Allopathic Schedule

for Primary Care Track

PGY1

RotationDuration (blocks
General Internal Medicine Inpatient 3
ICU 1
Night Float 1
Cardiology 1
*Ambulatory - Berkshire Heights 2
Ambulatory - A4/A3 Subspecialty Clinics in AM and Ambulatory Subspecialties in PM 1
Women's Health 1
Elective 3

PGY2

RotationDuration (blocks
General Internal Medicine Inpatient 3
ICU 1
Night Float 1
Cardiology 1
*Ambulatory - Berkshire Heights 2
Ambulatory - A4/A3 Subspecialty Clinics in AM and Ambulatory Subspecialties in PM 1
Psychiatry 1/2
Geriatrics 1/2
Transitions of Care 1
Neurology 1
Elective 2

PGY3

RotationDuration (blocks
General Internal Medicine Inpatient 2
ICU 1
Night Float 1
*Ambulatory - Berkshire Heights 3
Geriatrics 1/2
Musculoskeletal Medicine 1
Dermatology 1
Emergency Care Unit 1
Elective 2 1/2

Longitudinal Curriculum: Concurrent with block curriculum over 3 years of training 

  • Continuity Ambulatory Experience at Community-based Practice Site 
  • (1/2 day/week once or twice weekly based upon rotation; none during ICU, Night Float, General Inpatient Medicine rotations)
  • QI team project - longitudinal 
  • Portfolio project - longitudinal

*Ambulatory - Community-based general medicine – The resident will train at the community-based practice site for 7 months over 3 years. In addition, the resident will maintain continuity of practice through ½ day experiences at the same community based site once or twice weekly during many other rotations. The current ambulatory curriculum will be expanded to promote a greater depth of knowledge and skill for the spectrum of ambulatory medical problems, greater focus on the care of patients with chronic medical illness, greater awareness of community resources, greater focus on office team functions, and greater depth of experience in process improvement. “Business issues in health care” will be actively incorporated into the training curriculum.

The resident will provide care to his/her panel of patients approximately 8 half day sessions per week and will be involved in process improvement education and implementation 2 half days weekly. Community outreach experiences may also occur during this time. The resident practice will occur in an office setting along with other primary care providers. Several core clinicians trained in faculty development and process improvement will serve as mentors. The resident will be an active participant in a practice that is developing a medical home model. The resident will develop skills in working in a team with other staff, including physician extenders. The resident will also become aware of organizational changes, resulting from the health system’s evolution toward an Accountable Care organization.

Regular ambulatory conferences including ambulatory morning report will occur onsite and will be integrated into the residents’ general didactic program.

Quality Improvement Project – A robust QI training curriculum already exists and is in its 5th year for the internal medicine residency. The PCRE residents will continue in this 3 year long longitudinal “learn by doing” program, but will serve in separate teams that will focus on projects relevant to the ambulatory practice sites or community. The experience of the PCRE residents will be even more intense since 10% of their ambulatory office time will be devoted to their projects. The program leadership will help the resident define the problem based upon Institute of Medicine’s six aims (safe, effective, equitable, efficient, timely, patient centered) and will facilitate involvement of other stakeholders. The program leadership will also assure support for data gathering and analysis and create opportunities for the resident to report results to organizational leadership. The resident will also be integrally involved in strategies to “spread” the improved processes more broadly through the organization or community.