Procedures, POCUS, and More

WFM offers extensive inpatient and outpatient procedural training with the option of additional training in special procedures to gain competence.

Examples of Standard Procedures Include

POCUS (Point of Care Ultrasound)

Our POCUS training begins day one, supplemented by targeted, practical workshops. We currently use SonoSim training units but may soon transition to the Butterfly platform. Four portable ultrasound units are dedicated for resident use, in addition to personal Butterfly units.

Inpatient Adult Medicine

  • central line placement (with ultrasound guidance as indicated)
  • rapid sequence intubation
  • ventilator management
  • lumbar puncture
  • paracentesis
  • thoracentesis, chest tube placement
  • arterial line placement
  • cardiopulmonary resuscitation

Maternity Care

  • non-stress tests
  • OB ultrasound
  • repair of perineal lacerations/episiotomy
  • spontaneous vaginal delivery and assisted vaginal delivery
  • induction and augmentation of labor (using various methods)
  • external fetal monitoring and internal monitor placement
  • assisting Cesarean section (primary C-section competency optional)

Residents routinely perform 80 vaginal deliveries as a baseline, with much higher numbers achieved when desired. Optional training in caesarean section competency is available. A high-/low-OB track, offered in the PGY-2 and PGY-3 years, facilitates this training. The program is accredited as OB Fellowship-Equivalent by the American Board of Physician Specialties.

Inpatient Pediatrics

  • lumbar puncture, neonates and children
  • endotracheal intubation in newborns
  • newborn resuscitation
  • newborn circumcision

MSK

Residents gain extensive experience in musculoskeletal diagnosis and ultrasound-guided diagnosis and injection through dedicated resident MSK clinics led by our family medicine / sports medicine faculty.

Other Outpatient Procedures

  • Dermatologic: abscess incision and drainage, laceration repair, skin biopsies, lesion removal/destruction, toenail removal, lipoma and cyst removal
  • Gynecologic: colposcopy, cervical biopsy and endocervical curettage, endometrial biopsy, IUD placement, microscopic diagnosis of vaginal smears, Nexplanon insertion/removal

Outpatient procedures are incorporated longitudinally into resident clinic times, corresponding rotations, and an optional one-month procedures elective rotation.


In addition to the above experience, the program’s simulation laboratory training includes rapid-sequence intubation, mechanical ventilation, and NRP, PALS, ALSO and ACLS protocols.

Optional Certifications

  • Colonoscopy: Residents in the colonoscopy module complete 100–200 colonoscopy procedures.
  • Suboxone waver: Residents can opt-in to suboxone waiver training.
@ 2021 Waco Family Medicine Residency