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: 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.