Rotations

First Year - Second Year - Third Year

There are now two tracks at AHEC Fort Smith. Residents will decide between an OB track and a non-OB track after their first year. In the non-OB track, residents will still get exposure to OB but will not be required to see as many obstetric patients and can focus more time on medicine. Those choosing the OB track will get more intense OB training, especially in surgical obstetrics. The following rotations will change slightly depending on which track you choose. Please check back for additional information that will be coming soon. AHEC will also be starting an OB fellowship for those wishing to get more experience in surgical obstetrics.

First Year Rotations

 
Two ½ days per week in clinic
Nursing Home visits monthly

Ambulatory Family Medicine/Orientation
All first year residents spend the month of July together in the Family Medical Center, getting to know one another, the faculty, and staff of the clinic. Residents are taught the intricacies of the clinical setting and how they will function as residents. Many common clinical and procedural skills are intensively reviewed to ensure a common background for new graduates from diverse medical backgrounds. ACLS, PALS, and NRP courses are taught during this month.

Emergency Medicine
Each first year resident will spend one month in the busy Emergency Department either at Sparks Regional Medical Center or at St. Edward Mercy Medical Center. Residents function as an ER physician, and are always under the supervision of competent ER staff. Residents achieve cognitive and procedural skills in all types of emergency medicine, trauma, acute behavioral crises and major and minor emergency surgery. The first year resident will not have call responsibility during this month.

Internal Medicine
This is a one month experience working with a private Internal Medicine physician. The resident is expected to round on their panel of selected patients, initiate a care plan for the hospitalized, and attend clinic with the assigned physician. Residents will still maintain their normal clinic schedule at the Family Practice Center.

Surgery
Residents work with a surgeon at the hospital and at his office, on both inpatient and outpatient surgical problems for one month in each of the first two years. Emphasis is placed on pre- and post-operative care, and management of complications when they arise. The resident is not expected to become a surgeon, but to be familiar with surgical techniques and procedures, and to manage the surgical patient in consultation with a surgeon.

Obstetrics
Complete obstetrical training is one of the major strengths of this program. Residents will spend 2 months on the OB service their first year. During the first year, residents are expected to learn to manage normal pregnancy, normal labors and deliver uncomplicated patients. First year residents will also learn to recognize abnormal pregnancies and labors and interventions necessary to promote good outcomes. An upper level resident will always be available to assist the first year resident, as well as family practice and obstetrical faculty back-up.

Pediatrics
A 3 month inpatient experience at Sparks Regional Medical Center is required. All pediatricians on staff commit their inpatients to the teaching service, assuring a more than adequate patient population for residents learning to manage the common illnesses that require hospital admission.

Family Medicine (inpatient service)
Residents will spend 3 months on the family medicine inpatient service in their first year. Residents care for the patients admitted through the clinic or from patients assigned to the service through the Emergency Department. These patients will represent the full spectrum of care from infants to elderly adults, with any and all medical problems represented. Two upper level residents and two first year residents, along with a faculty member will make up the medicine team.

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Second Year Rotations     

Three ½ days per week in clinic
Nursing Home visits monthly

Cardiology
Residents will spend one month with a private practice cardiologist, learning the intricacies of caring for the cardiac patient in both the inpatient and outpatient settings. Emphasis is placed on caring for the cardiac emergencies, such as acute MI. Residents polish their skills on ECG interpretation and are exposed further to treadmill stress testing, the Cardiac Cath lab, echocardiography and other evaluations of cardiovascular function.

Dermatology
This intensive one month block rotation is intended to complement the longitudinal experience in dermatology that the resident gains throughout their residency. This rotation is with one of several dermatologists on the volunteer clinical faculty. An extensive collection of slides is also available for the resident to review.

Rural Family Practice
This rotation will consist of a one month experience with a rural family physician in Clarksville, Arkansas, a small town about fifty-five miles from Fort Smith. This city has a modern hospital and a knowledgeable group of family doctors, with minimal specialist care available. Residents will see how the family doctor functions in a more rural setting, learns when and what to refer, and how to stabilize and transport patients. Housing is provided and the weekends are free for the resident to return to Fort Smith. The resident will not have call responsibilities during this rotation.

Medical Subspecialty
Residents will choose a rotation with any number of medical sub-specialists faculty; gastroenterology, pulmonology, endocrinology, nephrology, infection disease, or others. This rotation allows the resident an opportunity to focus on an area of interest or to improve their knowledge and skills in an area in which they feel weak.

Obstetrics
The second year resident will have an additional 2 months of OB. During this rotation, residents will continue to expand their knowledge in normal obstetrics, supervising first year residents with deliveries, and will begin to learn the skills needed for more complicated obstetric cases, such as forceps, vacuum extraction, cesarean section, pre-eclampsia, gestational diabetes, or pre-term labor.

Pediatrics
The second year resident spends one month with a pediatrician in his office on outpatient pediatrics, then an additional month in the neonatal nursery, following more complicated cases as they occur. Emphasis is placed on stabilizing very ill or premature infants for transportation to a tertiary care facility.

Family Medicine (inpatient service)
An additional 3 months to be finished over the course of the second and third years with half of the month in the ICU and the other half as the senior resident overseeing the progress of the first year residents and medical students.

Elective
Any rotation in the field of the residents choice.

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Third Year Rotations

Three ½ days per week in clinic
Nursing Home visits monthly

Obstetrics
Third year residents have an optional 2 months of high risk obstetrics. It is required for those intending to include obstetrics in their practice. Emphasis here is on the management of the high risk patient, intervention during more complicated deliveries, and sharpening c-section skills.

ENT/Ophthalmology/Urology
Residents spend two weeks on each of these rotations in their third year, learning basic evaluation and management of common problems in these areas. Diagnostic skills and techniques for intervention appropriate to the family physician are emphasized.

Gynecology
During the third year, each resident will spend a month with a gynecologist in his office and in the hospital. Emphasis in placed on the common GYN procedures that family physicians will encounter in their practice, such as colposcopy, endometrial sampling, and pelvic examinations. Coupled with longitudinal experiences the resident gains from their own patients and the health department clinics, residents can feel certain of their proficiency in this area.

Psychiatry
All third year residents spend one month with a psychiatrist, either in the hospital inpatient setting or with the local mental health center outpatient clinics. This experience is to complement the considerable longitudinal experience the resident will encounter in his own panel of patients the Family Practice Center. Emphasis is placed on common problems such as depression, anxiety, panic disorders, behavioral problems, and drug and alcohol dependence.

Orthopedics
Residents will spend one month in their third year with an orthopedist. Residents are not expected to perform orthopedic surgery, but will gain experience in pre- and post-operative care, evaluation, stabilization and management of common orthopedic problems.

Sports Medicine
A one month rotation with a sports medicine clinic. Emphasis will be on sports medicine evaluations, casting and splinting techniques, and evaluation and treatment of acute problems.

Practice Management
Two weeks of the third year are spent in an intensive practice management course, to complement the longitudinal curriculum for the three years. This will help the resident in finalizing plans for his practice the coming year.

Electives
Residents will have 4-6 months to focus on areas of interest to them. Common choices for these months include: pulmonary medicine, nephrology, hematology-oncology, infectious diseases, endocrinology, plastic surgery, urology, neurology, radiology, and rheumatology.