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Curriculum

The curriculum at Tacoma Family Medicine (TFM) is rigorous and progressive. It is a progressive three years of observation, assistance, performance with supervision, and autonomy with periodic evaluation in both ambulatory and hospital settings. Initially, inpatient rotations take the majority of residents’ time, laying a strong foundation in medical management of complex problems. However, as residents enter the R2 and R3 years, increasing time is spent in TFM continuity clinics and on ambulatory rotations – the educational and vocational core of a family physician’s career. During this time, residents develop family-based relationships with their assigned panel, gaining increased insight into the importance of building a therapeutic alliance with patients.

During rotations, residents work collaboratively with TFM’s sister programs Puyallup Tribal Health Authority (inpatient adult medicine, inpatient family medicine, pediatrics, obstetrics) and East Pierce Family Medicine (pediatrics). The inpatient internal medicine and family medicine teams follow patients at ICU level of care, with residents managing ICU patients with inpatient and critical care specialists. Because the call and night float residents provide coverage for all three services, our pediatric and ICU experience is longitudinal, so residents will admit pediatric and adult patients during all inpatient rotations.

CurriculumFirst-year highlights:

  • Eight weeks family medicine inpatient service, seeing pediatric and adult patient from Tacoma Family Medicine and Puyallup Tribal Health Authority
  • Eight weeks adult inpatient medicine with Tacoma General Hospital inpatient medicine specialists
  • Eight weeks obstetrics with rural-OB fellow, managing deliveries
  • Four weeks inpatient pediatrics with Mary Bridge inpatient pediatric specialists and two weeks outpatient pediatrics
  • Four weeks dermatology and six weeks orthopedics sub-specialty training
  • Four weeks community medicine with various providers in the area combined with practice management
  • Four weeks of rural/urban training at site of resident’s choosing

Second-year highlights:

  • Four weeks adult inpatient medicine with Tacoma General Hospital inpatient medicine specialists as senior
  • Four weeks inpatient pediatrics with Mary Bridge inpatient pediatric specialists as senior and two weeks behavioral pediatrics
  • Eight weeks obstetrics and six weeks gynecology, including colposcopy clinic
  • Four weeks surgery, either office based or inpatient with trauma surgery team
  • Four weeks of rural/urban training at site of resident’s choosing
  • Six week emergency medicine
  • Four weeks subspecialty elective and four weeks outpatient geriatrics

Third-year highlights:

  • Four weeks family medicine inpatient service, seeing pediatric and adult patient from Tacoma Family Medicine and Puyallup Tribal Health Authority as senior
  • Four weeks obstetrics (with option for more if in resident’s plan for future practice)
  • Six weeks pediatric emergency medicine with integrated sports medicine
  • Ten weeks subspecialty training
  • Sixteen weeks elective rotations to help residents achieve goals for future practice
  • Two weeks practice management
  • Scholarly project on topic of choice with faculty advisor

Longitudinal highlights:

  • Weekly didactics sessions on Thursday afternoon with protected learning time for 1st year resident
  • Monthly resident-led psychiatric case conferences
  • Monthly nursing home visits for 2nd and 3rd year residents
  • Night float covering the medicine and pediatrics service

Residents leave with the training to work in inpatient and outpatient settings, in urban, suburban, and rural areas. TFM’s goal is to create the full-spectrum family medicine physicians of the future and to provide care to all people with compassion and respect.

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