Over the course of three years of training, our primary care residents benefit from numerous robust clinical experiences within outpatient general internal medicine and its subspecialties. This experience is gained through rotations in a variety of settings including private general internal medicine, private and university subspecialty offices, and their own weekly continuity clinic practice.
The two week intern cardiology/pulmonary selective boasts foundational experiences at two premier subspecialty practices with one-on-one teaching and hands-on exposure to the full breadth of outpatient cardiac and pulmonary testing.
Second year residents spend a minimum of 16 weeks devoted to ambulatory training. This includes a total of 14 weeks in dedicated ambulatory block rotations and at least 2 weeks of elective. Residents may select ambulatory settings for all 8 weeks of scheduled elective bringing the ambulatory training to 22 weeks. In addition, the required neurology and non-CCU cardiology rotations during the PGY-II year incorporate both hospital-based and outpatient-based experiences.The ambulatory block rotations for PGY-II residents include one 6-week rotation in a community primary care teaching practice, one 6-week rotation that includes continuity clinic sessions and several specialty clinics as described below, and a 2-week rotation focused on quality-improvement and systems-based practice. While on the ambulatory specialty block, residents have two continuity practice sessions weekly, participate in our diabetes disease management, joint injection, and dermatology clinics and attend specialty practices of their choosing to round out the experience. The two-week quality-improvement rotation occurs in the first half of the PGY 2 year and is an opportunity for residents to do a comprehensive review of their own panel of patients, identify an area where they can improve processes of care and develop an intervention. As noted below, there is a structured opportunity in the PGY-III year to assess the effectiveness of this intervention.
During third year, residents spend a minimum of 18 weeks devoted to ambulatory training. This includes a total of 14 weeks in dedicated ambulatory block rotations, at least 2 weeks of elective and 2 weeks of Emergency Medicine. Residents may select ambulatory settings for all 8 weeks of scheduled elective bringing the ambulatory training to 24 weeks.
The ambulatory block rotations for PGY-III residents include two 6-week rotations in a community primary care teaching practice with protected time for research, peer teaching, or quality improvement projects if desired and a 2-week rotation that, depending on the interest of the resident, can focus on areas such as policy and advocacy, narrative medicine, business of medicine, quality improvement, or clinician educator training.