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

Third year residents spend three to five half-days each week in the Family Medicine Center. Each resident provides health care for his or her panel of patients. Patients also are treated for episodic illnesses as in a family physician's office. Third year residents have greater clinical judgment to know when they need assistance; however, faculty supervision is available in the center at all times. Chart auditing and patient safety conferences stimulate residents to review their own performance more closely. Patients in the Family Medicine Center who require admission into the hospital are admitted directly to the inpatient service.  Third year residents share after hours and weekend call for Family Medicine Center patients. During the third year, each resident's patient panel is approximately 300-350 individuals and the resident is responsible for reaching a total of 1800 outpatient encounters at the Family Medicine Center.

Electives - four blocks

The purpose of the elective blocks is to allow residents to augment their education with an individualized plan developed by each resident and his or her advisor. Elective rotations can occur in a variety of settings in Klamath Falls and beyond. Electives may also be used to augment cognitive or procedural skills, pursue areas of passion in medicine or for international medicine experiences.

Inpatient Medicine - 4-12 weeks

The inpatient medicine rotation for third year residents takes place at Sky Lakes Medical Center. The second and third 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.

Maternal Child Health- 0-8 weeks

This rotation is for MCH/OB track residents only as third years have the ability to tailor their education based on whether they intend to provide maternity care after graduation.

As third-year residents on MCH/obstetrics, have greater independence and involvement triaging and managing patients at the Family Birthing Center. Residents gain skills in both low and high risk obstetrics and assist on C-sections. Options for primary C-section training exist through our C-section pager program, through which recent residents have primaried more than 65 C-sections.

Surgery - 4 weeks

The surgery rotation takes place at Sky Lakes Medical Center in Klamath Falls. The emphasis is on learning minor outpatient surgical procedures, first assisting at major surgery and perioperative care. Three experienced general surgeons from the community supervise residents, on a one-to-one basis.

Subspecialties - longitudinal

Training in otolaryngology, urology, and ophthalmology occur in Klamath Falls in order to further residents' skills in recognizing, managing and coordinating primary care issues related to each of these fields.

Pediatric ER - 4 weeks

Another innovative rotation, we have residents stationed in our Sky Lakes ER with the goal of evaluating every pediatric patient in the ER and, between such cases, they are free to roam the ER, doing procedures or scanning one and all for practice in the Point of Care Ultrasound field.  

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.