Second-Year Rotations
Behavioral Science - 4 weeks
This dynamic and interactive rotation comprised of practical, skill-building workshops and accompanying readings brings residents together as a full class for the first time since the orientation month - RTT residents join via teleconferencing. Topics spanning the breadth of behavioral science are explored daily in confidential seminars, and self-care is practiced and promoted through protected time for mind-body medicine sessions. Residents engage in seminars focused on practice management, reflective discussions on death and dying, relationship counseling, adverse childhood events, and more. During this rotation, all residents receive dedicating training on medication-assisted treatment (MAT). Unlike the main program, RTT residents complete their Buprenorphine Waiver training during their R1 year. Residents also plan and participate in a 3-day weekend retreat with their colleagues and loved ones.
Community Medicine - 4 weeks
RTT residents complete their Community Medicine block between their R1 and R2 years to provide an immersive opportunity to learn more about the history of the Port Angeles region and resources available to support their clinical practice. During this time residents meet with providers with the methadone clinic, Clallam County Public Health, local tribal health leaders and representatives from a host of other community-based resources.
Elective - 4 weeks
Future practice plans and areas of educational need play a role in determining elective choices for residents. Residents work with their advisor to determine what educational areas are appropriate topics for consideration. Residents may choose from a list of reputable community teachers compiled by the director of the curriculum, or select their own elective rotation site with guidance from their advisor. All residents prepare a detailed schedule of their elective, general goals for the rotation, and specific competency-based learning objectives.
Emergency Medicine - 4 weeks
During this block residents work one-on-one with emergency medicine attending physicians at Olympic Medical Center. In this setting you will learn to triage, stabilize and manage a variety of acute conditions. A strength of the RTT program is the flexibility to adapt the level of acuity care to fit the needs of your training goals - which can range from management of bread and butter patient presentations to complex trauma cases, emergent placement of invasive airway support and running codes with the guidance and support of the attending physician. As a resident physician in a rural emergency department you will also gain valuable experience in learning how to quickly interface with specialists remotely in order to triage with your team which patients can be safely managed at OMC vs patients that require emergent transfer to a larger tertiary center.
Geriatrics - 4 weeks
This rotation will provide the opportunity to develop their skills in geriatrics. Opportunities special to this rotation include shifts with home health nursing, in home wound care, separate comprehensive wound care training (online and in-person). There is also protected time to schedule home visits with your geriatric patients and to practice end of life discussions. You will also join our local multidisciplinary hospice center rounds via teleconferencing.
Gynecology - 4 weeks
Residents will spend dedicated time with both the OMC Women's Clinic in Port Angeles as well as the local Planned Parenthood. Time with the OMC Women's Clinic includes both inpatient and outpatient opportunities for gyn care to meet the training goals of our residents. Outpatient procedures include LARC (IUD placement/removal, Nexplanon placement/removal), colposcopy training, gender care and a variety of other repro management skills. Inpatient skills include opportunities to join our obstetrician colleagues with hysteroscopy, myomectomy, novasure and D&C procedures.
Medicine/ICU - 12 weeks
Inpatient medicine is split between time with North Olympic Healthcare Network's Family Medicine (NOHN) service and time working one-on-one with Olympic Medical Center's hospitalist service, which is comprised of both internists and family medicine physicians. Time on the NOHN service will provide opportunity to manage a full-spectrum service, where you will balance management of OB, pediatric, med-surg floor and ICU patients who have established as patients at NOHN. Time with the hospitalist service will not include OB or pediatrics and instead your learning will be primarily focused on higher acuity patients in the ICU, with opportunity for placement of central lines, running codes, as well as intubation and vent management. Regardless of which service you are on you will have the ability to follow your patients through multiple services. As an example, if you admit an acute abdomen patient who requires surgery, you will be welcomed to join our general surgery team in the OR, providing the ability to learn about inpatient care from a more comprehensive viewpoint. Other examples of this include following patients to our endoscopy suite with gastroenterologists or pulmonologists for bronchoscopy.
Orthopedics - 4 weeks
Residents will spend one month with in the OMC orthopedic clinic, working with both orthopedic surgeons and physician assistants to further develop diagnostic and management skills for common orthopedic complaints. Opportunities to deepen this training include dedicated time with casting technicians as well as time in the OR with orthopedics surgeons.
Outpatient Pediatrics - 4 weeks
We have dedicated one month to working with the OMP Children's Clinic, which also serves as a rural clinical site for Seattle Children's Pediatric Residency. Time is split between in patient call with the pediatric attending physicians with morning rounds on hospitalized pediatric patients and acute care of same day pediatric visits in clinic. As part of your call shifts with the pediatrician group you will attend cesarean and higher risk vaginal deliveries in order to perform NRP (neonatal resuscitation). More on-call NRP shifts can be arranged if this is a particular interest to the resident.
Surgery - 8 weeks
RTT residents will spend two blocks with our surgery colleagues at OMC (Olympic Medical Center) in both the outpatient and inpatient setting. Outpatient surgery clinic will include work up of common surgical complaints as well as time dedicated to sharpening your technical skills with opportunity to training in outpatient surgical procedures such as larger cyst/lesion excisions and hemorrhoidectomy. Inpatient call will include admission and management of surgical cases, where you can expect to first assist on a wide range of surgical cases, including laparoscopic cholecystectomies, appendectomies, colectomies, hernia repairs, Nissen fundoplications, sentinel lymph node biopsies, mastectomies and more.