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Ambulatory Care RotationDuring each of the three years of residency training, the Ambulatory Care Rotation (ACR) is devoted to training residents to care for patients in the outpatient setting. As part of ACR, residents spend three or four half days each week seeing general medical patients in their own continuity practices. Categorical and Primary Care residents also attend dedicated sessions in subspecialty clinics including thyroid, breast, Ob/Gyn, orthopaedics, rheumatology, dermatology, HIV, pulmonary medicine, neurology, opthalmology, ENT, and geriatrics. Community medicine experiences are incorporated into ACR blocks. These include opportunities to work with Boston Healthcare for the Homeless (led by MGH's Jim O’Connell, MD), the TB/HIV and Hepatitis C/HIV clinics at the Shattuck Hospital, and a variety of other community medicine sites. Related Links
Ambulatory requirements are specified below for Categorical, Primary Care, and Preliminary residents.Categorical
Primary Care
Preliminary
Example Weekly ACR Schedule for IMA Continuity Resident
Ambulatory CurriculumACR ConferencesAmbulatory care conferences are integrated into ACR blocks and draw from a variety of topics in outpatient medicine. There is a bilevel curriculum, with one curriculum for interns and another two-year expansive curriculum for residents. Regardless of the level of training, the academic year is divided into three learning blocks. Each learning block covers topics that advance as the year progresses. During each block, there are daily lectures from 8am to 9am and on Tuesday mornings; didactic lectures extend from 8am to noon. In addition, interns have 7am patient case discussions with the ambulatory chief resident and teaching senior once a week. Dermatology Case ConferenceDermatology Case Conference is a monthly conference where cases are discussed with a dermatology attending physician. Residents are encouraged to photograph any interesting or perplexing dermatological findings seen in clinic to present during these monthly conferences. This conference is not only helpful for resident education, it also assists in patient care as it often leads to an expedited dermatology consultation. Ambulatory Intern ReportThis is a weekly conference for interns to discuss difficult clinic cases or challenges in their continuity clinic practice with the ambulatory chief resident and the teaching senior. The conference is informal and interns are welcome to ask any questions that have come up during the course of their clinic experience. Evidence-Based MedicineThis workshop is devoted to the critical review of the medical literature relevant to certain clinical issues. A recent peer-reviewed study is selected by the presenter (resident or faculty) and circulated in advance to attendees. During the conference, the study design, methodology, and biostatistical methods are reviewed in detail. Senior Resident TalkSenior residents in the Primary Care Program are required to give a presentation to ACR residents on topics of their choosing. Senior talks provide an opportunity for residents to develop skills in public speaking and teaching. Specialty ConferencesThese occur two to three times per week on the ACR rotation. Specialists, both medical and non-medical, present discussions on the current clinical management strategies of commonly encountered problems from their respective fields. These conferences cover topics in cardiology, gynecology, psychiatry, orthopaedics, gastroenterology, pulmonary, and geriatrics, among others. Mini-CoursesDuring each ACR block, certain topics are presented in-depth, such as teaching techniques for residents, approaches to multicultural care, public health, diabetes, women’s health and evidence-based medicine. Each course is usually given three times throughout the year (once within each learning block). Women’s Health WorkshopThe Women’s Health workshop provides a dedicated morning for discussion and instruction on topics in Women’s Health, including a focus on HPV, breast exams, and pelvic exams. Preclinic ConferenceThis is a monthly conference during a pre-continuity clinic protected time for most residents (several of the off campus clinics cannot accommodate this into the schedule due to travel time, but these clinics have their own dedicated learning time). Topics this year include back pain, Dermatology – what the PCP needs to know, osteoporosis, the knee exam, thyroid nodules, Psychiatry – what you can treat and when to refer, allergic rhinitis, and care of the noncompliant patient. For more information about the Ambulatory Care Rotation, Continuity Practice, Practice Sites, and Outpatient Medicine, please click on the following page links below: |
Contact Us Internal Medicine Residency Program Massachusetts General Hospital Department of Medicine 55 Fruit Street GRB 740 Boston, MA 02114 Phone: 617-726-2865 Fax: 617-724-7441 Email Us Global Primary Care Program Massachusetts General Hospital Department of Medicine Center for Global Health 100 Cambridge St., 15th Floor Boston, MA 02114 Phone: 617-724-1215 Fax: 617-724-1637 Email Us Detailed Contact Information Categorical NRMP Number: 1261140C0 |
