Curriculum

Working at a Tribal Clinic we have a unique opportunity to integrate traditional Native American Medicine with Western Medicine.  Additionally, we regularly discuss how historical trauma and healthcare disparities have affected and continue to affect our patient’s care. As a resident, you will have the opportunity to participate in these ancient traditions, including sweat lodge ceremonies, a traditional canoe journey, tribal gatherings and dances. You will also have the opportunity to learn about Native diets, local nutrition and herbal therapies.

Our residency continues to highly value our osteopathic founding principles as we were initially established as an AOA program.  We continue to integrate osteopathic practice and principles into our curriculum, but you don’t need to be an osteopathic medical student to apply!  Residents are allowed and encouraged to practice OMT during any of their office visits.  We have a dedicated OMT clinic half day once a week.

Residents work closely with Dr. Nichole Thorsvik, an ONMM specialist certified by the American Osteopathic Board of Neuromusculoskeletal Medicine, in the residency OMT clinic as well as working with her seeing her own patients.  Dr. Thorsvik, our Director of Osteopathic Education, works in conjunction with our faculty to integrate osteopathic principles and practice our didactics, disease intensive sessions and everyday appointments.

MDs are encouraged to participate in our osteopathic clinic.  We provide additional training to MDs who are interested in osteopathic principles and manipulative medicine.

During orientation there is a structured experience regarding treating opiate use disorder and interns complete the training needed in order to prescribe Suboxone (™).  Residents participate in a required chemical dependency rotation early in their intern year.  This rotation focuses on treating chronic pain, chemical dependence and chemical addiction.  Residents work closely with our MOUD multidisciplinary team and providers during this rotation and throughout the duration of their residency.

OMM hands-on workshops are conducted monthly. In addition to the workshops, OMM clinic days are held every Wednesday afternoon and are supervised by community OMM specialists. Residents are able to perform OMM daily for continuity of care patients.

Click here for a sample block schedule.

Orientation – 4 weeks (PTHA)
Family Medicine Inpatient – 12 weeks (Tacoma General Hospital).
Pediatrics – 4 weeks inpatient, 4 weeks outpatient (Mary Bridge Children’s Hospital, PTHA)
Obstetrics – 8 weeks (Auburn Medical Center, Tacoma General Hospital,)
Community Medicine – 4 weeks (PTHA)
Emergency Medicine – 4 weeks (Good Samaritan Hospital)
MOUD/Chemical Dependency- 4 weeks (PTHA)
Practice Management – 2 weeks (PTHA)
Elective – 2 weeks
General Surgery – 4 weeks (Multicare Cedar Surgical Associates)

Internal Medicine – 4 weeks (Tacoma General Hospital)
Pediatrics – 4 weeks inpatient, 4 weeks outpatient (Mary Bridge Children’s Hospital)
Emergency Medicine – 4 weeks (Good Samaritan Hospital)
Practice Management – 2 weeks (PTHA)
Orthopedics – 4 weeks (Multicare Orthopedics and Sports Medicine)
GYN – 4 weeks (Community Health Care)
Night Float – 2 weeks + 4 weekends (Tacoma General Hospital)
Behavioral Health – 2 weeks (PTHA)
Indian Health Service Selective – 4 to 6 weeks
Electives – 8 weeks

Family Medicine Inpatient – 4 weeks (Tacoma General Hospital)
Pediatric Emergency Medicine – 4 weeks (Mary Bridge Children’s Hospital)
Practice Management – 2 weeks (PTHA)
OMM Sports Medicine/OMT – 4 weeks (PTHA, Multicare Orthopedics and Sports Medicine)
Night Float – 2 weeks + 4 weekends (Tacoma General Hospital)
Geriatrics – 4 weeks (PTHA)
Indian Health Service Selective – 4 weeks
Sub-specialties – 8 weeks
Electives – 12 weeks

There are multiple elective opportunities through all academic years.  The number of these rotations increase during each academic year.  Residents are able to select these in conjunction with faculty to focus their education in areas of interest, future practice, and expansion of medical knowledge.

Our residents have a unique opportunity to serve Native American health needs in rural locations, in some of the most beautiful parts of North America. PGY-2’s travel for 6 weeks to Dillingham, Alaska where they work closely with local physicians to deliver full-spectrum care to a wide variety of patients in a remote location.

PGY-3’s have the opportunity to spend 4 weeks at another IHS site, serving either rural or urban Native health needs. Our program partners frequently with the Seattle Indian Health Board in downtown Seattle, and residents have rotated at Neah Bay, Lummi Island, Cowlitz, Muckleshoot and other reservation sites in the state of Washington. Opportunities at out-of-state reservations may be specially arranged for interested trainees. Residents have traveled back to Dillingham, Alaska, Juneau, Alaska, Blackfeet Service Unit in Montana, NARA in Portland, Oregon and Little Traverse Bay Bands of Odawa in Michigan.

Residents participate in our procedure clinic starting their first year.  These half days involve 1:1 precepting completing common family medicine procedures, including but not limited to, long acting reversible birth control, skin procedures, joint injections, circumcisions, and colposcopies.

One half day each week is designated for residents to participate in didactics. Topics are presented by faculty members, residents and community-based sub-specialists.

We hold disease intensive didactic sessions once monthly, as well as once quarterly procedure clinics in partnership with other local residencies.