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A weekly procedure clinic at Highland Family Medicine provides an opportunity to focus on procedural medicine—wart and toenail removal, injections, dermatologic procedures, and a variety of other procedures. A weekly colposcopy session at Highland Family Medicine is available as an elective experience to all residents. This session is supervised by two family medicine attendings experienced in a multitude of gynecological procedures. In addition, the Rochester medical community is rich in opportunities to obtain further procedural skills not available at the outpatient facilities.
Procedure Teaching Cores
Supervised workshops on many simple procedures are provided as part of core teaching. These include skin surgery, suturing, nail procedures, casting and splinting, joint injection/aspiration, and gynecological procedures such as IUD insertion, endometrial biopsy, and colposcopy. Training in circumcision procedures occurs as a part of the obstetrics rotation and with each resident’s continuity deliveries. Training in obstetric ultrasound is an integrated part of the Obstetrics rotation. There is a longitudinal elective opportunity to learn abortion procedures and management.
Residents have the opportunity to learn to do colposcopies, IUD insertions, cervical cryotherapy and endometrial biopsies in the Colposcopy Clinic held one afternoon each week. The clinic is staffed by two family medicine faculty, both of whom have had extensive experience in doing colposcopy. Given the large numbers of female patients in most primary care practices, family physicians that are able to do these procedures are in high demand and are able to offer a valuable service to their patients.
During the gynocology rotation in the 2nd year, residents spend one day at Planned Parenthood to observe options counseling and pregnancy termination services. It is strictly observational experience and does not involve residents in directly providing medical or procedural pregnancy terminations. The intent is to give residents a more comprehensive understanding of the work involved with their patients’ own decision making processes and possible terminations. Residents who do feel that this shadowing experience is not congruent with his/her personal beliefs and views, may opt out and are scheduled for office and teaching instead.
The residency also offers a longitudinal reproductive health elective. The purpose of this elective is to provide training in medical and first trimester surgical abortions and well as first trimester ultrasound. Starting as an R2, one resident per year may enroll in this elective which encompasses elective time as well as weekly half day sessions when on outpatient rotations. The experience is at a private abortion practice. Residents work one on one with a national leader in the field of medical abortion, learning ultrasound, D+C and medical abortion techniques.