Continuity Year 2

RHEUMATOLOGY OUT-PATIENT CONTINUITY CLINIC-YEAR 2

The principle educational goals for the outpatient continuity for second 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 more skillfully	DPC, CCC, FC
Examine the musculoskeletal system more skillfully	DPC, CCC, FC
Refine 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 rheumatology 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.