Orientation

Our interns spend two weeks getting acquainted with one another, faculty members, hospital staff and community preceptors. A structured program is presented with emphasis on Family Medicine concepts and practical tools to succeed in residency. New residents are introduced to clinic teams, trained in the electronic health record, assessed for learning styles and learn pearls from fellow residents. Our paid two-week orientation period includes ACLS and NRP training.

Balanced Family Medicine

Cascades East Family Medicine Residency has embraced comprehensive family medicine education through a modified “Clinic First” model. We believe that continuity of care is the core of what we do and have shifted our educational structure to emphasize the importance of continuity clinic throughout residency. We are also comprehensivists who train for the broad scope of practice needed to meet the needs of rural communities. To this end, we have named our new curriculum, ‘Balanced Family Medicine’ to honor these values. Inpatient rotations are limited to two weeks at a time and clinic weeks and longitudinal experiences are interspersed throughout the mini-block (2 week) model.

Family Medicine Clinic - longitudinal

Residents in the first year of training participate in longitudinal care of patients in the Family Medicine Center during clinic weeks and also during continuity clinics interspersed with other learning. Experiences involve patient care and orientation toward quality care in primary care. Instruction by full and part-time family medicine faculty from the community helps residents develop skills in the evaluation and management of a variety of health problems. Instruction in patient care emphasizes disease prevention, health maintenance, utilization of community resources and management of the emotional aspects of patient care, panel management, with special attention to the appropriate use of consultants. During the first year, each resident will be responsible for the ongoing care of approximately 100 patients, and must have at least 150 patient encounters over the year.

Inpatient Medicine - 16 weeks

First year residents spend have eight 2-week blocks on their inpatient medicine service at Sky Lakes Medical Center in Klamath Falls.

Our patients are admitted either from the emergency room or directly from clinic. We are responsible for Cascades East patients, several area primary care clinic patients and any patients without admitting physicians in the area. There are multiple admissions per day and this includes ICU admissions and care.

Residents have responsibility for the in-hospital and longitudinal care of these patients under the supervision of family medicine and internal medicine faculty. The first year residents work as part of a team along with a second or third year resident on the Resident Medical Team.

Maternal Child Health - eight weeks

First year residents spend 8 weeks in maternal-child health training with an emphasis on low risk obstetrics, but with significant high risk obstetrical involvement, as well. We manage patients with the supervision of faculty and community providers, including family physicians and OB-GYNs.  We deliver between 60-70 babies each month, with residents leading almost every delivery. 

Orthopedics - longitudinal

Our structured exposure to orthopedics includes one block with the orthopods in the first year and another focusing on sports medicine in the third year. The first year rotation emphasizes outpatient management of common office problems and fracture care. Sports medicine experience and operative orthopedics are also part of this rotation. In addition, we have a specialty teaching from an experienced orthodpedist for orthopedic problems in the family medicine center.

Behavioral Health- longitudinal

This longitudinal rotation occurs during all three years and provides education in the integration of behavioral health and primary care. Included in the series is experience with our behavioral health providers in warm hand-offs, health and behavioral interventions, specialty mental health care with a psychiatrist in the community, and time with other mental health and behavioral health providers in the community. Home visits, video precepting, and aspects of community health are also integrated into this experience. Our behavioral health faculty also facilitates a focus on provider wellness, recognizing that this is integral to our role as healers.

Emergency Medicine - longitudinal

Sky Lakes Medical Center in Klamath Falls has a busy emergency department, with over 26,000 outpatient visits per year. Experienced emergency room physicians boarded in emergency medicine staff the emergency department. This rotation focuses on learning to assess emergency department patients and basic skills such as suturing, care of fractures, management of major and minor trauma and psychiatric emergencies.

Inpatient Pediatrics - four weeks

This pediatric rotation takes place at Doernbecher Children's Hospital at OHSU in Portland, Oregon. The emphasis is on the assessment and management of primary care pediatric problems that will be encountered in a hospital setting. The strong teaching environment of Doernbecher provides an excellent learning experience and the program provides housing for residents in Portland during this block.

Outpatient Pediatrics - four weeks

The pediatric rotation provides experience and instruction in the assessment and management of children with a wide variety of problems including acute infections, chronic debilitating diseases, disorders of growth and development, nutritional disorders, mental retardation and congenital malformations. Instruction is provided by community pediatricians in both inpatient and outpatient care. Considerable experience in well-child care is gained. Residents carry a pediatric pager and see emergency room pediatric patients and participate in admissions and round on patients in the hospital.

Gynecology - longitudinal

This rotation occurs under the supervision of obstetrician/gynecologists in Klamath Falls and also working with family physicians in setting emphasizing gynecological and reproductive health care. Residents participate in the evaluation of outpatients and performance of procedures such as endometrial biopsy and colposcopy. Reproductive health procedures and work in a public health clinic is also included.

NICU - three weeks

A three-week rotation in Neonatal Intensive Care takes place at the NICU in Medford, Oregon, under the direction of a board certified neonatologist who has a wealth of experience in academic teaching and care of ill and premature newborns. This experience prepares residents to stabilize and prepare infants for transport in isolated communities upon graduation.