Much of the training in behavioral health occurs during a four-week rotation during the first year of residency. The rotation is overseen by a clinical psychologist who is fellowship trained in primary care psychology.
Inpatient Family Medicine
The inpatient family medicine rotation is an exclusively upper-level service that develops efficiency, autonomy and advanced medical decision making. In this rotation, second and third year residents manage an integrated inpatient service that includes care for newborns, children, adolescents, adult and geriatric patients. Residents spend four months on the inpatient family medicine service at Providence Health Center.
Pulmonology & Critical Care
In addition to the ICU experience residents receive on the inpatient adult and family medicine services, they also spend one month during their second year on a pulmonary medicine & critical care rotation. The rotation includes extensive ICU/CCU experience caring for around 10-15 patients per day. During this rotation, residents also learn key procedures for critically ill patients and advance their understanding and ability to manage a mechanical ventilator.
Residents spend four inpatient weeks working closely with practicing cardiologists caring for patients with a variety of cardiovascular diseases. Beyond contemporary management of myocardial infarctions, arrhythmias, heart failure and hypertensive emergencies, residents also gain understanding of cardiovascular imaging, nuclear stress testing, echocardiography, treadmill stress testing and arrhythmia monitoring.
Orthopedics & Sports Medicine
Residents spend two months in the outpatient orthopedics and sports medicine rotation. Additional optional sports medicine experience is also offered including Saturday football season walk-in clinics, staffing of local high school football games and other local sporting events such as rodeos, performance of pre-participation sports physicals and the opportunity to work alongside sports medicine physicians at Baylor University athletic events. Longitudinal training is provided in the form of regular casting and musculoskeletal exam workshops along with training in ultrasound guided injections. Collaborative training with our Sports Medicine fellowship enhances the experience.
In addition to the inpatient experiences caring for the surgical problems of non-pregnant women on the Obstetrics & Gynecology rotation, residents spend two weeks managing ambulatory gynecologic problems. This rotation occurs in a women’s health facility and is supervised by faculty obstetrician/gynecologists.
Educational research demonstrates that participation in a rural rotation during residency is associated with advantages following training, including greater familiarity with community health resources, participation in health activities of the community, and physician assimilation into the community. The third year rural rotation is a two week experience at a clinic in the town of McGregor, Texas, population ~ 5,000, located 15 minutes west of Waco.
Besides a longitudinal component, a two-week dedicated geriatrics rotation is provided in the third year of training. This rotation includes supervised home and long-term care facility visits. The rotation focuses on the fundamentals of geriatric care and also examines the importance of hospice and palliative care in contemporary medical practice. The supervising family medicine faculty is the medical director for a large skilled nursing facility and has specialized training in hospice and palliative medicine.
Ophthalmology / Otolaryngology / Urology
Residents spend four weeks in the ophthalmology and ambulatory surgical specialty setting adding to their knowledge of ophthalmology, otolaryngology and urology. Because residents have cared for patients in their own continuity clinics in both their first and second years of training, by the time they reach this rotation, they will have some proficiency in diagnosing and managing several of the pertinent entities in each of these domains. As such, this rotation offers an opportunity for residents to refine their knowledge and skills while working with ophthalmologists, otolaryngologists and urologists. An additional training for vasectomies is available.