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Program Coordinator

Teri Yaeger
101 W. 8th Ave.
Spokane, WA 99204
P (509) 474-3237
F (509) 626-9917

There are 13 four-week rotations each year.  R1s start one week before seniors, so there is always  contintuity of patient care.

R-1

General House staff
4 weeks (6 days/wk)

In-pt Cardiology
1 week (5 days/wk)

Medical ICU
1 week (6 day/wk)

Nights-Medical ICU
1 week (5 nights/wk)

In-pt Gastroenterology
1 week (5 days/wk)

Emergency Medicine
1 week (20 shifts/rotation)

Night Shift
1 week (5 nights/wk)

Ambulatory (continuity clinic)
1 week (5 days/wk)

Out-pt Dermatology
½ - 1 week (5 days/wk)

Subspecialty Elective (such as out-pt neuro, ENT, Ophtho, GYN, Radiology, Phys Med & Rehab
1 – 1-1/2 week (5 days/wk)

Continuity Clinic (not on ICU, ICU nights or house staff nights)
On-going (½ day/week)

r-2

General House staff
1-1/2 weeks (6 days/wk)

Hospitalist Consult Service
½ week (5 days/wk)

Medical ICU
1 week (6 day/wk)

Out-pt Cardiology
1 week (5 days/wk)

In-pt Neurology
1 week (5 days/wk)

In-pt Psychiatry Consult Service
½ week (5 days/wk)

Night Shift
1 week (5 nights/wk)

Ambulatory (continuity clinic)
1 week (5 days/wk)

Out-pt clinic with community internist
½ week (5 days/wk)

Endocrinology
1 week (5 days/wk)

Infectious Disease
1 week (5 days/wk)

Geriatrics
1 week (5 days/wk)

Systems of Medicine
1/2 week (5 days/wk)

Subspecialty Elective (such as out-pt neuro, ENT, Ophtho, GYN,  Radiology, Phys Med & Rehab, Palliative Care)
1-1/2 week (5 days/wk)

Continuity Clinic (Except for ICU, Nights and House staff)
On-going (1 day/wk)

R-3

General House staff
2 weeks (6 days/wk)

DMC in-pt Pulm
1 week (6 days/wk)

Medical ICU
1 week (6 day/wk)

In-pt Cardiology
1 week (5 days/wk)

Hospitalist Service
1 week (Shifts modeling hospitalist sched)

Night Shift
1 week (5 nights/wk)

Ambulatory (continuity clinic)
1 week (5 days/wk)

Nephrology Consult
1 week (5 days/wk)

Hematology/Oncology
1 week (5 days/wk)

Out-pt Pulmonology
1 week (5 days/wk)

Out-pt Rheumatology
1 week (5 days/wk)

Subspecialty Elective (such as ENT, Ophtho, GYN,  Radiology, Phys Med & Rehab, Palliative Care)
1 week (5 days/wk)

Continuity Clinic (Except for ICU, Nights and House staff)
On going (1 day/wk)

General Medicine [R1, R2, R3 years]

The in-patient ward service comprised of two interns, one senior resident, medical students, pharmacy students/residents/attending and a single faculty attending occurs at Providence Sacred Heart Medical Center. Patients come from emergency room admissions, our residency clinic and transfers from rural community hospitals.

  • We provide care for the majority of poor and underserved patients in our region
  • The breadth of disease is extraordinary with many complex patients that allows for development of triage skills, differential diagnosis and generation and practice in cost conscious medicine
  • These are 6 day rotations, working M-F and either Saturday or Sunday

Purple Team [R1s, R2s]

This team consists of one R2, one intern, one medical student and one faculty attending.   While patient care remains a cornerstone, the team was created to develop the teaching and leadership skills of a new senior resident.

Subspecialties

Cardiology [R1, R2, R3 years]

An active contingent of cardiologists and cardiothoracic surgeons has made Spokane a prominent center for the diagnosis and treatment of cardiovascular disease.  Residents work with one of several teaching cardiology groups.

Gastroenterology [R1 year]

The R1 on this hospital rotation works one-on-one with a gastroenterologist seeing patients referred for consultation.  A broad spectrum of clinical GI problems is covered.  

Rheumatology

The rheumatology rotation occurs in an outpatient setting.  The resident is exposed to common rheumatologic diseases and often performs many diagnostic and therapeutic joint-based procedures.

Endocrinology

This outpatient rotation focuses on assisting residents with diagnosis of complex endocrine diseases.  The majority of the rotation is devoted to helping residents hone their skills in treatment of diabetes and thyroid disease.

Infectious Disease

This inpatient rotation is a consultative service.  The resident learns to perform a thorough physical exam with infectious etiologies in mind.  The resident also learns to communicate his/her conclusions to the referring physician succinctly.  Each resident physician leaves this service with a secure “framework” for choosing antibiotics.

Nephrology [R2 or R3 year]

Primarily an inpatient rotation.  The resident assists with admissions and consultations for critically ill patients.  The intricacies and indications for dialysis are explored.  Ongoing care of the chronic kidney disease patient from an internist’s perspective is an important aspect of this rotation.

Oncology/Hematology [R2 or R3 year]

Primarily an office based rotation.  This rotation explores the diagnosis and treatment of common oncologic and hematologic diseases.  The resident works with all aspects of the care team to provide care – nursing, social workers, pharmacists, oncologists and radiation oncologists.

Neurology – [R1, R2 or R3]

Each resident completes 2 neurology rotations at least one of which occurs in the inpatient setting.

Dermatology [R1]

Residents are provided a framework for the diagnosis of skin disease.  Common outpatient dermatologic procedures are taught and performed.

Systems of Medicine [SOM] [R2]

This is a 2-week seminar in which senior residents expand their knowledge of patient safety and quality improvement as well as gain a more in-depth view of patient perspective through computerized modules, faculty-and-staff moderated discussion and didactics. 

Outpatient Pulmonology [R2 or R3]

The resident provides consultation for a variety of pulmonary diseases as well as ongoing care for the most difficult to treat pulmonary problems. Residents will develop continuing skills in interpreting PFTs. An introduction to Sleep Medicine is also included.

Inpatient Pulmonary [R3]

Occurring at Deaconess Hospital, this rotation assists the senior residents to consult on the most critically ill patients. The senior resident leads a team of interns and supervision is provided by intensivists and Pulmonary/Critical care physicians.

Medicine B [R1]

Occurring at Deaconess Hospital, this rotation provides additional inpatient experience for the intern. The traditional team model, interns, senior resident and attending is used. The intern will work in the ICU and on the inpatient wards.

Inpatient Psychiatry Consultation [R2]

Psychiatric diseases are a common internal medicine problem. This rotation assists the resident to provide consultation for hospitalized patients.

Emergency Medicine [R1 year]

Emergency medicine training is completed at Providence Sacred Heart Medical Center [PSHMC] under the supervision of board certified emergency physicians.  The training exposes residents to a wide variety of common acute general medical problems, as well as experience in managing patients with multi-system problems that arrive at this Level II Trauma hospital.

Hospitalist Rotation [R3 year]

During this 4-week exposure to hospitalist medicine, senior residents work directly with an attending Faculty Hospitalist. With supervision, the resident is the primary physician for a team of approximately 10 hospitalized patients with varied medical problems; they often work with subspecialty consultants and gain skills in interprovider communication and coordination of care. Residents are also exposed to various systems of medicine including value-based purchasing and hospital billing. The fast pace of this rotation helps residents work on organization and efficiency.   

The schedule is designed to mimic a typical hospitalist schedule:

Week 1: Monday—IMR clinic; Tues-Sun—Hospitalist Service 7AM-7PM

Week 2: Monday—Hospitalist Service; Tues—AM IMR clinic; Wed-Sun—OFF

Week 3: Monday—IMR clinic; Tues-Sun—Hospitalist Service 7AM-7PM

Week 4: Monday—Hospitalist Service; Tues—AM IMR clinic; Wed-Sun--OFF

Consult Medicine[R2 year]

This experience with the Faculty Hospitalist service designed to enable residents to become more familiar with the role and function of hospitalist physicians as consultants.  The rotation focuses on preoperative evaluation and risk assessment and covers a number of topics related to the medical co-management of patients and peri/post-operative care. Read more…

This is a 5-day per week rotation with continuity clinic on Mondays. A checklist is given to the residents as they rotate through the consult attendings to ensure adequate coverage of pertinent topics, such as.

  • Congestive heart failure
  • Coronary artery disease
  • Diabetes Mellitus (insulin and oral agents)
  • Valvular heart disease (particularly aortic and mitral stenosis)
  • COPD / Asthma
  • Bleeding diatheses
  • Anticoagulation
  • Appropriate DVT prophylaxis
  • Necessity of routine preoperative testing
  • Prevention and management of postoperative delirium
  • Evaluation of post op fever