Ambulatory Clinic Experience
In addition to busy in-patient experience, the medical residents have an on-site ambulatory facility. The clinic has several medical and surgical specialty services, staffed by the residents from the respective residency programs and faculty. In addition, general radiology, mammography, phlebotomy, orthopedic services, and full-time pharmacy services are available for the patients.
Goals of the Ambulatory Teaching Clinic
- Patient-centered training
- Provide continuity of care
- Teach time management skills
- Teach efficient use of resources
- Interpretation of diagnostic testing
- Management of chronic diseases
- Assessment of disability
- Consultation and referral skills
- Understand how to be an advocate for patients
- Monitor and provide comprehensive preventive care
- Understand how to manage care and the billing system
Overview of Outpatient Schedule
The adult medicine clinic is in the Professional Office Building, Suite 114 of Sinai-Grace Hospital. The clinic is open Monday through Friday from 8:00 AM to 12:00 PM for morning sessions and 1:00 PM to 5:00 PM for afternoon sessions. Residents are assigned to see patients by appointment; PGY-3 residents are also required to see walk-in patients in addition to their scheduled appointments.
Residents are supervised by teaching faculty. Each case is discussed, the chart reviewed, and co-signed by the faculty. A primary Medical Assistant is assigned to work with each resident at the clinic.
Patient Scheduling
Continuity of care is strongly emphasized, and patients are scheduled with their assigned resident whenever possible.
| Year | New Patients | Follow-Up Patients | Time per New Patient |
|---|---|---|---|
| PGY-1 (first 6 months) | 1 | 3 | 60 minutes |
| PGY-1 (last 6 months) | 1 | 4 | 60 minutes |
| PGY-2 | 2 | 5 | 45 minutes |
| PGY-3 | 2 | 6 + walk-ins | 45 minutes |
Follow-up patients are allotted 30 minutes. The attending supervisor may redistribute patients to other residents based on volume.
Emergency Department Rotation
In addition to their continuity clinic, PGY-1 residents rotate through the Emergency Department at Sinai-Grace Hospital for one month. Residents complete 8–10 hour shifts and have first contact with all patients they evaluate in the ED. All cases are discussed with the ED attending physician after evaluation.
Subspecialty & Elective Rotations
Residents have subspecialty and elective rotations throughout all three years of training, rotating with various medical sub-specialties in the outpatient setting. Residents see patients scheduled for the day and discuss diagnosis and treatment plans with the attending physician.
Education
At the start of every clinic session, there is a 15-minute group discussion with the supervising faculty. Topics are assigned to residents by the clinic supervisor ahead of time. At the end of the academic year, a comprehensive ambulatory curriculum-based exam is administered to all residents.
Supervision
The faculty-to-resident ratio is 1:4, both in morning and afternoon clinics. Faculty do not see private patients in the resident clinic.