Intern ambulatory block
In intern year, there are 12 weeks of ambulatory rotations divided into six 2-week ambulatory blocks.
Outpatient general internal medicine continuity practice
- Each intern is assigned a primary practice site:
- Edward S. Cooper Internal Medicine
- Penn Internal Medicine University City
- Philadelphia VA Medical Center
- Interns work as a partner in the blended faculty/resident outpatient practice.
- Over 3 half-day sessions each week, interns build a panel of patients and see them for visits longitudinally .
- Interns will also have opportunities for direct observation and feedback related to physical examination skills, agenda setting, motivational interviewing, and counseling.
- Each block has dedicated administrative sessions designed to learn key aspects of panel management, outpatient triage, intervisit care, and inbox management.
- For 2 blocks of the year, interns participate in a primary care immersion rotation (Firm Rotation), in which they assist with triage of acute concerns via telephone and secure portal messaging, and provide cross-coverage for colleagues who are out of the office. During these rotations, interns may choose to have elective enrichment clinic experiences in:
- Addiction Medicine
- Women’s Health / LARC
- Refugee Clinic
- Pre-Operative Evaluation
Outpatient subspecialty care
- Interns will take a deeper dive into the more ambulatory focused subspecialties that have less exposure while on the inpatient wards and select a longitudinal clinic within a subspecialty. Options for this experience include:
- Infectious Disease
- Endocrinology
- Nephrology
- Rheumatology
- Allergy and Immunology
- Sleep Medicine
- Interns will spend 1-2 sessions/week in their chosen specialty during the second half of the year.
- An asynchronous curriculum will support this experience
Outpatient didactics
- Interns have protected time for didactic half-days on protected time for didactics Wednesday and Friday mornings.
- Each block has an outpatient theme. This structure allows interns to focus their learning on specific, high-yield topics that are led by faculty experts in diverse areas of medicine. Teaching is case based:
- In addition, core curriculum content is delivered that is appropriate for interns:
- Communication and Professionalism
- Evidence Based Medicine
- Academic and Personal Development
- Arts and Medicine at the Philadelphia Museum of Art
- Transitions of Care
- Outpatient Didactics
- Simulation Center Experiences for procedures and acute care scenarios
Upper year blocks and ambulatory report
Outpatient general internal medicine continuity practice
- Junior and Senior residents continue working in their assigned primary practice sites as a partner in the faculty/resident outpatient practices:
- Edward S. Cooper Internal Medicine
- Penn Internal Medicine University City
- Philadelphia VA Medical Center
- Over 3-4 half-day sessions each week, residents continue building a panel of patients and see their assigned patients for longitudinal follow-up.
- Residents build upon skills from intern year to develop more independence with seeing the patients on their panel.
- Each block has dedicated administrative sessions designed to learn key aspects of panel management, outpatient triage, intervisit care, and inbox management.
- Four sessions each block are designated for academic pursuit to allow for meeting with mentors and pursuit of other scholarly work.
- For 1-2 blocks of the year, upper year residents participate in a primary care immersion rotation (Firm Rotation), in which they assist with triage of acute concerns via telephone and secure portal messaging and provide cross-coverage for colleagues who are out of the office. During these rotations, residents may choose to have elective enrichment clinic experiences in:
- Addiction Medicine
- Women’s Health / LARC
- Refugee Clinic
- Pre-Operative Evaluation
- Diabetes Clinic (precepted by an endocrinologist embedded in primary care)
Outpatient subspecialty continuity practice
Subspecialty clinic-reuniting outpatient with a patient cared for in the hospital
- Junior and Senior residents will select a longitudinal subspecialty of their choice to serve as their subspecialty continuity clinic experience.
- Residents are paired with a faculty member of their choosing or matched based on interest and personality with a faculty member in the chosen subspecialty.
- Residents are expected to prepare charts, see patients independently, pend orders, and precept with their subspecialty preceptor.
- This clinic allows residents to have a truly immersive experience in a subspecialty to solidify career goals.
- This experience also allows residents to build a longitudinal relationship with a clinical mentor in their prospective field.
- Those who are interested in a career in general internal medicine may choose this experience to explore a subspecialty area -or- choose an outpatient internal medicine longitudinal experience such as addiction medicine, weight management, community medicine clinic, etc.
Outpatient subspecialty continuity practice
- Residents have protected time for didactics Thursday mornings.
- Upper year residents have a curriculum that spans 2 years. Each block has an outpatient theme. This structure allows interns to focus their learning on specific, high-yield topics that are led by faculty experts in diverse areas of medicine. Teaching is case based:
- In addition, core curriculum content is delivered that is geared towards upper year residents:
- Team Leadership
- Educating Learners
- Evidence Based Medicine
- Academic and Personal Development
- Quality Improvement and Safety
- Communication
Ambulatory report is an interactive lunchtime conference that occurs weekdays during the ILM block. It consists of a two-year rotating curriculum that covers core topics in ambulatory medicine:
- Primary dedicated education during the Ambulatory Block
- Daily (Monday – Friday), interactive, case-based sessions
- Curriculum coordinated and delivered by Ambulatory Chief Resident, APDs, and Core Faculty
- Core Case topics cover evaluation and management of common outpatient presentations, including hypertension, diabetes, musculoskeletal complaints, and women’s health
- Mastering Outpatient Medicine Series covers topics relevant to Ambulatory Practice, such as telehealth, health insurance, advanced care planning, and oupatient interdisciplinary care
- Population Health Series provides residents with knowledge and tools to care for the panels in holistic manner with attention to both in-office and intervisit care strategies
- Special sessions co-led by clinical pharmacists and nurse practitioners
- Fun sessions too! Medical Jeopardy and Family Feud!
Content
- Core Ambulatory Medicine Topics (50%)
- Mastering Outpatient Medicine Series
- High Value Care
- Patient Safety
- Health Equity
- Telehealth Skills
- Diagnostic Reasoning Case-of-the-Day
- Primary Care Journal Club