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Ambulatory Block Rotations

The Internal Medicine Residency Program at CHA is committed to excellence in outpatient training. In our “2+4” program structure, residents spend two weeks immersed in ambulatory rotations, alternating with four weeks of other training experiences (inpatient wards, ICU, elective, etc) throughout the 36 months of their training.  This structure allows residents to be engaged in outpatient medicine without the distraction from concurrent inpatient ward responsibilities, and allows our residents to truly function as primary care providers at the ambulatory care practices in which they see patients.

Im Residency Immersion schedule
Interns and residents have 4 continuity clinic sessions (1/2 day each) per week during ambulatory rotations, as well as one half day per week reserved for administrative responsibilities. The remainder of the time on ambulatory rotations for interns is spent in longitudinal ambulatory rotations in Geriatrics, Mental Health, and Addictions Medicine (see below). Second- and third-year residents spend the remainder of their time on ambulatory rotations rotating through medicine subspecialty clinics and at least one rotation as the Ambulatory Teaching Resident.

Longitudinal Experiences for Interns:

On ambulatory rotations, interns spend a half day per week at Addictions Medicine, a half day per week seeing patients with a psychiatrist at his/her continuity practice site, and one full day on Geriatrics. These experiences occur during the entirety of the internship year, and provide important foundations for a comprehensive education in ambulatory medicine.

Ambulatory Sub-specialties:

In addition to their continuity clinic sessions, second- and third-year residents on ambulatory rotations have dedicated time to learn in the subspecialties of Internal Medicine. Three half days per week are spent in single specialty area, over the course of two ambulatory rotations. Each resident will rotate through Endocrinology, Gastroenterology, Hematology-Oncology, HIV Medicine, Rheumatology and Orthopedics, and Neurology during his/her training. 

Ambulatory Teaching Resident:

Each second- and third-year resident on ambulatory is assigned to be the Ambulatory Teaching Resident at least once per year. During this rotation, the resident is responsible for developing and leading the daily Ambulatory Morning Report conference. This is an opportunity for the resident to develop skills as a teacher and facilitator, with the coaching of an expert teacher mentor.