PGY-1 PCG Learning Objectives
Educational Purpose
The intern continuity clinic serves as an introduction to the longitudinal care of the outpatient general medicine patient. Goals for this first year of the experience include efficient use of time and schedules, effective doctor patient communication, appropriate documentation, health care maintenance skills and competence in the evaluation and management of common outpatient complaints.
Description of the Rotation
The Intern Continuity Clinic is structured as a half day clinic experience occurring during ambulatory blocks, which are two week blocks occurring every six weeks (4+2 model). Interns build and follow their own patient panel with the assistance of assigned faculty preceptors. These preceptors are immediately available for discussion and, if necessary, interview and examination of the each patient during the intern’s clinic. Each preceptor will be responsible for advising no more than 4 interns at a time. Preceptors will have no other clinical responsibilities outside of resident precepting during the half day session.
Interns are expected to present each clinic encounter to their preceptors and discuss appropriate management. During the first six months of training, every patient must then be seen and examined by the attending preceptor. After six months of training, the intern will either return to the examination room to complete the interaction alone or be accompanied by the attending for further clinical evaluation. This will be determined by the complexity of the case. Interns are encouraged to ask their preceptors to interview and examine patients if they are uncertain about aspects of the history and examination. Interns are not responsible for completing the encounter’s billing form. The attending will complete the billing sheet and perform appropriate documentation as required by HCFA.
For knowledge areas, see Resident Continuity Clinic Objectives
PGY-2/3 PCG Learning Objectives
Educational Purpose
The resident continuity clinic is an opportunity for our residents to refine their skills in the longitudinal management of the ambulatory general medicine patient. Goals for these two years are include competent management of complex multisystem disease, an approach to the problem patient, doctor to doctor communication and phone medicine.
Description of the Rotation
The Resident Continuity Clinic is structured as a half day clinic experience occurring during the ambulatory block, usually 4 half-days of clinic over a 2 week block, which occurs with frequency of about every 6 weeks in the 4+2 model. Residents build and follow their own patient panel with the assistance of assigned faculty preceptors. These preceptors are immediately available for discussion and, if necessary, interview and examination of the each patient during the resident’s clinic. Each preceptor will be responsible for advising no more than 4 residents at a time. Preceptors will have no other clinical responsibilities outside of resident precepting during the half day session.
Residents are expected to present each clinic encounter to their preceptors and discuss appropriate management. Depending on the complexity of the case, the resident will either return to the examination room to complete the interaction alone or be accompanied by the attending for further clinical evaluation. Residents are encouraged to ask their preceptors to interview and examine patients if they are uncertain about aspects of the history and examination. Residents are not responsible for completing the encounter’s billing form. The attending will complete the billing sheet and perform appropriate documentation as required by HCFA.
Throughout the remainder of the week (when not in clinic), residents are expected to be available to their clinic patients by pager and through PCG support services. In the event that issues arise which require attending advice, the resident should contact either their assigned clinic preceptor or the PCG Faculty member on call. Residents are free to make use of the PCG Acute Care clinics where appropriate.
The knowledge areas for the Intern and Resident Continuity Clinic Curriculum are below.
Continuity Clinics – KNOWLEDGE AREAS
Preventative Health Care
The residents should be familiar with the current recommendations for health promotion and preventive health care. Residents need to know how to perform common preventive services including screening examinations of the breast and prostate. Residents need to be proficient in performing pelvic examinations and pap smears.\
Common Complaints
The resident needs to be able to evaluate common complaints including:
Fatigue
Dizziness and Vertigo
Weakness and Muscle weakness
Unexplained Weight Loss
Sleep Disorder
Hematuria
Dyspepsia and Abdominal Pain
SOB
Cough
Headaches
Back pain
Joint pains
Diarrhea
Common Medical Problems
The resident needs to be able to diagnose and treat the following common medical problems. The resident needs to have expertise in the initial evaluation and long term management of each of the following conditions. It is important to emphasize indications for and appropriate timing of referrals.
Hypertension
Diabetes Mellitus
Congestive Heart Failure
Coronary Artery Disease
Atrial fibrillation
Hyperlipidemia
Asthma and COPD
Cerebrovascular Disease
Peptic Ulcer Disease
Irritable Bowel Disease
Gastroesophageal Reflux Disease
Alcoholic Liver Disease
HIV
Osteoarthritis
Osteoporosis
Anxiety and Depression
Seasonal Allergic Rhinitis
Sinusitis
Benign Prostatic Hypertrophy
Impotence
Common Lung Infections
Urinary Track Infections
Chronic Pain Syndrome
Women’s Health
The resident needs to have familiarity and expertise in dealing with the following women’s health issues:
Dysfunctional Uterine Bleeding
Benign Breast Disease
Breast Lumps
Birth Control and Family Planning
Oral Contraceptives
Hormone Replacement
Abnormal Pap Smears.
Psychosocial
Dealing with Difficult Patients
Alcohol and Substance Abuse
Domestic Violence
Disability
Economics of Drug Therapy
Advanced Directives
Death and Dying
Living Will