UNM FAMILY MEDICINE RESIDENCY

ROTATION INFORMATION

AMBULATORY SURGERY

 

Rotation name: Ambulatory Surgery

 

Year: R2/3

 

Rotation contact information:

 

Preceptors and contact information for his rotation: please contact all preceptors prior to beginning the rotation to confirm the schedule.  

 

• John Jones MD, jjones14@salud.unm.edu
• Jerica Johnson MD, JeriJohnson@salud.unm.edu
• Melanie Baca MD,  MBaca@salud.unm.edu
• Miguel Gonzales MD, Miggon07@salud.unm.edu
• Kira Paisley MD,  kpaisely@salud.unm.edu
• Toby Palley MD,  TPalley@salud.unm.edu

 

Important notes about this rotation/updates to rotation:

When you work at 1209 University Ave. clinic DO NOT park in the lot that is immediately to the west of the building. Parking services may ticket you.

 

If you have a Lomas parking structure permit please park next door behind the building that houses the Satellite coffee. There are some spots marked "Physician Parking" that you can use. The other option is to park down the hill to the west and what is called Lands West parking and then walk up the hill to the clinic. 

 

Location: 

 Various Locations, see schedule below

 

Pre-requisites:

none

 

Description of rotation: 

working in various practice settings to achieve increased comfort and potentially competency in common outpatient procedures

 

Process and contact for sick days:

 please contact your preceptor for the day and Dolores Garcia for any days off of this rotation

 

Schedule:

On the 3^rd Wednesday morning (8-noon) of the calendar month, residents will have hands-on POCUS training time with Dr Chamberlain and sports medicine faculty with focus on musculoskeletal ultrasound exams.

This will be located at the UNM Athletic Training room. 

*Please send a tiger connect message to Dr Chamberlain 1-2 days before to confirm and to make sure you know where to go!

 There are some months where this experience will not be the 3^rd Wednesday morning, but we will let you know when the rotation starts if that is the case.

 Remember to wear your scrubs.

Remember to log your scans in New Innovations.

 

 

PLEASE CONFIRM WITH EACH PRECEPTOR 2 WEEKS PRIOR TO THE START OF THE ROTATION

	MON	TUE	WED	THU	FRI
Morning	Continuity Clinic	Introduction to Point-of-Care Ultrasound   location: BatCave and 3N   Contact Jerica Johnson MD to confirm prior to starting rotation	Community Project/Admin Time   Except for the third Wed AM of the calendar month- POCUS with Dr. Chamberlain at UNM Athletic Training Room	Dr. Jones' Procedure Clinic location: NEH Clinic 7801 Academy Blvd NE, Albuquerque, NN 87109 Contact John Jones MD  to confirm prior to starting rotation (may be on wards)	Dr. Jones Procedure Clinic NEH Clinic 7801 Academy Blvd NE, Albuquerque, NN 87109 Contact John Jones MD to confirm prior to starting rotation (may be on wards)
Afternoon	Procedures with Melanie Baca MD location: 1209 University Blvd NE, 87102 Contact Melanie Baca MD to confirm prior to starting rotation	Continuity Clinic	FM Resident School	Procedures with Toby Palley MD location: 1209 University Blvd NE, 87102 Contact Toby Palley MD to confirm prior to starting rotation.  You will work with Dr. Palley UNLESS Drs. Gonazles or Paisley are scheduled for vasectomies. If they are scheduled you will work with them instead.  You will see a note in Qgenda to clarify.   Vasectomies at CRH variable- will be added to your schedule with Drs. Kira Paisley and Miguel Gonzales Center for Reproductive Health (2301 Yale Blvd. SE, Building E Albuquerque, NM 87106) Center for Reproductive Health (2301 Yale Blvd. SE, Building E Albuquerque, NM 87106)   Contact Dr. Miguel Gonzales and Dr. Kira Paisley to confirm prior to starting rotation (may be on MCH)	Continuity Clinic

 

 

 

Educational Goals

Goals and Objectives:  Outpatient Procedures and Skin Care Goals and Objectives 2017.5.12.docx

The goal of the Ambulatory Surgery rotation is to attend specific specialty surgical clinics, as well as experience some ambulatory procedural training.  For many, these procedural experiences are largely gained longitudinally through your clinic and other rotations such as ICU, inpatient, dermatology, Sports Medicine, etc.  This block provides an opportunity to gain some additional exposure and experience, as well as brush up on medical knowledge that may not have been obtained up to this point. 

 

Though few Family Physicians perform major surgeries, most participate in preoperative and postoperative care, either in the hospital or in clinic.  Some Family Physicians choose to perform various outpatient procedures in the office setting, while almost all help counsel patients about surgical procedures, and make appropriate referrals for surgical care.  Competency in specific procedural skills will of course vary based on a resident's exposure, subject to some random variation, and interests.  The resources below highlight some of the surgical care management, as well as procedural skills that we believe a Family Medicine physician can attain competency in.  Often the process of competency in procedures continues after residency, and is guided by what resident's choose to pursue. 

 

This is not meant to be a complete list of what is possible; other rotations focus more on inpatient procedures such as paracentesis, lumbar puncture (inpatient wards), or joint injection (sports medicine).  Please use this rotation to familiarize yourself with the conditions listed below, along with the procedures you are exposed to in your clinic.  Consider the linked articles to be a functional curriculum.  You are strongly encouraged to read these articles over the course of the block.  

 

Educational Resources

Aortic Abdominal Aneurysm 

Abdominal Aortic Aneurysm_AAFP.pdf

Vascular Surgery

vascular surgery_an update_2007_AAFP.pdf 

FAMILY MEDICINE resident handbook for vascular surgery RO

Conscious Sedation

Conscious Sedation for Minor Procedures_NEJM.pdf  (2011)

Procedural Sedation_AAFP.pdf(2005)

Diabetic Foot Ulcer Care

Diabetic Foot Care_JFP.pdf

Diabetic Foot Infection_AAFP.pdf

Grading and Treatment of Decubitus Ulcers

Pressure (Decubitus) Ulcers_AAFP.pdf

Procedural sedation and analgesia in the emergency department.pdf

Local Anesthesia

Principles of Office Anesthesia Part I. Infiltrative Anesthesia_AAFP.pdf

Principles of Office Anesthesia Part II. Topical Anesthesia_AAFP.pdf

Regional Anesthesia for Office Procedures Part I. Head and Neck Surgeries_AAFP.pdf

Regional Anesthesia for Office Procedures Part II. Extremity and Inguinal Area Surgeries_AAFP.pdf

Minor Burn Care

Outpatient Burns Prevention and Care_AAFP.pdf

Wound Care

Evidence-based decisions for local and systemic wound care.pdf

 

Selected Specific Procedural Skills

Derm Biopsies

Shave and Punch Biopsy for Skin Lesions

Incision and Drainage of Abscess/Cyst

Minimal Excision Technique for Epidermoid (Sebaceous) Cysts_AAFP.pdf

Abscess Incision and Drainage_NEJM.pdf

Abscess Drainage Video

Cryosurgery

Cutaneous Cryosurgery_AAFP.pdf

Ingrown Toenails

Management of Ingrown Toenail (AAFP)

An example video of toenail removal

Vasectomy

Vasectomy An Update_AAFP.pdf

Addressing Post Vasectomy Questions and Concerns

Skin Laceration Repair

Essentials of Skin Laceration Repair_AAFP

 

Offline Resources to Check Out

Procedures in Primary Care(big book, contains articles by some of our faculty- LOTS of things covered)

Minor Emergencies (great, great book to have if you see lots of walk-ins, and bring to locums jobs.  Very quick to reference as needed)

Fracture Management for Primary Care- comes from the perspective that you want.\

Tarascon Medical Procedures Pocketbook- lots of procedures, small, relatively inexpensive

 

POCUS Syllabus:

Point of Care Ultrasound_Ambulatory Surgery Syllabus