VCU Internal Medicine Training Program
Ambulatory Rotations

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

• Continuity Clinics
• Weekly continuity clinics
• Continuity clinics are cancelled under the following circumstances:
• During ICU, Night Float, and Away rotations
• Post ICU overnight call
• For R2 & R3 ONLY – on MCV long & short call, and on VA long call
• For R2 & R3 WARD residents only, on Monday AM intern switch days
• For holidays and as needed for teaching retreats etc.
• Cancelled clinics are rescheduled whenever possible during the same week, or during the preceding or following week – check AMION carefully for rescheduled clinics
• All residents are expected to attend clinical duties (including continuity clinic) on Wednesday AM of switch days, even if post night float
• 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 Partners in Primary Care
• Partners are assigned by day of clinic
• Partners will rarely be in clinic at the same time (alternate ACC – VA)
• Partners are within the same training year to facilitate continuity when possible
• Each Partnership has a designated Attending
• Ratio 12 Attending: 8 Partnerships maximum
• 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
• Partners will see each others’ patients as necessary
• Attendings are available for support regarding patient management, as well as some follow-up duties when specifically asked by a Partnership
• Ambulatory Blocks
• PGY-1 Ambulatory Block (ACC Block)
• Focused introduction to the ambulatory experience
• Includes time in continuity clinic, geriatrics, pain clinic, CHF clinic, lipid Clinic, travel clinic
• Time for chart review and Partnership work
• Also assigned time with nursing staff, pharmacy, other healthcare professionals (PT/OT, nutrition) to develop appreciation of functions of other persons in our system
• Includes Med Tech Tuesdays: an introductory course in Evidence-Based medicine, information resources, and presentation skills
• PGY -2 Ambulatory Care Subspecialty Block (ACSB Block)
• Experience in non-medicine clinic-based specialties that have a significant clinical overlap with primary care: Neurology, Otolaryngology, Urology, and Adolescent Health
• Ambulatory Care Teaching Block (ACTB 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
• Combined with Primary Care Call (from home) duties
• 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)
• Indigent care community clinic
• Offered to Women's Health residents and general internist track
• Scheduled during the ACC, ACSB, ACTB, and Student Health blocks
• Chief medical resident supervision
• Gynecology clinic
• Pain Clinic