The Waco Family Medicine Residency Program offers extensive inpatient and outpatient procedural training with the option of additional training in special procedures to gain competence.  Examples of standard procedures include:

POCUS (Point of Care Ultrasound)

Every PGY-1 resident receives a SonoSim training unit for self-paced training through the first year.  This training is suplemented by targeted, practical workshops.

Inpatient adult medicine

  • central line placement (subclavian, internal jugular, & femoral — with ultrasound guidance as indicated)
  • rapid sequence intubation
  • ventilator management
  • lumbar puncture
  • paracentesis
  • thoracentesis, chest tube placement
  • arterial line placement
  • cardiopulmonary resuscitation

Inpatient pediatrics

  • lumbar puncture, neonates & children
  • endotracheal intubation in newborns
  • newborn resuscitation (including bag-valve-mask ventilation)
  • newborn circumcision

Maternity care

  • non-stress tests
  • limited OB ultrasound
  • repair of perineal lacerations/episiotomy
  • spontaneous vaginal delivery & assisted vaginal delivery
  • induction and augmentation of labor (using various methods)
  • external fetal monitoring and internal monitor placement
  • assisting cesarean section

Residents routinely perform 80 vaginal deliveries as a baseline, with much higher numbers achieved when desired. Optional training in gaining caesarean section competency is available.  A high-low OB track, offered in the PGY-2 and PGY-3 years, facilitates this training.

Outpatient procedures

  • dermatologic: incision & drainage of abscesses, suturing of lacerations, skin biopsies, lesion removal/destruction, toenail removal, lipoma or cyst removal
  • flexible sigmoidoscopy/colonoscopy (sufficient numbers for privileges upon graduation)
  • gynecologic: colposcopy, cervical biopsy and endocervical curettage, endometrial biopsy, IUD placement, microscopic diagnosis of vaginal smears, Nexplanon insertion/removal
  • musculoskeletal:  joint injection/aspiration, casting

Outpatient procedures are incorporated longitudinally into resident clinic times, corresponding rotations and an optional one-month "Procedures" elective rotation.

In addition to the above experience, the program’s simulation laboratory training includes rapid-sequence intubation, mechanical ventilation and NRP, PALS, ALSO and ACLS protocols.  Optional ATLS certification is available.