Procedures

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.