Residents at an Orioles game

Our residents receive extensive training in ambulatory medicine through their continuity clinics, subspecialty practices, acute walk-in clinics, and private practices. Through our noon core curriculum and ambulatory conferences, residents expand their primary care knowledge in both didactic lectures and small group discussions. The Associate Program Director for Ambulatory Education and the Primary Care Chief Resident are responsible for development and implementation of the ambulatory curriculum.

Continuity Medical Clinics

Residents immerse themselves in their continuity medical clinic throughout their residency training at 1 of 4 sites:

  • University Health Center (UHC)
  • Primary Care Clinics at the VA
  • Faculty Practice Office (FPO)
  • Mercy Medical Center

Academic General Internal Medicine (AGIM) and Clinical General Internal Medicine (CGIM) Rotations for Interns

Interns have four 2-week ambulatory blocks with 2 AGIM and 2 CGIM blocks

  • During Academic General Internal Medicine, interns attend their continuity clinics in the afternoons and have a variety of learning sessions in the morning including simulation and ultrasound sessions, literature in medicine, mentorship meetings, and wellness half-days.
  • During Clinical General Internal Medicine blocks, interns enhance their primary care knowledge by seeing a variety of acute and chronic medical conditions at our Faculty Practice Office. 

AGIM Rotation

  Mon Tues Wed Thurs Fri

Week 1

Mornings

Ultrasound

Sim

Practice Based

Learning

Lit in Medicine

Wellness

Check-In

Mentorship

Meeting

Week 1

Afternoons

Continuity

Clinic 

Continuity

Clinic 

Continuity

Clinic

Continuity

Clinic

Continuity

Clinic

 

         

Week 2

Mornings

Opioid Use

Disorder Didactics

ACLS Sim &

Mock Codes

Journal Club

Ambulatory

Hot Topics

Practice Based

Learning

Week 2

Afternoons

Continuity

Clinic

Continuity

Clinic

Continuity

Clinic

Continuity

Clinic

Continuity

Clinic

X+Y Scheduling 

Schedules for upper level residents are in a 4+2 format. 

  • X (4 weeks) = inpatient rotations, electives, ER and vacation time
  • Y (2 weeks) = ambulatory with continuity medical clinic in the afternoon and general medicine and subspecialty clinics in the morning.

Ambulatory Education

Consolidating continuity clinics into 2-week blocks allows residents to focus and build their ambulatory skills and patient panel, provide outpatient exposure to subspecialty care and allow for dedicated time for research and quality improvement.

To augment their outpatient education, we have several didactic lectures, small group sessions, and interprofessional pathways our residents can participate in both during their Academic GIM and Ambulatory Y blocks:

  • Longitudinal Subspecialty Clinics.  Resident can choose to "major" in cardiology, GI, ID, endocrinology, pulmonary medicine or other subspecialties over a 3-4 month period.  This allows residents to explore these areas in more depth and develop close relationships with faculty in the field.
  • Primary care conferences.  Using the Yale Office-Based Curriculum as a guide, we offer small group and didactic sessions on various outpatient medicine topics with GIM faculty helping to facilitate discussions
  • Opioid Use Disorder Education.  Interns receive early didactic lectures on opioid use disorder, buprenorphine waiver training, and harm reduction with special focus on the social determinants of health in this challenging patient population. Senior residents have the opportunity to rotate in buprenorphine clinics, methadone clinics, and syringe exchange programs. 
  • Inter-professionalism Pathways. We currently have 3 inter-professionalism pathways in Endocrinology, Infectious Disease, and Hematology and Oncology – Providing those residents that are interested with the opportunity to gain more in-depth education and exposure and a potential to gain a Certificate of Excellence in these fields.
  • Resuscitation simulation and Ultrasound Session. While not ambulatory-centric, these sessions allow residents to work with ED, Anesthesiology, and Critical Care faculty and fellows to build the skills and confidence in performing procedures and leading codes for when they return to their inpatient rotations.

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