The Ambulatory Experience
In July 2010, the residency program moved to a 3+1 block scheme. This innovative change was created to provide an outstanding outpatient experience without interruption by inpatient duties and to provide a dedicated core curriculum in ambulatory medicine. In this model, residents have an ambulatory week every 4th week throughout the 3 years of residency. The clinical component of the ambulatory week comprises a mix of continuity clinics and subspecialty clinics. The educational component of the ambulatory week consists of core curriculum topics, case discussions, subspecialty conferences and an academic half day. The academic half day focuses on important areas of clinical medicine that require skills practice in an interactive format. In 2010, the EBM “boot camp” kick-started the academic half days covering key topics to enable residents to apply evidence efficiently in patient care. This will be followed by “boot camps” in patient safety and quality and physician-patient communication.
Residents are active participants in the primary care practices at BMC and affiliated Neighborhood Health Centers and the VA. Our residents function as the primary care physicians for a panel of patients and provide comprehensive care for an extraordinarily diverse patient mix in a supportive environment, supervised and mentored by faculty preceptors. Throughout residency, the residents’ patient panel will grow in size and complexity as their skills mature. In addition to direct referrals from the community, residents may self-refer patients whom they care for on the wards and the emergency department to their own practice. In Spring 2010 the ambulatory clinics at Boston medical Center moved into the new Shapiro Ambulatory Care Center. The Shapiro Center is Boston’s newest outpatient care facility, is patient-centered is design, and its friendly environment is designed to maximize comfort and privacy while also providing a setting for our ambulatory education teaching.
Nine subspecialties have been designated as the core subspecialties of Internal Medicine: cardiology, pulmonary, gastroenterology, geriatrics, hematology-oncology, nephrology, rheumatology, endocrinology and infectious diseases. Through the course of 3 years, residents will have exposure to all nine specialties leaving them with a well-rounded, all-encompassing educational and clinical experience.