Clinical components that are common to the Categorical and Primary Care curricula include:
- in , 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.
Housestaff 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.
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.
Our faculty has developed an innovative, graduated program in systems-based practice, practice-based learning, communication and professionalism competencies. Over the three years, in the fall and spring elective periods, residents participate in two dozen interactive seminars and projects to acquire and practice these new skills under the direction of selected general medicine faculty. The seminars focus on quality improvement and have been instrumental in resident-led changes to the clinic workflow and to each resident’s personal practice. This curriculum reflects the values, interests and roles of general and subspecialty internal medicine physicians whether in practice or academia.
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.
Intern Support Groups — The first year of residency training can be stressful for even the most prepared house officer. Small groups run by members of the General Medical Faculty meet beginning early in September to discuss the rigors, frustrations and fears inherent in the life of an intern. Sharing with housestaff and faculty − all of whom have had similar feelings and experiences − aids in establishing bonds between residents and makes an otherwise rigorous year a learning experience among colleagues.
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.