All residents receive extensive training in ambulatory care, including continuity medical clinics, ambulatory blocks, walk-in clinics, emergency rooms, private practices and health maintenance organizations. Residents are exposed to a broad variety of patients under close supervision of faculty with expertise in primary care and preventive medicine. Through the weekly Ambulatory Care Seminars and weekly core curriculum during Morning Report, residents expand their knowledge of primary care and its related disciplines. The Associate Program Director for Ambulatory Education and the the Primary Care Chief Resident are responsible for development and implementation of the ambulatory curriculum.
Residents participate in a weekly continuity medical clinic starting in the beginning of their residency. Clinic sites include University Health Center (UHC), the Primary Care Clinics at the VA, the Faculty Practice Office (FPO), and Mercy Medical Center.
At each site, residents develop a close working relationship with their colleagues and the general medicine faculty, who are expert at providing one-on-one supervision in primary care. All clinic sites provide easy access to laboratory and radiologic studies, medical records, textbooks and electronic resources, such as Up-to-Date. The electronic medical record system, EPIC, is used at UHC and the FPO, while CPRS is used by residents at the VA Primary Care Clinic. A weekly pre-clinic conference provides residents with a comprehensive curriculum in primary care and preventive health.
By completing four Ambulatory Block rotations, residents attain expertise in primary care and are exposed to important skills for achieving competency in internal medicine. Residents rotate through various sites, both at the academic medical center and in the community. Residents may also choose to attend various medical subspecialty clinics. Select attendings at private practice sites, in managed care organizations and in public clinics precept residents during the rotation.
Residents have a wide range of choices during their Ambulatory Block rotations. If they are planning on a career in a subspecialty, they can attend outpatient clinics in that field or in one that complements that area of study. For example, a resident interested in oncology may choose an outpatient clinic in infectious diseases, in addition to attending clinic sessions and Tumor Board at the Greenebaum Cancer Center. Residents interested in primary care choose components to enhance their skills in women's health, sports medicine, rheumatology, ENT, travel medicine, ophthalmology, and dermatology. All residents spend time in a private practitioner's office to get exposure to "real life" primary care and learn the business of medicine.
Required components of the Ambulatory Blocks include geriatrics, neurology, psychiatry, literature in medicine, and completion of practice based learning exercises.
Through the Ambulatory Blocks and seminars held by UMMC, residents have the opportunity to hone specific skills useful for a career in primary care and general internal medicine. In addition, exposure to the practical business of medicine is provided through a lecture series.
Residents can enhance their skills in:
Practice Management Seminars
During the PGY-2 year, all residents rotate through our Faculty Practice Office (FPO), where they work alongside our general medicine faculty in a private practice setting. During their first year of training, residents rotate through the Emergency Room at UMMC and the Emergency Care Services (ECS) at the VA. They return to ECS in the 2nd and 3rd years, where they receive additional training in outpatient urgent care medicine. The Emergency Room experience is described under the University of Maryland Medical Center.