Four weeks are spent working with local cardiologists in their outpatient clinics. Residents evaluate new patients and follow-up on prior consults. They have opportunities to observe and learn the interpretation of exercise and nuclear stress tests as well as echocardiograms. This serves a valuable opportunity for residents to hone their EKG interpretation skills. Through this rotation, residents gain a better understanding of acute and chronic cardiac conditions. The schedule is Monday-Friday with standard business hours and no call.

Residents in their R1 year spend one month at Providence Sacred Heart Medical Center, a Level 2 Trauma Center that serves a large portion of the Inland Northwest. Residents complete 18 shifts divided between the pediatric and adult ERs, with one day per week of continuity patient care in the clinic. Second-year residents rotate at the nearby MultiCare Deaconess Hospital. There, residents complete 14 shifts in the adult ER with one day per week in clinic. During these rotations, residents learn how to stabilize acutely ill patients while gaining hands-on experience in procedures such as suturing, reducing fractures and dislocations, and intubations. The schedule is variable with the resident working several different shifts for varied experiences.

For two weeks during their R1 year, residents work with general surgeons in the community and at Sacred Heart Medical Center or MultiCare Deaconess Hospital. The focus is on preoperative assessment and management of postsurgical patients, assisting in the OR, postoperative care, and outpatient surgical management. The schedule is variable but is generally Monday-Friday with standard business hours and no call.

Residents learn about various models of care throughout their residency training. We have connections with community clinics to provide a wide range of experiences including care for unhoused, English as a second language, and Native American populations. This curriculum also includes 1:1 billing coaching, motivational interview training, leadership meetings, and group visit experience. Group visits are offered twice monthly to STHC patients interested in improving their wellness and offer an alternative way to provide care and education to patients.

Through a series of structured and longitudinal experiences, residents will have the opportunity to learn and perform POCUS in both the hospital and outpatient settings. Utilizing the program’s handheld portable ultrasound devices, residents can obtain and implement real time data while on rounds, in the STHC clinic or on the L&D floor.  FMRS also has a state of the art ultrasound machine at the STHC for even higher tech visualization which residents will become familiar with throughout their sports medicine rotations.

Residents rotate in obstetrics in all three years with an increasing level of responsibility. Interns are expected to complete two months of obstetrics. As seniors, they may choose to pursue an OB track, consisting of four months split between the R2 and R3 years. The minimum total OB requirement is four months. In addition to their own continuity patients, residents care for patients of community obstetricians and family physicians. Additionally, residents assist in caring for high risk patients of the OB hospitalists and perinatologists. Our OB fellowship serves to further support the experience. Call is shared either day or night on 12-hour shifts. All residents gain a robust experience in operative and non-operative obstetrics. Each resident is involved with approximately 60 to 80 deliveries per year.

Our program has a very strong inpatient medicine curriculum. Residents will gain experience working with the family medicine and internal medicine inpatient teams. The family medicine panel is mainly led by family medicine trained faculty. The panel admits our clinic patients from STHC as well as general admissions to keep a consistent census. There are two interns and two seniors during the day with one senior resident covering at night. Patients offer a range of complexity. We have a nurse coordinator for discharge planning.

Inpatient Pediatrics training takes place at Sacred Heart Children’s Hospital, which serves as the pediatric referral center for the Inland Northwest. Residents work directly with pediatric hospitalists for 8 weeks during their intern year and 4 weeks during their R2 year. The pediatrics’ team is composed primarily of family medicine residents. In addition to daily teaching rounds, didactics are provided during the rotation. Family medicine residents typically have one full day of continuity clinic each week. Each resident on the team will typically provide night coverage for 5-6 nights during each rotation. Outpatient pediatric experience is provided through pediatric clinic visits during the resident’s continuity clinic as well as 8 weeks of dedicated outpatient pediatric experience, 4 weeks each during the intern and R3 year. Time is dedicated to general outpatient pediatrics, with an emphasis on newborn rounding, developmental assessment, adolescent medicine, eating disorders, ADHD and learning disabilities.

A core element of the mission of Family Medicine Residency Spokane is to prepare graduates for practice in a broad range of clinical settings and locales.   The key benefits of requiring a rural training experience at our Colville Rural Training Track sites are to expose the resident physician to the unique demands and advantages of practice within rural communities as family physicians.   Our rural training sites expose our residents to role modeling by Family Physicians who provide not only an extensive range of primary, secondary emergency care, procedure and obstetrical skills, but also unique roles for involvement in the community and medical systems which are unique to rural practice.  During their R2 year, residents will spend a 4 week rotation at our Colville RTT site in Colville, WA,  where they will gain experience in rural hospital medicine, emergency medicine, obstetrics, and outpatient medicine.  There will also be ample opportunities to hone their procedural skills, performing clinic procedures that are a part of the typical clinic day of a rural family doctor. The schedule is variable with the resident working several different shifts for varied experiences.