Clinical Rotation: Ambulatory Care

Internal Medicine residents work in a variety of ambulatory care settings, including a hospital-based family health center (FHC), immediate health care facilities, and offices of physicians in private practice in the community. 

Primary Care
Categorical residents follow a panel of patients at the Family Health Center (FHC), a freestanding ambulatory care center that functions as a private office.  Residents are responsible for the ongoing care of their patients - scheduled continuity visits, episodic care, returning telephone calls, and following up on all tests.  The FHC has excellent support staff to help residents work efficiently.  Residents spend an average of one half-day/week in the FHC throughout their three years of training.

Residents have a two-month rotation in Ambulatory Care during the second and third years.  This elective is divided between seeing urgent care and continuity patents in the FHC, and working in outside practices in Gynecology, Pediatrics, Orthopedics, Allergy, Rheumatology, Podiatry, and Dermatology.  This rotation allows residents to concentrate on perfecting skills for managing medical problems in the ambulatory setting.

Urgent Care
Residents can schedule electives in one of several Immediate Health Care centers located in a variety of communities, ranging from inner city to suburban sites.  These centers tend to see younger patients who have been in good health, so have no regular physician.  They provide residents the opportunity to care for patients who are not seen in hospital-based practice. 

Residents schedule two rotations in the Emergency Department.  In the ED, which has 55,000 annual visits, residents perform procedures from suturing to urgent intubation, and learn to care for trauma and medical emergencies. 

Specialty Care
Residents work in the practices of private attendings during subspecialty electives.  They also work in the specialty clinics at the FHC, and so get the opportunity to observe the spectrum of disease and disease management in different settings.

Geriatrics
Residents participate in a rotation at the Jewish Home for the Elderly.  This outstanding academic facility trains residents from several surrounding hospitals and Yale University.  Residents learn comprehensive care of the elderly, including geriatric assessment and the importance of the multi-disciplinary approach.  During this rotation, residents also work within the community and accompany Geriatricians to patients' homes.  They learn how to deliver care to the homebound, and gain first-hand experience of the impact of healthcare services outside the traditional medical establishment.