Curriculum

R1 Curriculum

Our first year residents live in Portland and work alongside residents of the Providence Milwaukie Program. Our Hood River residents rotate through three hospitals during their R1 year in the Portland Metropolitan area. This provides them the benefit of learning in diverse environments and allows them a broad spectrum of training in these high-acuity medical centers of Portland. Participating hospitals are Providence Milwaukie Hospital for inpatient family medicine and internal medicine, Portland Providence Medical Center for Obstetrics, Neonatal and Intensive Care and Legacy Randall Children’s Hospital for Inpatient Pediatrics. For this upcoming year, the Hood River R1's will also have one week of inpatient addiction medicine experience and one week of medical spanish.

In the final block of the R1 Hood River year, our residents get an early start to their 2^ndyear and move to Hood River for their last 3 weeks of that year to help make relocating easier and get settled before beginning their second year. This 3 week last segment of the curriculum features a migrant and agricultural workers health curriculum, outreach to serve migrant farmworkers and native populations and an orientation to our community.

• Providence Milwaukie & Hood River Intern Schedule
• One Community Health - Learn more about our community health center.

What is the 1^st year like? Two residents’ perspectives

Providence Milwaukie Hospital

Providence Portland Medical Center

Randall Children’s Hospital at Legacy Emanuel

One Community Health in Hood River - New Building opened July 2020

Our PGY2 & PGY3 Residents of the 2024-2025 academic year (front row, from left to right): Owen Willis, MD - PGY3, Rachel Monroe, MD - PGY2, Jack Kennady, DO - PGY2 & Carina Souflee, MD - PGY3, learning about Diabetes Management from the Salud Team at One Community Health.

In the second and third years, residents live in Hood River, seeing patient at One Community Health, Providence Hood River Memorial Hospital, and community physicians’ offices.

Residents care for their patients at One Community Health for an average of 12 half-days a month. They admit to the inpatient service, do emergency room shifts, and attend deliveries at Providence Hood River Memorial Hospital. Additionally, they rotate with community physicians to gain experience in specialties such as surgery, orthopedics, ob-gyn, pediatrics, geriatrics, and rheumatology.

Residents are scheduled in 3-month blocks called “Quarto’s”. The schedule has dedicated time for assignments related specifically to each Quarto during “Elective Week”. Longitudinal elements provide the required number of hours in cardiology, surgery and surgical specialties, emergency medicine, behavioral health and psychiatry, sports and physical medicine, obstetrics and pediatrics. Quartos include blocks in maternal child health, surgery, orthopedics / rheumatology, procedures, rural health and elective blocks

The general Quarto themes are:

• Surgery and MSK (S/MSK)

• Maternal Child Health and Pediatrics (MCH/Peds)

• Procedures & Rural Health (P/RH)

• Elective & Away (E/A)

There are 13 weeks in each Quarto block. Weeks 1-12 of each Quarto will rotate between the following weekly themes for each resident.

1. Elective Week – replaces “Specialist week”: New template allows for flexibility in scheduling to incorporate additional elective/selective rotations & assignments. Residents are given the opportunity to tailor their assignments during these weeks to focus on areas of their personal interest. If elective assignments are not scheduled in advance, the schedule will default back to the templated assignments based on that particular Quarto. Elective/Selective “Menu” list options added to guide residents in their selections. **Note: Residents should focus the 1^st 6 months of PGY2 year on local assignments in order to become familiar with the community and ensure that ACGME hours requirements are on target to be met. 2^nd half of PGY2 year and PGY3 year allows more flexibility and time to focus on additional longitudinal and away electives.
2. Hospital Week – Runs Friday – Wednesday with overnight call on Friday and Monday. OCH clinic all day on Thursday, followed by a “Golden Weekend” with 3 days off whenever possible. During Hospital Week the residents have the opportunities to manage patients in all service areas of our 25-bed Critical Access Hospital. This includes managing inpatient adult medicine and surgical admits with our blended IM-FM Hospitalist Service those of community family physicians (many of whom are not graduates of our residencies. Residents will also co-manage labor and delivery patients and their newborns attended by Family Physicians and Ob Gyn’s and deliver those patients and assist on cesarean deliveries during this week. They also will have the opportunity to assist on surgeries of their inpatients and participate in hospital procedures under those attending physicians or our radiologists. The Emergency Department is staff 24-7 and residents are frequently there in down time during the hospital week or called to help with overflow or codes and traumas.
3. Clinic Intensive Week – Extra clinic half days, along with 2-3 half days dedicated for home study, QI/Research projects and interviews (seasonally).
4. Community Week – 1-2 ED shifts & 1-2 Women’s Clinic shifts, Hood River Care Center Geriatric Rounds, & OCH Clinic.

Week 13 of each Quarto is an “open” week to allow for make-up of any needed curricular areas or clinic hours, PMH coverage, away rotations, vacation, etc.

* Additional asynchronous care time built into schedules, especially during clinic intensive weeks.

Mandatory assignments to be scheduled in addition to regular rotations / not included on Quarto Templates include:

• ITE exams scheduled at end of October each year.

PGY2

• Inpatient Peds @ Legacy Randall Children’s Hospital on Green Team. PGY2's are scheduled for a 1-2 week rotation during their 2nd year. Additional weeks can be scheduled as elective time for anyone interested.
• Schedule and take Step 3 exam by January of 2nd year.

PGY3

• Peds ED @ PSVMC. Must work a minimum of 5 shifts in order to reach mandatory ACGME requirement for Pediatric ED encounters (50 total)
• High Risk OB Rotation @ PSVMC (Required for OB Competency – optional if not planning to do OB after residency). The curriculum and rotations are organized longitudinally, with 3-month blocks of focus called “Quartos.”

Home Call In Hood River: Residents take call overnight for One Community Health about once-a-week, and also while on overnight shifts in the hospital. Home Call includes triaging after-hours phone calls, managing labor patients and going into the hospital for deliveries, pediatric admissions or neonatal resuscitations.

Continuity Deliveries: We encourage all of our residents to be full spectrum family physicians and deliver a goal of 80 babies during their training. 10 of those must be continuity deliveries that they have also provided the prenatal and post-partum care for. Residents are expected to be called in for their continuity deliveries even when not on call or on hospital week.

Hospital work includes daily rounding with the inpatient family medicine service. Residents manage adult, pediatric, maternity and neonatal patients, in addition to shifts in the Emergency Room.

Download Longitudinal Schedule Curriculum 5.0