Clinic Rotations
Over one-third of our educational program is conducted in the outpatient setting. The Internal Medicine ambulatory experience consists of six months of daily services plus one-half day per week of continuity services. This equates to over one year of ambulatory experience within the three year residency training. This training provides the resident with the opportunity to learn the primary care knowledge; attitudes and skills needed to practice ambulatory medicine.
The primary care knowledge, attitudes and skills consist of:
- Comprehensive evaluation, which emphasizes diagnosis; risk identification; preventive care; and developing a comprehensive health care plan to include all the patient’s problems.
- Coordination of care delivered by the health care team of one’s partners, nurses, consultants, other physicians, laboratories, or other health care providers.
- Continuing care over time for all the patient’s illnesses and other health problems, including telephone evaluation and management during both office and after hours.
- Cost-effective care.
- Personal humanistic care delivered with compassion, respect and integrity.
- Providing consultation with the appropriate tests and recommendations.
- Learning the management and treatment of either new or established patients seeking acute or urgent care.
The Ambulatory Clinic Team
The learning team consists of the clinic attending, medical director, senior residents, interns and non-internal medicine residents. The clinical attending is the physician who is taking responsibility for the supervision and direction of the care delivered to the patient by the resident.
- The medical director is responsible for the day-to-day operations and the physician’s activity in the clinic. He is responsible for the monthly schedule and the assignment of residents and attendings to the general medicine, continuity, block and subspecialty clinics.
- The senior residents have larger panels of patients and focus most of their continuity clinic time on the continuing, preventive and comprehensive care of a stable panel of patients. They have more independence in managing their patients than interns.
- The interns will acquire a panel of patients in transfer from residents who have left the program and from new patients they discharge from the hospital or from the emergency room.
- Non-internal medicine residents from Family Medicine and Psychiatry each take one to two months of ambulatory medicine. These residents will work in acute care, general internal medicine and triage situations in the clinic.
Evaluation
Residents are given monthly performance evaluations for each rotation. Additionally, residents are given immediate feedback on their clinical skills, history taking and physical exam skills, patient rapport and diagnostic and decision-making skills.
ICU Rotations
Residents are integrated members of the ICU team providing intensive treatment with supervision by a critical care attending physician on a continuous basis. In this rotation there is focus on airway management, hemodynamics, and the assessment of multi-system function. The ICU rotation offers intense, hands-on learning on ventilator management, sepsis treatment, intubation, and numerous other procedures.
Procedures
Residents are expected to develop competency in routine internal medicine procedures including placement of central lines, LP’s, thoracentesis, paracentesis and skin biopsy. You will gain experience in these procedure during rotations in ICU, inpatient wards and anesthesia.
Required Subspecialties
- Cardiology
- Critical Care Medicine
- Emergency Medicine
- Geriatrics
- Hospice/Palliative
- Nephrology
- Neurology
- Oncology
- Pulmonology
List of Electives
- Allergy
- Anesthesiology
- Cardiology
- Critical Care Medicine
- Dermatology
- Gastroenterology
- Hospice/Palliative,
- Infectious Disease
- Medical Informatics
- Nephrology
- Neurology
- Neuro ICU
- Obesity Medicine
- Oncology
- Pulmonology/Critical Care
- Research
- Sleep Medicine
- Sports Medicine
- Ultrasound
