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Ambulatory Curriculum

Overview

We provide a comprehensive ambulatory curriculum to all medical residents. It is presented over a three-year period and includes lectures, case-based discussions, practical workshops, and seminars. Primary Care Track and HIV Primary Care Track residents receive additional curriculum on content that is germane to these areas.

The intern outpatient curriculum is delivered during ambulatory block rotations in a one-year cycle. The PGY2 and PGY3 curriculum is delivered during practice week rotations in a two-year cycle. General internal medicine faculty members, specialists, and senior medical residents serve as lecturers, discussion facilitators, and seminar leaders. Learning objectives are presented for each content area, and educational materials are posted on the BIDMC Medical Housestaff Wiki. Other venues/opportunities for ambulatory curriculum include the Ambulatory Care Conference, Journal Clubs, Primary Care Seminar, and the Hopkins Ambulatory Care Modules.

Content Areas

Ambulatory curriculum is divided into In The Clinic, Chronic Disease Management, Prevention, Behavioral Medicine, and Practice Management. Physical examination skills are also taught in separate sessions. Examples of content in each of these major areas follow:

In The Clinic

• Anemia
• Arthralgias/Arthritis
• Back Pain
• Breast Disease
• Common Skin Disorders
• Contraception
• Cough
• Diarrhea
• Dyspepsia
• Dizziness
• Fibromyalgia
• Influenza
• Irritable Bowel Syndrome
• Knee Pain
• Menopause
• Menstrual Abnormalities
• Pregnancy and Lactation
• Red Eye
• Sexually Transmitted Diseases
• Sexual Dysfunction
• Thyroid Nodules and Disorders
• Upper Respiratory Tract Infections
• Urinary Tract Infection
• Vaginitis

Chronic Disease Management

• Anticoagulation
• Asthma
• Atrial Fibrillation
• Chronic Hepatic Disease
• Chronic Obstructive Pulmonary Disease
• Chronic Renal Disease
• Congestive Heart Failure
• Coronary Artery Disease
• Dementia
• Diabetes Mellitus
• HIV Infection
• Hypertension
• Hyperlipidemia
• Inflammatory Bowel Disease
• Obesity
• Osteoporosis
• Primary Care for the Cancer Survivor
• Primary Care for the Developmentally Disabled Patient
• Primary Care for the Post-Transplantation Patient
• Seizure Disorders

Prevention

• Aspirin Prophylaxis
• Breast Cancer
• Cervical Cancer
• Coronary Artery Disease
• Colon Cancer
• Diabetes Mellitus
• Genetic Screening
• Hyperlipidemia
• Immunizations
• Lung Cancer
• Prostate Cancer
• Skin Cancer
• Smoking Cessation
• Stroke

Behavioral Medicine

• Advance Directives
• Alcoholism
• Anxiety
• Chronic Pain Management
• Culturally Competent Care
• Domestic Violence
• Dementia
• Depression
• Disability
• Domestic Violence
• Eating Disorders
• End-of-Life Care
• Insomnia
• Managing the Challenging Patient
• Motivational Interviewing
• Sexual Assault
• Somatization
• Substance Abuse

Practice Management

• Coding and Documentation
• Practice Resources
• Quality Improvement
• Telephone Medicine

Other Venues/Opportunities

Ambulatory Care Conference

The Ambulatory Care Conference is a weekly Department of Medicine conference that covers core clinical topics in outpatient medicine.

Journal Clubs

The HCA Journal Clubs promote evidence-based medicine and critical literature review in the resident's practice. The objective of the program is to study how clinical questions (such as diagnosis, prognosis, and treatment) are answered by scientific research involving populations or groups of patients. Participants learn to assess the validity of published evidence by understanding basic clinical research strategies, such as study design and statistical measurement, as well as gaining critical literature appraisal skills.

• Case-Control, Odds Ration, Bias
• Confounding, Stratified Analysis
• Critique of Contemporary Literature
• Decision Analysis
• Diagnostic Tests
• Meta-Analysis
• Multivariable Analysis
• P Value, Cohort, Relative Risk
• Randomize Control Trials, Power, Sample Size
• Survival Analysis

Primary Care Seminar

A dedicated bimonthly lunch seminar series has been developed to provide training in areas of particular interest to primary care practitioners. Areas of focus this year include office orthopedic evaluation (knee, shoulder), physical/occupational therapy, knee and shoulder injections, cryotherapy, primary care of LGBT patient, and models of primary care. Topics planned for the future include medication adherence, travel medicine, occupational health issues, palliative care issues, complementary/alternative medicine, and preoperative medical evaluation.

Hopkins Ambulatory Care Modules

The Hopkins Ambulatory Care Modules is a web-based curriculum on common outpatient topics that is paired with didactic offerings during ambulatory rotations.

Contact Information

Residency Training Program
Internal Medicine
Beth Israel Deaconess Medical Center
West Campus, Deaconess Building, Suite 306
One Deaconess Road
Boston, MA 02215
617-632-8273
617-632-8261
primarycare@bidmc.harvard.edu