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:  palpation & ultrasound-guided joint injection/aspiration, casting, splinting

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.

"I practice in a rural setting in a family practice that I own. In addition to clinic, I do inpatient care including ICU, obstetrics (including surgical obstetrics), as well as endoscopy. My training is owed to Waco Family Medicine Residency. Very supportive faculty and staff. My family had a great experience with great friends and a great church. If I had to do it all over again, I absolutely would choose Waco."
Mcclanahan Headshot
John McClanahan, DO
Class of 2011