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Residents’ ambulatory experiences come in several forms. It is through the composite of these experiences, where the residents attain and develop the knowledge and skills that are necessary for delivering outstanding ambulatory patient care. The bulk of these experiences occur in the general medicine continuity clinics, where residents develop long-standing relationships with a panel of their own patients. In addition, during several structured Ambulatory Block rotations, residents acquire additional knowledge and skills in primary care, sub-specialty, and specialty outpatient medicine. |
Learning and caring for the “whole patient”, can only occur when the patient feels comfortable enough to allow the physician to understand his/her life, not just as a patient, but as an individual. This is achieved over time, in the continuity clinic, where residents take on first-contact, primary responsibility for a group of patients who are referred or recruited into the residents’ own practices. These patients are drawn from a variety of settings; some are discharged from the hospital by the same resident, some are referred to the practice from other specialty clinics, some are recent visitors of our emergency/urgent care centers, and many are self-referred from our surrounding communities just for primary care. This diversity of patient origin, allows our residents to learn the ambulatory diagnostic and therapeutic approaches to patients with acute illnesses, and the longitudinal delivery of high quality care to patients with chronic medical conditions.
Faculty members from the Division of General Medicine supervise residents at all times in the general medicine clinics. All resident clinic offices are equipped with computers with access to electronic medical records, clinical management resources, UpToDate, and Medline. |
During these blocks, residents spend all of their time in the ambulatory setting, and have no inpatient responsibilities. At present, PGY-1 residents have one ambulatory block, while PGY II and III residents have 2 blocks. During these blocks, residents will act as office-based physicians, and spend a large portion of their time seeing patients in the general medicine clinics. In addition, they will also rotate to nearly 40 specialty and subspecialty experiences located both on and off the CUMC campus.
Aside from these practical experiences, several structured and comprehensive didactic series fill out the rest of the Ambulatory Block. These include a basic primary care lecture series, a formal epidemiology curriculum, several case-based teaching reports, and a weekly Division of General Medicine conference. In addition, all residents also attend teaching sessions on primary care psychiatry, addiction medicine, and quality improvement.
Ambulatory Hematology & Oncology
Cancer is a leading cause of death in the United States and hematologic abnormalities, both malignant and non-malignant, are frequently encountered in medical patients. The Ambulatory Hematology & Oncology rotation strives to educate residents in the diagnosis, evaluation, and treatment of hematologic and oncologic diseases in a diverse patient population.
During this rotation, PGY1 residents rotate through a variety of hematology and oncology specialty clinics to become familiar with the crucial elements of history, physical exam, differential diagnosis, and evaluation of patients with hematologic or oncologic diseases. Residents are assigned a panel of patients, with an emphasis on patients in the initial stages of diagnosis and management. Under the supervision and mentorship of attending physicians and senior fellows, the PGY1 residents work to formulate diagnostic and management plans with a focus on high quality, compassionate, evidence-based care.
To augment clinical exposure, residents also attend several teaching conferences and participate in the weekly pathology and hematology conferences during which physicians from a range of specialties, including pathology, medicine and surgery teams, convene to discuss challenging cases.
Regardless of the residents’ future career path, the overall goal of the 3-year ambulatory experience is to provide the trainees with the necessary skills, knowledge, and attitude to deliver compassionate, high quality, comprehensive, and evidence-based medical care to all of their patients.
For more information, refer to the Ambulatory Clinics homepage.
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