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
- thoracentesis, chest tube placement
- arterial line placement
- cardiopulmonary resuscitation
- lumbar puncture, neonates & children
- endotracheal intubation in newborns
- newborn resuscitation (including bag-valve-mask ventilation)
- newborn circumcision
- 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.
- 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.