Primary Care Track

In July 1985, in recognition of the increasing need for broadly trained primary care internists, the Department of Medicine implemented a Primary Care Track under the direction of the Division of General Internal Medicine. The goal is to train physicians in comprehensive care of the adult patient. The core training experience focuses on in-patient internal medicine, an experience essentially identical to that provided in the Categorical Track. Graduates of the Primary Care Track describe themselves as well prepared to practice primary, consultative, and critical care medicine, and they have performed as well on the ABIM certifying examination as graduates of the Categorical Track. The Primary Care Track offers an optional curriculum, that provides primary care training with an additional focus in Women’s Health Continuity Clinics In recognition of the need to acquire skills in out-patient medicine, the Primary Care Track provides more ambulatory training than is offered in the Categorical Track. Primary Care residents practice ambulatory medicine at two sites. Residents attend the Russell Ambulatory Clinic on a weekly basis. In addition, residents have a VA Medical Center continuity clinic which meets weekly, providing an opportunity to follow patients discharged from VA in-patient services. In both clinic sites, the resident is regarded as the primary physician with the attending physician serving as consultant and teacher. The attending physician to resident ratio is low (typically one attending working with four residents) to assure opportunity for close instruction and optimal teaching.

Block Months

The block month is a major distinguishing characteristic of the Primary Care Track. Block months are rotations devoted to ambulatory training. The purpose is to allow concentrated time in ambulatory medicine without in-patient responsibilities. One block month is provided during the R-1 year and two during each of the R-2 and R-3 years. For a typical block month, approximately 30% of the time is devoted to the continuity practice of general intemal medicine. The remainder of the time is devoted to areas such as geriatrics, office gynecology, otolaryngology, ophthalmology, dermatology, sexually transmitted diseases, sports medicine, and subspecialty internal medicine clinics. The specialty clinics are selected on an individual basis.

Typical R-1 Primary Care Block Month

Typical R-2 or R-3 Primary Care Block Month

The resident has the opportunity to work on a one-on-one basis with attending physicians in various medical subspecialties. Didactic Curriculum The primary care didactic curriculum includes multiple conferences and seminars each week. Ambulatory Care Conference for R-1 residents is a twenty-minute session held weekly at the beginning of clinic and covers topics including health maintenance and preventive medicine. Ambulatory Morning Report is a one-hour, learner-centered, case-based discussion held three times a week during block months. The General Medicine Tuesday Noon Conference reviews clinical topics relevant to primary care.