Family Medicine Clinic
The integration of continuous, comprehensive patient centered care is paramount to future primary care based health care for our nation and is a cornerstone of this program. With a focus on comprehensive physical exams taught by faculty with a combined 80 years of primary care experience residents will gain superb experience in the family medicine clinic. Throughout intern year residents will spend a minimum of one session per week in the FMC, including a full week during the GYN & Community Health rotations. Residents will begin this rotation building a foundation in clinic logistics; practice management policies and procedures; while also reviewing basic clinical policies and procedures; and build a patient base. Residents concentrate on continuity of care running an inpatient medicine service and gain experience in procedures such as vasectomy, LEEP, circumcision and lesion removal; specialty clinics such as “Emerge” a multi-specialty substance abuse in pregnancy program, geriatrics, nutrition, psychiatry, gynecology, podiatry, orthopedics, pediatrics and adolescent care; and practice management.
Inpatient Adult Medicine
This rotation provides residents with the opportunity to follow clinic patients to the hospital on a family medicine service. Residents on this rotation see a diverse adult patient population from across the region. Residents receive general internal medicine experience throughout the three years and manage patient care throughout the hospital; including post-operative patients, ICU, oncology patients and patients needing end of life care. As interns, residents develop a solid understanding of the management of the hospitalized patient and participate in code calls for both adults and newborns. During the second year they solidify skills in advanced medical management, critical care and enhanced procedural skills. During the R3 year each resident serves as the team leader on the inpatient service.
Pediatric training consists of treating pediatric patients in both inpatient and outpatient settings throughout all three years. Inpatient pediatric medicine is conducted at Providence Sacred Heart Children’s Hospital located in nearby Spokane, Washington where residents have the opportunity to work with Pediatric hospitalists. This portion of the program emphasizes recognizing and responding to signs and symptoms of serious and frequent childhood illnesses. There is additional training on developing treatment plans with both the patient and the parents. Because of the large patient volume, and ability to work in coordination with the Spokane residents, many find the pediatric curriculum one of the strong points of the program.
Obstetrical care is a fundamental aspect of our residency training, with a total of 6 months over the three years, and includes working with active obstetricians & certified nurse midwives; as well as seeing patients longitudinally in the Family Medicine Clinic. Residents participate in NICU rounds and actively care for newborns under the care of a fulltime neonatologist. The Kootenai Health Birthing Center averages 130 deliveries per month and residents are involved in all aspects of low and high-risk OB care, including opportunities to work in the NICU. The gynecology curriculum is taught in a variety of care settings, including the Family Medicine Residency center, the Kootenai Health Family Birth Center, and other locations that partner with the residency.
Kootenai Health provides training on a wide range of surgical procedures in a modern state-of-the-art facility. The OR at Kootenai is busy with well over 6,000 surgeries each year. The residency program emphasizes medical knowledge, competence in surgical decision-making, principles of pre & post-operative care and development of intraoperative surgical skill; through assisting in both OR experiences and surgical clinics. Residents are paired with community general surgeons for this one-on-one training and partake in eight weeks of surgical rotations. Residents receive hands-on experience in a variety of surgical settings including general surgery in PGY1 & PGY2 and otolaryngology, ophthalmology and urology during PGY3.
Behavioral medicine plays a significant role in many family physicians’ practices; because of this behavioral and mental health education are integrated throughout all three years of training. Working closely with an onsite Psychiatrist, residents can discuss cases, refer and follow up with patients in the family medicine clinic; while learning to identify at-risk individuals and families to make interventions to prevent future problems. This onsite coordination leads to effective doctor-patient communication, enhances compassionate care and provides accurate diagnosis and treatment of psychiatric disorders in the primary care setting. The behavioral and social aspects of health and disease are always emphasized.
Two months are dedicated to emergency medicine in PGY1 & PGY2. The rotation is spent in hospital ED gaining a variety of hands-on experience relating to typical medical emergencies as well as triage. In addition to these experiences, residents will participate in workshops on emergency skills, learn core didactic materials, and complete ACLS, PALS, and NRP during their residency.
The adult critical care rotation takes place at the hospital where residents are supervised directly by Critical Care Intensivists in managing and caring for a variety of critically ill patients and exposed to a variety of illnesses and pathology. During this one month rotation residents will develop and refine their procedure skills, as well as increase their knowledge and competence in treating the critically ill patient.
All residents will spend time in rural Idaho to experience practicing full-spectrum family medicine in a small community.
The Community Health Curriculum represents a strong commitment to community medicine and training, with particular attention to cultural & economic diversity with all of its nuances. Components this rotation includes introduction to integrative models of care and healing, wilderness medicine and survival skills, environmental medicine, occupational medicine, nutrition, motivational interviewing techniques, health promotion, disease prevention, as well as introduction to public health care delivery systems. During the Community Medicine block rotations, the residents will attend didactic lectures and work with physicians, a wide-range of health and medical professionals, public health department personnel, and other residents and in a variety of local community settings in rural Idaho. As part of this rotation, subject matter and exercises geared toward enhancing gender and cultural sensitivity and awareness will be utilized which strongly align with the overall behavioral science curriculum.
Orthopedics and Sports Medicine
Because Kootenai Health is located in an active community, orthopedics and sports medicine are fundamental parts of our residency. Residents will receive all-inclusive training and acquire detailed exam skills, x-ray interpretation, surgical management, and casting techniques. Residents are paired with competent and experienced orthopedic and sports medicine staff.