Competencies and Expectations
First year experiences are intended to expose interns to the myriad of internal medicine disciplines and to help them establish competency in triage, resuscitation and management of a wide variety of patients in both the inpatient and outpatient environment. In the second and third years, residents continue to mature in their clinical problem solving skills and develop skills in leadership, teaching and systems based practice.
In our system of mentored autonomy, residents assume increasing responsibility for establishing accurate differential diagnoses, honing in on the correct diagnosis, using the literature to identify appropriate management strategies and coordinating increasingly complex care plans for our patients. Throughout all years, faculty members are readily available for advice, coaching and supervision. Experiences in the outpatient setting are combined with inpatient service to emphasize the skills needed to diagnose and manage the illnesses routinely encountered in primary and tertiary care settings.
Resident Continuity ClinicResident continuity practice provides the opportunity for residents to assume the role of the primary care provider for a panel of patients, many of whom the residents meet when they are hospitalized for an acute illness and are identified as someone who needs a primary provider.
Residents have continuity practice blocks (CPB) every third four-week block, during which they see patients four half days per week. The care of a resident’s patients is shared in a three resident practice group. Within the three resident practice group design, patients still have one resident they consider their primary physician. The rest of this four-week block is dedicated to an outpatient elective or other special elective.
CPB allow trainees to immerse themselves in the ambulatory practice setting with a more real-world primary care schedule. Residents do not have inpatient responsibilities distracting them from the clinic. Likewise, when they are on an inpatient ward or non-CPB elective assignment, their responsibilities are not interrupted by a weekly clinic. An ambulatory conference series dedicated to outpatient topics is also an essential component to this immersion experience.