Common Components

Common Components

Clinical components that are common to the Categorical and Primary Care curricula include:

  • A 3-year outpatient continuity experience in University Medical Associates, our nationally recognized faculty-resident practice. All residents work together in an outpatient firm system with a dedicated firm attending.
  • Ambulatory electives in all outpatient internal medicine subspecialties as well as clinic rotations in sports medicine, orthopedics, dermatology, adolescent medicine/student health, women’s health, ophthalmology, palliative care, and the Charlottesville Free Clinic.
  • An opportunity to take a Health Policy elective in which the resident joins Carolyn Engelhard, MPA and her graduate level class to explore issues involving private and public health coverage as well as exploration of various health systems.
  • Ample opportunities for national and international rotations, with established rotations on the Eastern Shore of Virginia, the Navajo Reservation in Arizona, Latin America, and Africa.
  • A comprehensive 3-year ambulatory curriculum, covering core primary care clinical topics, systems- and practice-based learning, advanced physical diagnosis, advanced interviewing skills, and office procedures.
  • Opportunities to conduct research projects under the mentorship of nationally recognized general internists and geriatricians. Areas of expertise include medical errors and patient safety, cancer screening, care of the underserved, chronic illness care, geriatrics, and palliative care.
  • Continued advisory support throughout all three years to help each resident create and maintain career goals as well as promote discussion of difficulties encountered with the new role as physician.

Continuity Clinic

Nadkarni_HeleniusHousestaff in the Categorical and Primary Care Tracks provide comprehensive, ongoing care to a panel of primary care patients in our university-based general medicine clinic, University Medical Associates (UMA). The clinic resides in a newly renovated and dedicated space with computers in each exam room and utilizes EPIC, the hospital-wide electronic medical record. Interns have clinic one half-day per week and residents see patients one half-day per week when on inpatient rotations and at least twice per week when on elective rotations.

(Pictured:  Ira Helenius, M.D., Medical Director at UMA (L), and Mo Nadkarni, M.D., Division Chief for General Medicine, Geriatrics and Palliative Care (R); both are Firm Attendings at UMA)

Housestaff are assigned at the beginning of the PGY-1 year to an outpatient "firm" at UMA. This consists of a General Internal Medicine faculty mentor/firm director, a firm nurse, and approximately six residents who follow their patients over the span of their three-year residency. This team approach yields optimal patient care while facilitating the development of a mentoring relationship with a primary care faculty role model. With a base of 8,000 patients and 25,000 annual visits, diverse opportunities are provided for long-term patient management and continuity of care. Clinics do not occur on call days or post-call days.

Primary care at UMA also involves an array of health care resources including full-time clinical pharmacists, nurse practitioners, diabetes educators, a respiratory therapist, a nutritionist and a social worker. A daily outpatient morning report and longitudinal primary care curriculum are integrated into the UMA training experience.

Ambulatory Curriculum

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The “+1” week allows our residents to focus their energy on outpatient medicine, but we want to complement this with a dedicated ambulatory education series. The result is the design of our Wednesday morning ambulatory curriculum. All residents spend the Wednesday morning during their “+1” week at these sessions. The first hour of each session is spent utilizing an ambulatory, case-based curriculum which covers the assessment and management of common ambulatory conditions. The second hour is dedicated to longitudinal quality improvement projects, in which residents learn and apply various principles of quality improvement to actual issues identified within the UVA Health System. The last two hours of the session are comprised of a rotating series of lectures which vary according the each resident’s level of training. Some examples of topics include safe sign out and handoff of care practices, motivational interviewing, office procedures, humanism in medicine, health policy, and career guidance including contract overview. We also include an outpatient journal club once per quarter to cover new discoveries in ambulatory medicine and principles of critical appraisal of literature.

(Pictured: General Medicine attendings Drs. Brian Uthlaut, Jennifer Marks, Matthew Goodman and Katherine Jaffe with Ted Perry, PGY2 [second from left])

Special Ambulatory Electives

Migrant Health Eastern Shore — This one-month rotation on the rural eastern shore of Virginia offers an opportunity to provide primary care to a rural underserved cross-cultural population of local residents and migrant farm workers – working in the clinic, on the migrant farm worker camps and on the tiny island of Tangier (reached by boat or small plane). This is a rich environment for learning about public health and cross-cultural/international health.

Indian Health Service — A one-month rotation at one of our affiliated Navajo Reservation sites offers an opportunity to provide primary care to underserved Native Americans and to learn the tenets of cross-cultural medicine and population-based health. Residents are supervised by a UVA Internal Medicine program graduate.

International — Residents have been supported in overseas rotations in Kenya, Uganda, Saipan, Brazil and India and are encouraged to develop unique experiences that help them meet their goals for future practice and enhance cross cultural training in the residency program. Residents can choose from locations with established relationships with UVA or can create their own experience.

Advisory Support System

Committee on Residency Education (CORE) — Department faculty have a major interest in housestaff development and education. The CORE supervisory board includes the Program Director, six to eight key Clinical Faculty, the Chief Residents, and an additional resident representative. CORE faculty members are assigned incoming housestaff and serve as their mentor and advisor. This relationship is solely advisory in nature allowing residents to openly discuss all aspects of training and career planning with their assigned CORE advisor. This 1:1 relationship continues through all years of training and fosters a smooth transition from medical school to residency and then on to a fellowship or career practice. Core faculty members also facilitate assignment of faculty subspecialty and research mentors to assist housestaff in meeting their career and educational goals.