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Family Medicine Residency Coordinator

Diane Borgwardt
624 E. Front Ave.
Spokane, WA 99202
P (509) 626-9951
F (509) 626-9920

It has been our privilege at Providence Northeast Washington Medical Group to have established the first Family Practice Rural Training Track site in the United States in 1986. The Colville Rural Training Track remains the longest running RTT in the United States. We appreciate and enjoy our close working relationship with Providence Family Medicine Spokane, and our affiliation with the WWAMI program of the University of Washington School of Medicine.

Since 1986 we have matched one resident each year to our “1-2” program, the first year of which is spent at Spokane Family Medicine, and the second and third years in Colville. In 2016 for the first time we expanded the program to begin matching two residents each year, so by the summer of 2018 we will have our full complement of 6 residents – 2 in Spokane doing their internships, and 4 in Colville at any given time.

Of the 27 Family Physicians who have graduated from the Colville RTT, more than 80% have stayed in rural medicine, and about 1/3 have remained in or near Colville. Those residents who have continued to do OB in their practices are doing C-sections, and almost all of them graduated from the program C-section ready. Many of our graduates are also doing upper and lower endoscopy as part of their full-spectrum family medicine practice. Our program also includes robust training in inpatient, emergency and community medicine, and its longitudinal design allows for each resident’s training to be customized to suit his or her needs and desires.

Providence Health and Services operates two hospitals and five clinics in northeast Washington, where the drawing area is about 40,000 people living in a wide geographical area. Colville, a town of 5,000, houses the larger hospital, Providence Mount Carmel Hospital, as well as three of the clinics (including the primary training clinic, which is a multispecialty clinic adjacent to Mount Carmel). Chewelah, with a population of about 2,500, has a small Family Medicine clinic and the smaller of the two hospitals, Providence St. Joseph’s Hospital. Kettle Falls, with around 1,500 people, has a vibrant stand-alone family medicine clinic. Resident training makes use of most of these facilities.

Providence Mount Carmel Hospital and Providence St. Joseph’s Hospital are both critical access hospitals. Mount Carmel has been consistently recognized by state and national associations for its excellence of care and has recently achieved a “baby-friendly” designation. The referral center for both hospitals is in Spokane, 70 miles south of Colville.

Our medical staff consists of 30+ providers, mainly Family Medicine but also including general surgery, urology, orthopedics, podiatry, internal medicine, diabetes education and radiology. Visiting physicians provide resident teaching and patient care in nephrology, cardiology, dermatology and oncology. Advanced Practice Providers form an important part of the team providing comprehensive care to people of all ages.

Additionally we have a dedicated staff of ER physicians and hospitalists, some of whom also work in the clinic setting. Our Family Medicine residents are an integral part of our practice in all settings, perform home visits, and play an active role in nursing home care on an ongoing basis for their own patients, and episodically for the patients assigned to other providers. We are especially proud of our obstetrics program, which consists entirely of Family Physicians and a wonderful team of OB nurses and provides exemplary care in a baby-friendly environment.

The Northeast Tri-county Health District offers public health services to most of our region, and our residents provide medical services there on a regular basis, including contraceptive management, cancer and STD screening and pregnancy diagnosis, and also are often called to help with environmental health screenings and investigations. Most of our residents become involved in a community project designed to solve an identified issue or to enhance specific services in our community, always in conjunction with public service organizations and/or local community associations.

In addition our residents are quickly embraced by the community, where they are asked to provide sports medicine and coaching services and/or asked to serve on various committees and boards.

Our physicians have the best of both worlds – we perform as primary and specialty physicians, as well as clinical instructors. Our residents receive excellent teaching and precepting over a wide range of clinical experiences. The residents also have the opportunity to establish their own practices and identity within the group and many join the group as long-term members of our community.

Colville is a close-knit community located in forested and mountainous northeastern Washington. The area offers beautiful scenery, ample year-round recreational opportunities and a range of cultural opportunities. Spokane, our “big city,” is only 1 ½ hours away.

The Colville Family Medicine Rural Training Track provides a unique opportunity for physicians in training to immerse themselves in rural medicine and to experience rural living as an integral member of the community. More importantly, it prepares new physicians to confidently practice the full spectrum of Family Medicine, ready to go out and live their dreams!


Curriculum

Colville Rural Training Track
Spokane Family Medicine

RTT Longitudinal and Block Curriculum segments, November 2015

R1 Residents train primarily in blocks in Spokane. The only longitudinal aspect during first year is continuity clinic. Here is the usual pattern for RTT R1 Residents:

Obstetrics
12 weeks

Gynecology
4 weeks

Peds - Inpatient
8 weeks

Peds - Outpatient
4 weeks

ICU
4 weeks

Sacred Heart House staff
4 weeks

ENT/Dermatology
4 weeks

ER
4 weeks

R2 Residents have their first couple of months in Spokane, but then work in Colville the rest of the year and during their R3 year, apart from electives. There are only 4 training blocks after the first year:

Obstetrics (Spokane)
12 weeks

Community Medicine/ER
4 weeks

Surgery
8 weeks

Orthopedics/Sports Medicine
8 weeks

 

The remainder of the R2/R3 curriculum is conducted in a longitudinal fashion:

Continuity Clinic
1-4 half-days per week, including during blocks

OB Call/C-sections
Every other week, for the entire week

ER
Variable (worked around other assignments)

Hospitalist Service
Variable (worked around other assignments)

Woman's Health/Family Planning
1/2 day, every other week, at NETCHD - Health Department

GI/Endoscopy
Under development, but like 1/2 day, every other week

Nephrology
Once a month

Oncology
Once a month

Cardiology
1-2 times a month

Research
1/2 day per quarter with mentor, and 1 hour per week

Practice management
Once per month, each resident, with Dr. Rehn, CEO