Obstetrics & Women's Health
Tacoma Family Medicine Residency Obstetrics
Tacoma Family Medicine (TFM) is well known for its strong training in obstetrics with both an excellent inpatient and outpatient OB experience. Our goal is that all graduates will be able to provide competent prenatal care, triage common obstetrical complaints, manage labor well, properly conduct a vaginal delivery and repair, and are good first assistants at C-section. Residents spend a total of 5 four-week block rotations on the OB service. They also care for and deliver their own continuity clinic OB patients. Most residents leave TFM having managed more than 100 total deliveries.
Inpatient Obstetrics Experience
Tacoma General Hospital (TGH) serves as the referral center for Southwest Washington resulting in approximately 3000 deliveries per year including VBAC/TOLAC, preterm and medically complex cases. Our combined clinics, in the 521 Building, provide prenatal care for 900 of those deliveries. Family Medicine residents and Family Medicine rural fellows are the only postgraduates on labor and delivery. TGH services include a perinatal special care unit, level 4 NICU, OB Emergency Department, and 24 hour in house Laborist group. Teaching and supervision of the residents is done by core TFM Family Medicine faculty, as well as MultiCare OB/gyn attending faculty providers (MOGA), TGH Laborists, and Maternal Fetal Medicine specialists. . All TFM Family Medicine faculty include obstetrics in their practices (including some with surgical OB skills) thereby providing direct role models for our residents. The entire complement of services and teachers makes this facility an excellent training ground for obstetrics.
Outpatient OB Experience
Our unique OB Access Clinic (OBAC) allows residents and fellows to provide both low and high-risk prenatal care with direct supervision from our own obstetric faculty and Certified Nurse Midwife with consultation support from MultiCare’s Maternal Fetal Medicine specialists.
High risk OB cases include caring for women with medical high-risk conditions (diabetes, hypertensive disorders, twin gestations, high BMI patients, opioid or substance use disorders) in addition to women with higher risk social needs. The OBAC clinic works closely with an in-house Maternity Support Services group that provides social work services, home visits, nutrition and lactation support. Residents and fellows also staff the OBAC NST/AFI antenatal clinic during their OB rotations. Throughout their three years residents care for their own continuity clinic OB patients and are supervised by TFM Family Medicine Faculty.
Cesarean Section Training
Residents who are planning to include C-sections in their future practice are eligible to participate in the C-section track and take back up C-section call by the end of their second year. With additional C-section call, some residents have attained the skills for C-section privileges by the end of residency. Residents in the C-section track are also invited to participate in a series of four half day C-section Workshops in their R3 year. Workshops include a number of topics and hands on sessions to supplement C-section training on the labor deck.
Rural Family Medicine with Obstetrics Fellowship
The Rural Family Medicine with Obstetrics Fellowship is a one-year experience designed for family medicine physicians who plan to work in a rural setting.
The Tacoma Family Medicine Residency and Fellowship Program are closely aligned and work synergistically with each other on the labor deck and in the OBAC clinic. The fellows play a critical role as teachers to our residents and are considered junior faculty. They provide direct supervision and teaching on the labor deck for the interns and back up for the residents. In addition, they periodically serve as preceptors in our family medicine clinic.
Interested in our OB fellowship? Learn more here.
Women’s Health at Tacoma Family Medicine
Because we do a lot of obstetrical care at TFM, we also do a lot of longitudinal women’s health and contraceptive care. Just by being a resident here and doing continuity clinic, you will become very facile at contraceptive counseling and procedures, such as IUD and Nexplanon placement / removal. In addition, residents spent 6 weeks in the R2 year on a dedicated gynecology rotation. This experience includes gynecology clinic with our OBGYN faculty, colposcopyand procedure clinics with family medicine faculty, and time at Planned Parenthood during their general women’s health clinic (also often a source of contraceptive procedures). There are also opportunities to pursue abortion care training for residents who are interested.
*These photos are from our yearly GYN workshop, which covered hands-on skills including colposcopy, leeps, cryotherapy, and more.