Ambulatory Training

Experience in outpatient medicine is an important component of our training program. Each trainee has a continuity practice experience in which they serve as the primary care physician for a panel of patients. They provide comprehensive care for their patients, including preventive care, chronic disease management, acute care, and transitional care following hospital discharge. Strong relationships are forged and residents learn critical ambulatory medicine skills. Outpatient training takes place during the ambulatory (“+2”) blocks.
outpatient medicine bldg
We have three categorical ambulatory clinical sites:
-    3701 Market Street, 6th Floor – Edward S. Cooper Clinic
-    3701 Market Street, 7th Floor – Penn Internal Medicine University City
-    Corporal Michael J Crescenz VA Medical Center

All of our ambulatory clinical sites are within a 10 minutes’ walk from any of the three hospital sites and all are easily accessed by public transit. The Penn Center for Primary Care is the site of the Penn Internal Medicine Primary Care Residency Program and is located on the campus of Penn Presbyterian Medical Center.

All of our clinical sites are blended faculty / resident practices. Our residents are fully integrated partners in practice, and the blended clinic model ensures a well-functioning clinic with strong staff support. Our practices have:
-    Medical Assistants, Patient Service Associates, Clinic Coordinators
-    Registered Nurses, Licensed Practical Nurses
-    Nurse Practitioners
-    Social Workers
-    Clinical Pharmacists
-    Embedded Behavioral Health Providers

Incoming interns inherit a panel of 60-80 patients, with the intent of growing to a panel size of 80-100 patients as a senior resident. Interns and residents practice in Resident Care Teams (RCTs) under the supervision of dedicated faculty preceptors, all of whom are general internists in the Division of General Internal Medicine. Resident Care Teams are organized such that inbox cross-coverage is provided by co-resident team members when a resident PCP is rotating on inpatient services. Thus, there are no outpatient coverage responsibilities while residents are rotating on inpatient blocks.

We have a diverse patient population drawn primarily from the surrounding West Philadelphia community. Approximately 25% of our patients have Medicaid and 40% have Medicare. Our resident-centered continuity is about 60%, meaning that most of the time, our residents are seeing their own patients, with the other visits composed primarily of acute (sick) visits and hospital discharge visits for patients of other residents and attendings in the practice.

In addition to practicing together, faculty and residents work together to create an ongoing series of weekly conferences based on cases, a curricular framework, and the most recent medical literature. Ambulatory Report takes place daily at lunchtime and provides a robust curriculum led by faculty and residents.

With regard to outpatient clinical mentorship, each resident develops a longitudinal relationship with a faculty preceptor who provides feedback and mentorship over the three years of ambulatory training.

Ambulatory Education Leadership

-    Patrick Sayre - Associate Program Director
-    Lauren Mechanic – Educational Co-Lead for PIMUC
-    Brad Fetzer – Educational Lead for Corporal Michael K Crescenz VA Medical Center
-    D. Rani Nandiwada – Program Director for the Primary Care Residency Program
faculty

Outpatient Practices

Firm Rotations

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