PGY-3 Rotations and Electives

Comp-OB or Gynecology Clinic

As a third year resident, you return to Darnall for a more intensive obstetric and gynecology experience.

• OB pathway
  • Participate in more high-risk deliveries
  • Some c-sections
• Gynecology pathway
  • Focus on the further evaluation of abnormal pap smears through colposcopy
  • Evaluation and management of dysfunctional uterine bleeding
  • Other gynecologic complaints

Family Medicine Hospital Service

As the senior resident on the service, you oversee the care of all patients. Again, you utilize all your knowledge and skills from your residency to maximize patient care.

Ideally, you will be in charge of the service, with the attending in more of a "consult" capacity.

Pediatric Acute Care Clinic

As a required rotation during your third year, the night clinic will increase your exposure to common pediatric conditions. Appointments usually involve brief acute care problems and are scheduled approximately every 10 to 15 minutes.

The most common problems are

• Viral upper respiratory infections
• Reactive airway disease
• Streptococcal pharyngitis
• Diarrhea with and without dehydration
• Fevers
• Rashes
• First time moms with newborn questions

Staff and additional residents are present in the night clinic. "Teaching cases" are plentiful and the staff is readily available to discuss finer points and management decisions when needed.

Autonomy is encouraged, but not a requirement.

Sports Medicine

Designed for third years, you will be given the unique opportunity to become a high school football team physician.

You will prepare for your duties by attending a sports medicine lecture series throughout the months of July and August. Lectures are scheduled once a week, and are given by both family medicine staff and orthopedic surgery staff.

Your primary responsibility is to manage and treat injuries incurred during your assigned team’s home games. On the average, there are six home games, but there may be more depending on scheduling.

Your team may be one of the traditional football powers in the state's largest 5A division, or it may be one of the smallest 1A schools where you can honestly get to know each of the 50 students.

While at the game, you are expected to manage common sprains, strains and fractures. The experience is actually very enjoyable for most. The community, especially if small, is very grateful, and Scott & White supports your participation and pays for your efforts.

Geriatrics

During this one month rotation you are paired with an independent local geriatrician and you will:

• Do rounds in the nursing home
• Attend family care conferences
• Attend hospice rounds
• Attend interdisciplinary team meetings

Neurology

During this rotation you primarily will be responsible for the neurology hospital and consult services, although some time is spent in the neurology clinic. You generally work with one or two residents training at Scott & White and with students from The Texas A&M University System College of Medicine.

The service can be busy, but the hours are usually reasonable. On average there are three to five consults per day, most of which deal with

• strokes
• TIAs
• intractable headaches
• neuropathic pain
• neurological syndromes such as MS
• Myasthenia

Formal teaching is conducted during rounds, following consultations and during clinic evaluation of patients. Occasionally, lectures are offered which may include concentrated analysis of MRI/CT scans and other procedures.

The staff comprises an excellent mix of personalities and residents who choose to work with one of the pediatric neurologists will enjoy an even more diverse staff complexion.

ENT

You work with the staff and residents of the department

• evaluating suspected neoplasms of the head and neck
• managing allergic rhinitis
• evaluating cleft palates
• treating other ENT disorders

This rotation presents many opportunities for performing flexible rhinolaryngoscopies and ensures excellent exposure to many problems seen in the Family Medicine clinic day to day.

Gynecology Clinic

Residents work with the OB/GYN staff in the DACH clinic. There is good exposure to menstrual dysfunctions with procedures including endometrial biopsies, colposcopies and LEEPs.

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Electives

In your third year, you may choose from several medicine and general electives. Ask for a list of electives when you interview and be sure to inquire about any particular rotation that you are interested in, as we also allow special electives to be arranged.

Gastroenterology

This is a very popular elective and most choose to take it at the Olin E. Teague Veteran's Center with its newly renovated, state-of-the-art facility, but Scott & White is also an option.

While working at the VA with three board certified gastroenterologists, your primary responsibility is the endoscopy suite. On average, most residents perform 30 colonoscopies and endoscopies. The staff is very supportive and eager to teach techniques that make routine office procedures easier and more efficient

Residents also work with staff on the consult service. The consults are always instructional because the staff discusses each consultation when it is completed. Lectures on significant topics are scheduled and the very reasonable hours feature weekends off. The staff is very understanding about continuity clinics and the few family medicine calls for that month.

Other Electives:

• Anesthesia (Block Clinic)
  • Learn Block injections, intrathecals, etc.
• Away Rotations
  • These are arranged by each resident and approved by the program director.
• CCU
• Comp Gyn
  • More intense and complex Gyn
• Endocrine Clinic
  • Diabetes, thyroid abnormalities, lipid disorders, other endocrinal issues
• Plastic Surgery
• PICU
  • Intensive care in the pediatric ICU
• Medical Informatics

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