While the majority of healthcare delivery occurs in ambulatory settings, internal medicine residency training remains largely hospital-based. To address this imbalance between training and practice, the Yale Primary Care Program is committed to providing expanded and uncompromised ambulatory training. Innovative curricula ensure continuity of care with patients, continuous relationships with supervising faculty, diverse clinical settings, and experiential learning with graduated autonomy.
Morning report takes place Monday through Saturday at all inpatient training sites is an interactive case-based discussion led by the chief residents with guidance and participation by faculty. One report each week is specifically for interns and Saturday report is for all housestaff in the hospital. We emphasize clinical reasoning and pathophysiology of disease in these discussions. Indications and accuracy of diagnostic testing, medical management and the literature supporting the most appropriate options are reviewed, and key concepts are summarized as “take home” learning points.
Residents have required inpatient and outpatient rotations each year complimented by an array of elective opportunities in general internal medicine, all medical subspecialties, global health, and research. The rotation schedule consists of thirteen four-week blocks. The inpatient rotations are a mix of specialty teams (Oncology, Liver Disease, Renal Disease, HIV Disease) and general medicine including a Firm dedicated to care of the elderly hospitalized patient. Each resident has four weeks of vacation each year.
The ambulatory medicine didactic curriculum of the Yale Primary Care Residency is among the most comprehensive and effective seminar series offered in any training program. Organized around 12 recurring outpatient medicine themes, the curriculum features lectures, interactive seminars, peer teaching, self-directed and experiential learning, workshops, and off-site experiences. By way of example, two recent theme day schedules are detailed below.