At Indiana University, we strive to provide our residents with a well-rounded training program. Our ambulatory program is designed to not only train future primary care physicians, but also subspecialty physicians who will spend a significant amount of time practicing in the office setting and treating chronic diseases. Ambulatory education is a vital aspect of every resident's training, and we continually explore innovative ways to improve our residents' outpatient experience.
We have designed our ambulatory curriculum to ensure that each resident, upon graduation, is proficient in caring for outpatients. We do recognize that some residents, particularly those choosing to practice primarily in the outpatient setting, may wish to pursue additional ambulatory training experiences. Our program is flexible, and the format offers those residents the opportunity to choose primary care electives and allocate up to fifty percent of their time in the outpatient arena.
Beginning with the first week of internship, our residents have their own continuity clinics one half day a week. Clinic sites include IU hospital and affiliates, VA hospital and affiliated with Eskenazi Hospital include the Primary Care Center, Blackburn, Forest Manor, North Arlington, Grassy Creek, Westside, and 38th Street (the predominantly Spanish-speaking clinic).
Each resident sees his/her own patients in the same site at the same time each week for all three years, and is generally staffed by his/her preceptor who also is familiar with the patients. In addition to ambulatory medicine, residents are also encouraged to learn important skills such as billing and coding, time management, and office procedures. Intensity-responsive scheduling allows continuity clinics to be cancelled during inpatient months including some call days, night float, and ICU rotations. Through our EIP - REACH program, the Patients First initiative has allowed us to integrate a one-week "immersion week" in which residents spend a dedicated week in clinic without the distraction of ward responsibilities.
Interns will have one ambulatory rotation per year, and second and third year residents have two ambulatory rotations per year with slightly different emphasis during each block. In addition, all residents in the rotation participate in a number of workshops and "academic half-days." These twice-weekly didactic sessions are case-based and interactive and based on a three-year rolling curriculum of outpatient topics. The speakers are a mix of specialists and general internists dedicated to teaching. Special physical exam skills are provided through cardiovascular auscultation workshops. A coding and billing workshop allows residents to hone this important set of skills. Great emphasis is also placed on doctor-physician skills education.
The ambulatory rotations are devoted solely to ambulatory care, and during these months our residents spend their days in the outpatient clinics located in the campus hospitals and also in private offices in Indianapolis. Our newly re-designed curriculum provides our residents with week-long, multi-disciplinary, sub-specialty immersion experiences. Specialty weeks include endocrinology, women’s health, infectious disease, dermatology, pulmonology, cardiology, hematology, oncology, nephrology, neurology, sports medicine, pre-op clinic, physical medicine, gastroenterology, allergy, and palliative care. During the second and third years, each resident may tailor his or her experience according to personal interests and goals. Two other ambulatory-based rotations, geriatrics and rheumatology, are required for everyone.