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Ambulatory Training

The University of Massachusetts Medical School and the UMassMemorial Health Care system have a strong history of valuing Primary Care as the core of a patient’s health care experience and care coordination.  Each categorical resident will be assigned a continuity clinic site, where they will become a valued member of a health care team and co-manage a panel of patients. Residents attend continuity clinic during their Ambulatory weeks, but not during inpatient or ICU service weeks. In this 4+1 system, we are able to separate inpatient and outpatient responsibilities, allowing for a more concentrated and enhanced experience in each environment. Residents also have ample opportunity to experience other ambulatory clinic experiences in subspecialty clinics (Medicine/Surgery), community clinics, and interprofessional environments.

Ambulatory Week

After 4 weeks on an inpatient, ICU, or elective rotation, all interns (preliminary and categorical) and residents are on Ambulatory week.

During ambulatory week, categorical interns and residents will have:

  • 5 Continuity Clinic sessions
  • 1 morning of Didactic/Ambulatory Core Curriculum sessions
  • 2 Subspecialty clinic sessions
  • "Golden Weekend" off
  • 2 Independent learning sessions to complete ("Green Blocks")
    • Clinic documentation and lab/radiology follow up
    • Independent online learnind modules
    • Longitudinal Quality Improvement Project

During ambulatory week, preliminary interns will have:

  • 4 days of elective of resident's choice
  • 1 morning of Didactic/Ambulatory Core Curriculum sessions
  • "Golden Weekend" off
  • 1 independent learning sessions to complete ("Green Block")
    • Independent onine learning modules
    • Longitudinal Quality Improvement Project

Continuity Clinic Sites

Benedict Adult Primary Care Clinic –Site Directors: Richard Palken, MD & Jeeva Subramanian, MD

The Benedict Primary Care Clinic is the largest ambulatory clinic supporting outpatient residency training and is located on the University campus. More than one third of our residents train at this academic site. The clinic serves a very large, diverse, and medically complex patient population. Seventeen experienced faculty preceptors guide 35 residents in the practice of primary care internal medicine. Residents are paired with individual faculty members (primary preceptors) for their 3 years of training. Residents have their own sub panel of patients that are under the care of their academic faculty primary preceptor. This close pairing promotes continuity of care for patients as well as education and mentoring opportunities for residents.

Tri-River Family Health Center - Site Director: Andrew Siber, MD

Tri-River Family Health Center (TRFHC) is a UMass Memorial multi-specialty clinic located in Uxbridge, Massachusetts approximately 30 minutes from Worcester. Founded in 1978, TRFHC has become a paradigm for fulfilling the respective interests of medical education and community health care. The Internal Medicine Department is staffed by 8 Board-certified UMass faculty, many of whom are graduates of the UMass Internal Medicine Residency Program. The clinic serves as a training site for both residents and medical students. UMass medical students from all four classes participate in TRFHC programs, and 20 medical residents have their continuity clinic at TRFHC.

Worcester VA Clinic

The Worcester VA Clinic provides comprehensive outpatient care for veterans. It is situated in a modern facility 5 minutes from UMass Memorial Medical Center. On-site services include radiology, laboratory, physical therapy, mental health, pharmacy, and many medical subspecialties. State-of-the-art medical informatics services and infrastructure greatly facilitate the care of the patient and enrich the experience of staff and residents. Four residents have the opportunity to be primary care providers with support of full-time staff.

Community - Based Faculty Sites

A variety of community-based practices participate in ambulatory education and are among our most popular sites.  Each site generally accommodates 1-2 residents and offers a patient population reflective of those encountered in the private practice setting. Driving distances vary from 10 to 40 minutes. Residents may choose a clinic site convenient to where they livet. The preceptors at each site have been chosen for their strong commitment to medical education. 

Ambulatory Core Curriculum  - Elizabeth Murphy, MD & Laura Hallett, MD

Thursday Morning didactic sessions are held for all Ambulatory Week Residents. A three year revolving curriculum includes Primary Care Core Curriculum (Prevention/Screening, Acute Care, Chronic Care), Geriatrics Core Curriculum, Quality Improvement, Medical Specialty Curriculum (Rheumatology, Dermatology, Endocrinology, GI, ID, Cardiology), High Value Care, and Evidence Based Medicine. A variety of teaching formats are used, including case-based, MKSAP embedded questions, Medical Jeopardy, and workshop format. All curriculum is housed on a Google wiki to provide mobile access for our residents. 

Geriatrics Training - Erika Zimmons, DO 

In addition to the Geriatrics Core Curriculum delivered during Ambulatory weeks, residents have online independent learning assignment expectations. Our trainees have a robust Geriatrics clinical experience as well. During PGY1, residents rotate through area Skilled Nursing Facilities with our geriatrics faculty members. During PGY2, they rotate in the Geriatrics Clinic where they participate in consultative and chronic care of elderly patients. During their PGY3 year, each resident does a home visit on one of their own geriatric clinic patients and also makes emergency home visits with Elder Services.

Subspecialty Clinic Experiences

Subspecialty clinic exposure is crucial to resident education given that most medical care is delivered in the ambulatory setting.  Our residents have ample opportunity to rotate through ambulatory clinics in Medical Specialties (GI, Cardiology, Heme Onc, Pulmonary, Rheumatology, Nephrology, Endocrinology/Diabetes, Dermatology, or ID/HIV) over the course of their training. We also offer experiences in other ambulatory settings such as Gynecology, Urology, Ophthalmology, Behavioral Medicine, Vascular Surgery, Physiatry, ENT, Nutrition, Palliative Care, Travel Clinic, and Multiple Sclerosis clinic.