Ambulatory Experience

Ambulatory care training is offered in multiple venues and rotation types:

• Continuity Clinics
  • Weekly continuity clinics – cancelled on on-call and post-call days in ICU, admitting days on inpatient services
  • Alternates weekly between VA Medical Center and VCUHS Ambulatory Care Clinic
  • General Internal Medicine Faculty at both sites
  • Residents have defined patient panel at both sites
  • Teaching is emphasized – our ambulatory care curriculum:
    • Web-based ambulatory care curriculum – modules assigned monthly
    • Module topics reinforced by clinic faculty during the month
    • Clinical question-based teaching in "real time"
    • Systems-based practice learning objectives and focus in POD system participation
  • Resident practice teams – the POD system
    • Each resident is part of a partnership, defined by day of clinic
    • Partners are responsible for managing patient follow up, phone calls, clinic paperwork – function as a practice group
    • Also perform peer chart review
• Ambulatory Blocks
  • PGY-1 ambulatory block
    • Focused introduction to clinical care and systems-based practice in the primary care setting
    • Includes time in continuity clinic, urgent clinic, geriatrics in the home and nursing home setting, mental health and pain clinic
    • Time for chart review and POD work
    • Also assigned time with the primary care clinic triage nurses, pharmacists, social workers and clerical staff as well as working with nutritionists, physical therapists and other specialists to which we frequently refer our patients
    • Additional educational experiences include:
      • A 4-session course on medical technology
      • An experience in chart review and participation in a performance improvement project in the ambulatory care clinic at MCVH
  • PGY-2 Ambulatory Care Block
    • Residents gain experience and exposure to specialty ambulatory care practices – both in and outside the field of Internal Medicine
    • Weekly sessions in each clinical experience
    • Participation in a chart review and performance improvement project
  • Ambulatory Care Teaching Block
    • Specialized block for Women's Health residents and General Internists Track
    • Ambulatory care experience in continuity clinic, urgent clinic, other ambulatory settings
    • Focused lecture series on ambulatory care topics by primary care providers, other ambulatory care specialists
  • Community Preceptorships
  • Experiences in the private sector with practicing physicians
  • May be primary care providers or outpatient-based subspecialists
  • Urgent care
    • PGY-3 experience
    • Acute care in the primary care setting – spend time in the faculty practice and in the teaching clinic
    • One-on-one supervision by faculty
    • Teaching role with MSIII med students
  • Student Health
    • PGY-3 experience
    • Student Health Clinic at VCU
  • Women's Health Electives
    • Primarily for Women's Health residents
    • VCU community-based practice at Stony Point Health Center
    • Outpatient experiences in gyn, primary care for women, breast health, osteoporosis, endocrine and others
  • Rheumatology and Endocrine
    • Incorporated into consultative elective
    • Experience in ambulatory setting in multiple clinics
      • Bone
      • Lipid Clinic
      • Diabetes/endo clinic
      • Rheumatology
      • Other
  • Other outpatient-based elective blocks
• Other – episodic outpatient experience
  • Community Free Clinic (Fan Free Clinic)
    • Offered to Women's Health residents and general internist track
    • Available to others if elected
    • Indigent care community clinic
    • Chief medical resident supervision
  • Gynecology clinic
  • Mental Health Clinic
  • Pain Clinic