FAMILY MEDICINE SERVICE

§        Admits 80% adult medicine patients and 20% OB and pediatrics patients. Lots of autonomy, excellent & supportive learning environment with residency faculty attendings and R3s acting as chiefs of service. Admit residency patients, patients of private providers, and co-admit with adult and pediatric hospitalists. Manage patients on the floor, telemetry and ICU. Consists of 2.5 months during intern year, 2 months during R2 year and 5 weeks as chief during R3 year.

§         Nightfloat call system with maximum 13 hour shifts. Five weeks nightfloat spread throughout R1 year, three weeks R2 year and two weeks R3 year. No 24 hour call.

OB/GYN

§          Priority of vaginal deliveries R1 year - you are never pulled out of a vaginal delivery for a C-section

§          OB fellows are in the hospital at all times for teaching and back-up with complicated L&D or antepartum management

§          Average 40-60 vaginal deliveries R1 year

§          15-40 Continuity deliveries R2 and R3 years (highest number for 45th street clinic residents)

§          Work with a panel of OB and FP docs who like teaching & working with residents

§          Advanced OB training option through OB Area of Concentration during R2-R3 years

§          ALSO (Advanced Life Support in OB ) training & certification R1 year

§          One month outpatient gynecology at Planned Parenthood during R2 year learning to insert IUDs and in-depth birth control and safer sex counseling

§          R3 gynecology month performing colposcopies and LEEPs under faculty supervision and rotating with community gynecologists

§          Opportunity to learn to perform elective terminations during R3 year

§          Nightfloat call system with three weeks nightfloat throughout R1 year and maximum 13 hour shifts.

PEDIATRICS

§          Four weeks of outpatient pediatrics during R1 year with board-certified pediatrician/hospitalist

§       Six weeks during R1 year at Seattle's Children's Hospital treating both general pediatrics and specialty cases

§    Two months in high-volume children’s ER at Mary Bridge Children's Hospital in Tacoma with supportive, resident-friendly environment during R2 year. Two weeks in intermediate-care newborn nursery (one level below NICU) and 4 weeks adolescent medicine during R2 year

§          Teen clinic for street youth at 45th Street Clinic during R2 and R3 year

§          Specialty training in managing ADHD

§         NALS (Neonatal Advanced Life Support) training/certification R2 year

§        Generally 10-20% of patients on the Family Practice Service are pediatric

CLINIC

§          1 month of clinic block during R1 and R2 years with 5 half days in clinic/week

§          R1 year 1 half-day/week

§          R2 year 2-4 half-days/week

§          R3 year 4-5 half-days/week

§     Training R1 year in Patient-Centered Interviewing including Agenda Setting, Patient Perspective on the Illness, Reaching Common Ground

§          Training R2 year in techniques of Motivational Interviewing

§         Co-visits with our staff psychiatrist a half-day/week at each clinic site for more complicated psychiatric patients

§         Co-visits and shadowing by staff psychologists a half-day/week at each clinic site with feedback on interviewing skills

Faculty Karen James and Pat Borman at curriculum retreat

BEHAVIORAL MEDICINE

§          2 weeks R2 year devoted to clinic counseling skills, including managing difficult patients, advanced motivational interviewing and brief cognitive behavioral therapy techniques for patients with depression and anxiety

§          Weekly Balint groups for each class

§          Training during Clinic Month R1/R2 year on Patient-Centered Interviewing, Agenda Setting, BATHE model

§          Co-visits with staff psychiatrist and psychologists for psychiatrically and behaviorally challenging clinic patients

EMERGENCY MEDICINE 

§          1 month during R1 year in Swedish ER focused on common ER presentations, management & procedures in a well-supervised setting.

§          Two months in high-volume children’s ER at Mary Bridge Children's Hospital in Tacoma with supportive, resident-friendly environment during R2 year

§          Optional elective during R3 year at Harborview Medical Center level one trauma unit

GERIATRICS

§          Continuity nursing home patients followed by R2 and R3s in team environment

§         A month in the R3 year is spent working in multidisciplinary settings focusing on geriatric population and their unique medical/social challenges. Outpatient experience at community based integrative geriatric programs focused on keeping patients living as independently as possible, working with our geriatric faculty at their clinics in nursing homes and assisted living programs, learning how to do full geriatric assessments in our clinics, opportunities to spend time on geriatric psychiatry service and palliative care.

§        Geriatrics Track designed for applicants with a special interest in geriatric medicine consisting 3 years family medicine residency and 4th year fellowship of in-depth training in geriatrics (2 residents each year selected through the Match)

SURGERY

§          During R1 year, two weeks are spent with surgeons who specialize in breast cancer. Spend time in their clinic learning about diagnosing breast CA, counseling patients, surgical follow up, and time spent in the OR assisting on procedures with focus on basic surgical skills.

§          During R2 year, two weeks are spent on the general surgery service at the main (First Hill) campus hospital.  R2s are paired with general surgery residents and work primarily in the hospital setting. Emphasis is on diagnosing general surgery problems and management of pre- and post-op patients.

COMMUNITY MEDICINE

§          During R2 year spend a month undertaking a variety of community medicine experiences, including outreach to the homeless community on the street and in shelters.

§          Participate in Head Start parent health education project focusing on East African population.

§          Participate in volunteer urgent care clinic for uninsured patients in low-income area of King County

§          Attend public health or governmental meetings.

§          Work in an occupational health clinic.

NEUROLOGY

§         R3 year work with consulting neurologists to hone clinical diagnostic and treatment skills

CARDIOLOGY

§          Inpatient and outpatient cardiology with dedicated cardiologist – 1:1, including visits to a rural site.

ELECTIVES

§          International rotation experience for up to 3 residents in their third year at pre-selected sites in Kenya, Nicaragua or Peru. New sites in development.

§          Rural rotations that you may create to fit your needs.

§       Pain elective, alternative medicine elective, sports medicine elective, eating disorders elective, pregnancy termination elective… pick what you want to do!

MULTISPECIALTY MONTHS

§        R3 year spend 2 months working with Rheumatology, Pulmonary, ENT, GI, Infectious Disease, Urology, Dermatology specialists in their clinics 1:1. Learn diagnostic and treatment skills pertinent to a family medicine practice.