CURRICULUM
The Curriculum for the Thermopolis Rural Training Track
Thermopolis, Wyoming, Resident In Training, Resident, Doctor, Medical School, Rural Doctor, Rural Residency Program, Rural Resident, University of Wyoming, Hot Springs County Memorial Hospital, chemotherapy, transfusions, wound care, pain management, cardiac stress tests and many outpatient surgeries.  We have two Nurse Anesthetists who provide outstanding care including OB epidurals, airway management, conscious sedation, and difficult vascular access.Train Family Physicians, family medicine, rural physicians, Frontier Medicine
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Curriculum First Year Block Rotations

The residents will spend a robust 1st year at the University of Wyoming Family Medicine Residency Program Casper with our core program.  The intern year is set up with a traditional block rotation format to take advantage of the specialists and all that the Wyoming Medical Center has to offer.    During that time, 1st year All PGY I residents spend one to two half days a week in their continuity clinic. Night call covered with float intern during the week & the weekend shifts covered in a rotating fashion by the remaining interns, depending on the rotation. One month is spent away from Casper for the pediatrics rotation in Salt Lake City. All first year residents are expected to pass ACLS, ATLS, ALSO, and NRP.

  • BEHAVIORAL MEDICINE 2 WEEKS

  • The resident spends two weeks working with our behavioral medicine staff (psychiatrist, psychologist and social worker), and with other community providers at multiple facilities in the community. The goals of this rotation are to gain basic skills in diagnosis and assessment of mental illness, to improve patient interviewing skills, and gain knowledge of resources available in Casper for mental health care.
  • COMMUNITY MEDICINE 2 WEEKS

  • Community Medicine consists of exposure to many of the ancillary services that are available in the hospital and community settings that aid in the delivery of comprehensive and quality care to patients. The following areas are included in the rotation: AIDS education, Public Health department services, nutrition and diabetic education, physical and occupational therapy, Child Development Center services, rehabilitation services, and clinical laboratory services.
  • EMERGENCY MEDICINE 4 WEEKS

  • While in the Emergency Department, the resident works directly with the ED physicians managing a variety of cases, including acute MIs, lacerations, asthma exacerbations, and a fortitude of trauma cases of various degrees (Wyoming Medical Center is a Level II trauma center with Life Flight service for most of the state).
  • FAMILY PRACTICE INPATIENT 10-12 WEEKS

  • The family practice inpatient (FPI) service is a team composed of two interns who are supervised by a senior resident. At times, a PGY2 resident is also on the team. On this rotation, the residents are responsible for all hospital admissions of UWFP Clinic patients. The FPI residents are also on the Trauma and “Code Blue” teams. The intern maintains one to two continuity clinics per week.
  • GENERAL SURGERY 4 WEEKS

  • During this rotation, the resident works with one of the general surgeons in Casper. The resident will have the opportunity to participate in the surgical patient’s care from the pre-op setting to the OR (including first assisting), and finally to the post-op management. Call is taken with the surgeon. All residents do a second month of surgery during their third year. Residents may opt to do one of these months with a surgeon in one of Wyoming’s smaller communities.
  • INTERN FLOAT 6-8 WEEKS

  • The night float rotation is designed to provide the intern resident with inpatient experience for a general family medicine service. The PGY2 float resident and PGY1 float resident function as a team to provide hospital coverage for all UWFPR patients and participate on emergency response teams for all patients in the hospital, including adult inpatients, pediatrics, and obstetrical patients.
  • OB/GYN 6 WEEKS

  • During this rotation, the resident performs inpatient rounds with the OB-Gyn/Peds team. Most days are spent in Gyn specialty clinics. When not in these clinics, the gyn resident helps cover L&D. The resident has two continuity clinics a week.
  • OB/PEDS 6 WEEKS

  • On the OB-Gyn/Peds service, the OB and GYN residents work with the senior resident to provide care for obstetrical patients on the L&D and postpartum units, newborns in the nursery, patients with gynecological problems, and all box call and community FM doctors’ pediatric patients. In addition to the two half-days of one’s own clinic, the obstetrical resident spends one half-day weekly in the ultrasound clinic. The resident also has the opportunity to assist and perform C-sections, vacuum and forceps deliveries, D&Cs, and tubal ligations.
  • PEDIATRICS INPATIENT 4 WEEKS

  • Salt Lake City Children’s Hospital is the setting for this rotation. The resident spends one month on the inpatient service as a member of the FM resident team. There is no clinic time. An apartment is provided in Salt Lake City
  • PRIMARY CARE PEDIATRICS 4 WEEKS

  • This pediatric rotation is spent with one of the local pediatricians. The goal is to receive exposure and experience in primary care pediatrics. The resident will complete daily hospital rounds with the pediatrician and also attend clinic at the pediatrician’s office.
  • ICU/CRITICAL CARE MEDICINE 4 WEEKS

  • The resident works one on one with our critical care/pulmonology specialists. The resident gains experience in general ICU care, especially ventilator management. There are also pulmonology consults on the floors and a plethora of procedures including thoracenteses, chest tube placement, central lines, and intubations.

Curriculum 2nd and 3rd year

Both of the below rotations will take place early in the second year

  • OBSTETRICS/GYNECOLOGY HIGH RISK- Spokane, WA

  • This rotation takes place in Spokane, Washington, where the resident works in a high risk/high volume setting on the labor and delivery floor. Our residents work under the direct supervision of Family Practice faculty and OB Fellows.
  • PEDIATRIC ER 4 WEEKS- Denver, CO

  • This rotation takes place in Denver, Colorado, where the resident works in a high volume Pediatric ER setting. Our resident will work under the direct supervision of Fellows and Pediatric Faculty.

Longitudinal Curriculum 22 months, Thermopolis, WY

The resident will live and train in Thermopolis during the remainder of the second and third year. We believe that the continuity of care is the center of what we do and the educational structure will emphasize this through the training process. Residents will see patients at the Red Rock Clinic in Thermopolis, the Hot Springs County memorial Hospital, and either the Worland or Basin Clinic. Residents will spend 5-6 half days in their continuity clinic weekly. They will admit patients to the hospital, do ER shifts, and attend deliveries all during the course of a week. Additionally they will work with community and visiting attendings to gain experience in specialties such as Radiology, Surgery, Gynecology, Ortho, Cardiology, etc.

Hospital work will include daily rounds and will involve managing adult, pediatric, maternity, and neonatal patients.

Emergency room shifts will be 1-2 shifts a week and 1 weekend a month. The call shifts will be home call and include covering hospital patients as well as clinic patient phone calls.

  • EMERGENCY MEDICINE

  • The longitudinal ER experience will mostly involve weekly call shifts, but will also include the resident’s involvement in any codes, MI’s, CVA’s, or traumas that occur during work hours if available. There is a dedicated 8 week time during the 3rd year that the resident will be working primarily as the covering ER/Hospitalist provider.
    The residents will take ACLS yearly and audit ATLS during the second or third year.
    Residents should have the knowledge to effectively diagnose and treat the common medical and surgical emergencies that present to the emergency room.
    Residents should be well versed in ACLS and ATLS.
    Residents should have the clinical and procedural skills needed to stabilize the emergency patient until appropriate medical, surgical, or pediatric treatment can be arranged; including transport if necessary.
  • BEHAVIORAL MEDICINE

  • This rotation occurs during all three years and provides education in the integration of behavioral health and primary care. Upon completion of graduation we expect residents to be able to diagnose and manage uncomplicated mental health disorders. This experience is to further build upon skills to diagnosis and manage common mental health conditions in the primary care clinic and hospital. The experience will also help the resident further refine skills in visit structure/patient interaction through direct observation.
    Residents will work with Clinical Psychologist seeing patients from their patient panel monthly as well as work with social workers in the hospital. Routine opportunity will occur during patient visits in the continuity clinic as well as the emergency room.
  • FAMILY MEDICINE CLINIC

  • Residents will spend 5-6 half days in their continuity clinics in Thermopolis and either Worland or Basin one day a week. Residents will be providing continuity care to a larger number of families with a greater degree of responsibility during their 2nd and 3rd year. Residents are encouraged to coordinate all of the health needs of their patients with the assistance of team members.
  • GENERAL SURGERY

  • Residents will work with local General Surgeons regularly with hospitalized patients as well as work with them doing endoscopy 2 mornings a week. They will follow clinic and hospital patients to surgery where they will act as first assistant. On occasion will see patients in clinic with the Surgeon. The goal being for the residents to be able to evaluate and work up patients with acute surgical problem as well as assist in the pre and postoperative management of patients. Residents will have exposure and training in endoscopy procedures and become proficient in different suturing techniques.
  • INPATIENT MEDICINE

  • The longitudinal inpatient experience will occur with daily teaching rounds at the hospital. Residents will run the inpatient service and develop proficiency in managing complex patients while becoming leaders of the inpatient care team and coordinating the inpatient care and the patients post hospital disposition.
  • MATERNAL CHILD HEALTH

  • The overall aim of this longitudinal curriculum is to build the base for progressing to the independent management of the following: prenatal, labor, delivery, and post-partum care; well and ill newborn care. This will occur with continuity clinic experiences as well as patient care in the hospital. Residents will have their own patient panel to follow longitudinally and will also be responsible for managing the other patients on labor and delivery. Additionally, the residents will get gynecology exposure with continuity clinic, working with visiting subspecialist, and working with the Family Planning Clinic.
  • PEDIATRICS

  • The high risk and higher volume pediatric experience will occur in the intern year and early in the second year with rotations at Denver Children’s and Primary Children’s in Salt Lake. Continued longitudinal experience will occur with the hospital, ER, and continuity clinic patients where they will see both acute problems and be involved in Wellness care.
  • GERIATRICS

  • Residents will work with Geriatric patients longitudinally in the continuity clinics, hospital, and will also have their own patient panel at the local nursing homes. They will do nursing home rounds 2x a month with an attending as well as doing home visits in selected patients.
  • ORTHOPEDICS

  • Residents will work ½ a day a month with visiting Orthopedists with both clinic and OR exposure. The residents will be involved in the preoperative and post-operative care of the patients. Focus will be working on acute and follow up fracture care, as well as proper splinting and casting techniques. Additionally they will work on POCUS training for joint injections and aspirations. Some Ortho procedural opportunities will also occur in the ER and continuity clinics.
  • SPORTS MEDICINE

  • Residents will spend one evening a week during the school year visiting the training room at the local high school to see patients with an Attending and the Athletic Trainer. Working with acute injuries, planning rehab as well as return to play. Aspects of patient education and prevention will be incorporated in the experience.
  • RADIOLOGY

  • Longitudinally, residents will work with a Radiologist who is in facility 2 days a week. Residents will review films on hospital as well as ER patients. The focus or aim of this experience if for resident’s to become familiar with reading plain films and initial interpretation of CT examinations. They will also learn the appropriate modality and films to order in specific situations.
  • SUBSPECIALTY CLINICS

  • Training in Ophthalmology, Dermatology, Cardiology, and, Oncology, and Vascular Surgery occur with visiting specialists in order to further residents skills in recognizing, managing, and coordinating primary care issues related to each of these fields.

Didactics

In Thermopolis three Thursday afternoons a month residents will have didactics covering all aspects of family medicine.  These will be attended via video conferencing like ZOOM.  The 4th Thursday the residents will travel to Casper for SIM labs.

Once a month will have SIM lab in Thermopolis as well for Ultrasound training, mock codes for trauma, cardiac arrest, difficult delivery, neonatal resuscitation, acute stroke care.

  Morning teaching will cover various internal medicine, OB, surgery, and outpatient topics.  Morning report will occur daily for new admissions and review of current inpatients.