Ambulatory Care Training
Residents rotate through a series of clinics to develop essential skills in primary care internal medicine as well as subspecialty medicine. Clinics include: General Medicine, Women's Health, Diabetes Management, Endocrine, Cardiovascular Risk Reduction, Rheumatology, Anxiety-Depression, Musculoskeletal, Tuberculosis, Gastroenterology, Hepatology, Renal, Pulmonary, Hem/Onc, Sexually Transmitted Disease, as well as other clinics per the resident's request. This rotation is supplemented by an extensive syllabus of key articles in ambulatory care internal medicine and structured teaching conferences.
This PGY1 rotation includes geriatric outpatient clinics (Geriatrics Clinic, Geriatric Depression Clinic, Cognitive Disorders Clinic, Hospice) at all hospitals, a supervised nursing home experience at our teaching nursing home and home visits to the elderly with the Hospital-based Home Care Team from the VA Medical Center.
Each categorical intern and many preliminary interns participate in a multidisciplinary week of musculoskeletal clinics at the VA. This experience is under the supervision of expert sports medicine trained internists, rheumatologists, and physical therapists. The experience allows for a focused clinical experience supplemented with lectures and physical exam teaching sessions dealing with non-operative musculoskeletal complaints. It includes experience in joint aspiration and injection.
Categorical residents are assigned a set ambulatory care clinic throughout their residency training. This enables residents to gain experience with continuity of care in managing their own panel of patients. All clinics provide experience managing patients with multiple severe, chronic illnesses, including coronary heart disease, hypertension, diabetes and heart failure.
As a PGY1, you will have four or five half-day continuity clinics during your +1 weeks. As a PGY2 and PGY3, you will have one half-day clinic per week throughout the year.
- IMC Clinic: The Intermountain Medical Center (IMC) clinic draws its patient pool from the community, including Spanish-speaking and immigrant populations.
- UUHC Madsen Medicine Clinic: The Madsen Clinic is a community internal medicine clinic that closely mimics private practice.
- VAMC Clinic: The George E. Wahlen Veterans Affairs Medical Center (VAMC) includes complicated medicine patients in Blue Clinic as well as regular experiences in the Women’s Clinic.
In addition to the subspecialty experiences while on general ambulatory, residents also rotate through various non-internal medicine subspecialties for a well-rounded experience. This includes: Addiction Medicine, community health clinics, Sports Medicine, Allergy and Immunology, Ophthalmology, ENT, Dermatology, and Psychiatry.
Inpatient ward experiences are an essential component of Internal Medicine Training. You will have the opportunity to work within three different models at our teaching hospitals. The variety of systems, patient populations, and attendings provide you with opportunities to experience various career paths. Our teaching services include both general medicine and subspecialty-specific teams. In addition to hospitalist-led traditional general medicine teams, we have focused specialty inpatient teams that include Oncology, Heart Failure, General Cardiology, Pulmonary, and a Hospitalist service where a senior resident works independently with the hospitalist faculty. The night float team, including faculty, residents, and interns, provide patient care overnight at each hospital.
We have a strong and varied ICU experience across multiple sites. The Shock/Trauma ICU at Intermountain Medical Center is consistently ranked as one of our resident's favorite learning experiences. This fast-paced ICU has dedicated teaching faculty - residents take care of ICU patients alongside services that can include surgical, trauma, neurosurgical, and thoracic ICU. Both the University and VA MICUs offer the broad-based pathology of a wide referral center along with ample opportunities for procedures. The University offers a separate Cardiovascular ICU rotation, providing an advanced and unique experience with an emphasis on cardiovascular pathology. The VA includes an opportunity for Cardiovascular ICU care within the MICU rotation. Both the Shock/Trauma ICU and University ICU rotations incorporate separate day and night shifts, which means residents no longer are working 28-hour shifts!
Elective time allows residents to individualize their training. Preliminary interns have 4 weeks of clinical elective time to further prepare them for their future careers. Categorical PGY-2 and PGY3 residents have 4-6 weeks each academic year to pursue individual interests. This pure elective time differs from medicine subspecialty experiences. Meaningful research experiences can be pursued under the supervision of committed, experienced, and productive faculty. Residents may also design their own unique clinical experience. Many residents use their elective time to participate in an international experience or outpatient experiences not offered in our standard curriculum.
Examples of electives include dedicated research time, procedural ultrasound, interventional pulmonology, echocardiography, and Thrombosis consults/clinic.