UNM FAMILY MEDICINE RESIDENCY

ROTATION INFORMATION

PROCEDURE ROTATION

Rotation name: PROCEDURE ROTATION

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.  

• 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 
• Ricardo Galicia MD, Rgalicia@salud.unm.edu
• Carlos Cano MD,  CACano@salud.unm.edu
• Toni Benton MD,  abenton@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:

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

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

Patient information videos: in English and Spanish from the CRH website (toward the bottom of the page) which explains the procedure, consent process, and post vasectomy instructions

Vasectomy An Update_AAFP.pdf

Addressing Post Vasectomy Questions and Concerns

Lac Repairs 

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_Procedure Rotation Syllabus