Continuity Year 1

RHEUMATOLOGY OUT-PATIENT CONTINUITY CLINIC-YEAR 1

The principle educational goals for the outpatient continuity for first year rheumatology fellows are indicated for each of the six ACGME competencies. The goals for BMC and VA outpatient continuity clinics are identical. The second column of the table below indicates the relevant principle teaching/learning for each goal, using the legend below.

Legend for Learning Activities (See attached for explanation)

DPC-Direct Patient Care**
CCC-Clinical Case Conference RC-Radiology Conference
FC-Fellow Curriculum JC-Journal Club
PC-Pathology Conference Inter-Hospital Rounds-IHR

*All Fellows are expected to read about their patients in an appropriate rheumatology text and supplement this general reading with references in the primary literature.
**All rheumatology out-patients are reviewed individually with the responsible rheumatology attending.

1) Patient Care
    Principle Educational Goals
Learning Activities*
Obtain a rheumatic disease history DPC, CCC, FC
Examine the musculoskeletal system DPC, CCC, FC
Develop basic rheumatology procedural skills DPC
Define and prioritize the patient’s rheumatic problems DPC, CCC, FC, PC, RC
Generate and prioritize differential diagnoses DPC, CCC, FC
Develop rational, evidence-based management strategies DPC, CCC, FC, PC, RC
2) Medical Knowledge
    Principle Educational Goals
Learning Activities*
Expand clinically applicable knowledge base of the basic and clinical sciences underlying the care of rheumatology out-patients DPC, CCC, FC, PC, RC, JC, IHR
Access and critically evaluate current medical information and scientific evidence relevant to rheumatic out-patient care DPC, CCC, FC, PC, RC, JC, IHR
3) Practice-Based Learning and Improvement
    Principle Educational Goals
Learning Activities*
Identify and acknowledge gaps in personal knowledge and skills in the care of ambulatory patients DPC, CCC, FC, JC, IHR
Develop and implement strategies for filling gaps in knowledge and skills CCC, FC, JC, IHR
4) Interpersonal Skills and Communication
    Principle Educational Goals
Learning Activities*
Communicate effectively with patients and their families in the out-patient setting DPC, CCC
Communicate effectively with physician colleagues at all levels, especially referring physicians DPC, CCC, IHR
Communicate effectively with all non-physician members of the health care team to assure comprehensive and timely rheumatology care of out-patients DPC, CCC, PC, RC
Present patient information concisely and clearly, verbally and in writing DPC, CCC, PC, RC, IHR
Teach colleagues effectively DPC, CCC, PC, RC, IHR
5) Professionalism
    Principle Educational Goals
Learning Activities*
Behave professionally toward patients, families, colleagues, and all members of the health care team All
6) Systems-Based Practice
    Principle Educational Goals
Learning Activities*
Understand and utilize the multidisciplinary resources necessary to care optimally for out-patient rheumatology patients DPC
Collaborate with other members of the health care team to assure comprehensive ambulatory rheumatology patient care DPC
Use evidence-based, cost-conscious strategies in the care of ambulatory rheumatology patients All

Evaluation Methods

Fellows are formally evaluated in writing, using ABIM standard evaluation forms by attendings quarterly and reviewed with the fellow by the Program Director twice yearly. The Program Director reviews all evaluations as they occur. If an unfavorable or marginal evaluation is received, an urgent appointment with the Program Director is scheduled to review the issues raised in the evaluation.