EMORY INTERNAL MEDICINE-PRIMARY CARE TRACK

Outpatient Experiences
&
Ambulatory Core Curriculum

Ambulatory Time: 48% of the three years in the General Medicine/Primary Care Track

During the first 2 years, general medicine residents rotate together on their respective ambulatory block months.  PGY-1 residents have ambulatory care in July, January, and May.  PGY-2 residents have ambulatory care in August, January, and May.  During months where both groups overlap, joint lectures, workshops, and activities are planned to ensure a uniform curriculum and to promote camaraderie.  PGY-3 residents have 1 of their 3 ambulatory months at any time throughout the year, while the other 2 months are in September and April, when the entire PGY-3 group will help develop an ambulatory didactic curriculum to build on the foundation of the first two years.

Residents use their ambulatory block months to tailor learning to their specific career goals.  In addition to exploring all the fields of internal medicine (rheumatology, cardiology, nephrology, geriatrics, etc), residents may concentrate their learning (e.g., women’s health or sports medicine), develop curricular projects, or pursue general medicine research.  Many residents have used this time to gain additional skill sets that enhance both their own knowledge base as well as their marketability.  In addition, senior residents are expected to develop lectures to present to the interns rotating on ambulatory care.

Traditionally, general medicine residents during their second year attend the Society of General Internal Medicine National Meeting.  This allows for interaction and fellowship with other residents and faculty committed to academic general medicine careers. Residents submit research abstracts, clinical vignettes, and workshops and, in the past, have both presented and won awards for their work. 

Descriptions for the “Typical Week on an Ambulatory Block”

Subspecialty Clinic: Clinical opportunities may be chosen from the preceding list or new opportunities may be developed.  Requests are encouraged in order for the individual resident to tailor his or her curriculum to meet personal learning goals.  Residents also may pursue special advanced training in career-focused areas, such as women’s health or sports medicine.

Didactics: A 4-hour block every Thursday morning is set aside for evidence-based medicine and psychosocial training (including cross-cultural medicine), in addition to other workshops from among the didactic topics listed above.  Also, there are morning lectures during the primary care months of all three years.  Residents attend the Ambulatory Core Conference from 12:30-1:30 on the day of their continuity clinic; otherwise, they are expected to attend noon conference at the hospital where they are attending clinic.

General Medicine: An opportunity to spend time with a general internist in a setting other than your regular continuity clinic.  Outstanding clinicians at Emory-Central Campus, Emory-Smyrna, Emory-Perimeter, and Crawford Long serve as both preceptors and mentors in exposing residents to another view of general medicine and the business aspects of managing a practice.  This experience is meant to compliment the general medicine experience of their continuity clinic.
Grady Primary Care Center/General Medicine Clinic: Four half days per week allow residents to schedule their own patients in quick follow-up for urgent issues, procedures (pap smears, flex-sigs), post-discharge follow-up, and counseling sessions, to acquire new patients for their practices.  They also provide residents the opportunity to see “same-day sick” patients of the practice in order to gain skill in acute issues in ambulatory care.  A weekly Case Conference enhances this learning by emphasizing physical exam skills and other issues related to urgent care.

Other Outpatient Opportunities:

Continuity Care Clinic - ½ day per week throughout residency; clinic conference stressing core issues in ambulatory medicine. 

Subspecialty Consult Rotations – Many subspecialty rotations include significant outpatient exposure, including oncology, rheumatology, and endocrinology.

Emergency Room - 1 month during the residency.

Other Activities

Regular Meetings With Program Leadership – Almost weekly during each ambulatory block month, Dr. Higgins meets with the residents to discuss issues affecting the general medicine/primary care track.  Either over breakfast or lunch, residents discuss both individual and group topics of importance relative to their learning goals and their experiences.

Social Events – During the general medicine residents’ ambulatory block months, there are evening journal clubs and scheduled social events.  Both faculty and residents attend these activities usually hosted by one of the general medicine faculty.  Social events in the past have ranged from whitewater rafting to potluck dinners to North Georgia hiking.

Journal Club – Residents organize a monthly potluck journal club, often on ambulatory care issues, at a someone’s home, to which all three classes are invited.

General Medicine/
Primary Care Track

Ambulatory Care Curriculum
2007-2008

 
Department of Medicine
Emory University School of Medicine