Primary Care Track
To develop well- trained, humanistic and compassionate leaders in primary care.
Scope of the Track: Primary care providers deliver care to patients with a variety of needs. The needs span the spectrum from acute illnesses to chronic disease management and preventative care. There is an increasing recognition that primary care is most effectively delivered in the context of a Patient Centered Medical Home and in collaboration with a wide array of other health care practitioners. We feel that to train the next generation of outpatient general internists not only do we need to focus on the medical knowledge required to diagnose and treat a variety of medical conditions, but we need to provide training in systems improvement, lean thinking, evidence based medicine, interdisciplinary and narrative medicine. Our goal is to train patient centered, humanistic and compassionate physicians who can serve as leaders locally and beyond.
Specific Goals for members of this track:
- I. Develop the medical knowledge base needed to provide outstanding patient care in the ambulatory setting.
- II. Develop the communication skills needed to successfully interact well with our patients and other health care providers.
- III. Develop the essential skills needed to be leaders and collaborative members of a Patient Centered Medical Home, institutional initiatives and their community.
- IV. Learn the scientific literature behind the patient interventions performed, in order to deliver the most evidence based and cost conscious care possible.
- V. Develop skills in efficiency in order to maximize face to face time with our patients. These include skills working with the electronic medical record (EMR), pre-visit planning and delegation of responsibilities.
- I. The majority of learning will be in an experiential fashion. The resident will see patients in a longitudinal fashion in their continuity clinic, where they are the primary care physician taking care of their panel of patients. This clinic will be staffed by experienced Internal Medicine attending physicians who are faculty at the University of Michigan and are recognized for their skills as outstanding educators.
- II. The residents will continue to have a strong inpatient training foundation as members of the traditional categorical residency program. As interns, they will have increased time in their continuity clinic during a 2-4 week long immersion in addition to a month of outpatient ambulatory experience in a variety of clinics. Second and third year will provide at least 8-10 months of outpatient experiences.
- III. Additional outpatient experiences will be selected depending on the needs of the resident in a variety of settings. These clinics can include non-Internal Medicine subspecialty clinics, underserved clinics, Internal Medicine subspecialty clinics and procedural clinics.
- IV. Starting in their second year, and when schedule permits, the resident will attend the General Medicine Clinical Conference at East Ann Arbor on Tuesday mornings from 8-9. These one hour conferences, designed for General Medicine attendings, cover a broad range of topics and include regular journal club type reviews.
- V. John Hopkins computer modules will be assigned monthly, starting in the second year, to correspond to the resident’s educational needs.
- VI. The resident will be expected to participate in the didactic experiences offered to all residents, including ambulatory and inpatient morning report, noon conference and TLS didactic sessions during the ambulatory blocks.
- VII. In the third year, the resident will consider doing a two week elective in systems improvement in order to develop the problem solving skills needed to be a leader in their field.
- VIII. In the third year, the resident will be encouraged to complete a coding curriculum and have at least two one-on-one audit/sit down session with a medical biller/coder from the University to review their documentation and coding practices.
- IX. The resident will be expected to complete a webinar in their third year with five sessions on motivational interviewing techniques.
- X. The resident will be involved in scholarship and complete a patient safety project and a research project as part of the categorical residency program.
- XI. The resident will have an opportunity to interact with a standardized patient on a difficult communication visit with feedback from a faculty member and the standardized patient.
- XII. The resident will participate in the primary care progress group and become a leader in the group as they become more senior.
- XIII. They will develop a reading plan that is developed by both the learner and their mentor and the articles will be available on a shared drive. These will include readings on sentinel articles in the field of general medicine, but also in areas such as patient doctor relationship, medical ethics, and narrative medicine.
- XIV. The resident will present at least once in the General Medicine Journal Club Rotation that occurs during the General Medicine Clinical conference at EAA on Tuesday mornings. They will receive feedback in a peer-review fashion after the session by three faculty.
- XV. The resident, in their senior year, will participate in extra training in EMR efficiency.
- XVI. The resident will have experience with teaching through the resident-as-teacher curriculum.
- XVII. The resident will have regular meetings with Dr. Collier and the other members of the track. There will be peer-mentorship available within the track by residents in their ‘home’ clinic.
- I. Residents can enter the track at any point in their training. Interest in the track should be expressed as early as possible. Interested residents will meet with Dr. Collier to discuss career goals. Approval into the track will be granted by the residency program.