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
Second year residents spend two to four half days each week in the Family Medicine Center. Residents at this level provide continuing care to a larger number of families than first year residents and have a greater degree of responsibility. Residents are encouraged to coordinate all of the health needs of their patients with the assistance of team nurses and under the supervision of family medicine faculty members. During the second year, each resident is assigned approximately 200-250 patients for continuing care and aim to experience at least 700 outpatient encounters. Second year residents share after hours and weekend call for Family Medicine Center patients. Residents may also become involved with the delivery of sports medicine services to local high schools and colleges.
Inpatient Medicine - eight weeks
The inpatient medicine rotation for second year residents takes place at Sky Lakes Medical Center. The second year residents supervise and assist the first year residents on the medicine service in delivering inpatient care. Residents will develop their proficiency and efficiency in managing complex patients and become leaders of the inpatient team, running teaching rounds and prioritizing admissions. As previously, our ICU is open, so we care for all levels of care while on this rotation.
Maternal Child Health - eight weeks
The maternal child health rotations take place in Klamath Falls at Sky Lakes Medical Center. The emphasis is on care of low and high-risk patients and continuation of experience in the first year. Additionally, residents follow the neonates at the Family Birthing Center. Second and third year residents help organize teaching experiences and supervise sign-outs.
Pediatrics - four weeks
The pediatric rotation provides experience and instructions in both inpatient and outpatient pediatrics, including the assessment and management of children with a wide variety of pediatric problems, supervised by community pediatricians. Opportunities exist for residents to do puberty teaching talks in local elementary schools. Residents participate in admissions, inpatient rounding and seeing patients in the emergency department.
Geriatrics - four weeks
The geriatrics rotation occupies four weeks in the second year curriculum. Residents work in a Post-Acute Care/Skilled Nursing Facility in Klamath Falls under the supervision of family medicine faculty and internal medicine faculty. The rotation emphasizes management of geriatric issues in post-acute care, wound care, and principles of ambulatory care of older adults.
Behavioral Health - longitudinal
This 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 both emergency medicine and family medicine staff the emergency room. Residents are encouraged to see the full breadth of emergency care, further their procedural training and use their Point of Care Ultrasound skills.
ICU - four weeks
The critical care rotation is four weeks in length and takes place in either Bend, Oregon, or in Klamath Falls. The rotation includes procedural training and supplements the learning we already receive while caring for ICU patients on the inpatient medicine team. The emphasis is on cardiology and pulmonary medicine. This is a busy rotation for trauma and critical care, as the Bend hospital performs cardiothoracic surgery and neurosurgery. Residents are supervised by a team of pulmonologist/intensivists. Housing is provided in Bend.
Frontier Medicine - 5 weeks
This five-week rotation takes place in one of four small communities in Oregon—Burns, Enterprise, Lakeview, or John Day. Residents work in a practice with family physicians and experience not just rural, but frontier primary care first hand. The program provides housing and travel expenses. Residents have the opportunity to staff the ER, provide surgical maternity care, and work in the clinic as well. Rural primary care and scope of practice is a continuum and on this highly-rated rotations residents get to ask themselves, “How rural do I want to practice?”
Elective - four weeks
The purpose of the elective blocks is to allow a resident to augment his or her education with an individualized plan developed by each resident and his or her advisor. Electives in the second year must take place in Klamath Falls but can include a wide variety of experiences. Residents are encouraged to use the time to further their learning in an area of need or to pursue one of their areas of passion in healthcare.