Office Based Medicine Track

Background: The UConn Health Center categorical Internal Medicine Residency Program is dedicated to the highest level of medical education for our residents who represent the future of internal medicine. Internal medicine itself is a broad subject and many residents choose to specialize by completing subspecialty fellowship training. Other residents may choose to practice without specializing, or may desire to practice primary care with a specific concentration in one area of Internal Medicine. To meet the needs of our residents, we have developed a focused Office-Based Medicine track within the program. The goal of this pathway is to expose residents to true outpatient general medicine in a variety of settings such as academic, urban, and private practice. In addition, the track is structured to provide the additional skill sets needed in outpatient medicine. This allows residents to appreciate the full spectrum of care that occurs in the community, from chronic disease management to acute illness or injury. Residents can gain an appreciation of the multi-generational patient population while learning effective means for counseling on smoking cessation, weight loss, and many other issues that require behavior modification. Evidence-based medicine, adherence to guidelines for care, and routine screening tests are all stressed as important adjuncts to comprehensive care. Rotations will allow residents to experience medicine in different outpatient environments such as urban community health centers and suburban primary care offices.

The Medical Home: The medical home is the future of medicine. It focuses on coordination of care across disciplines and settings. Primary care providers need to be able to coordinate recommendations by specialists, review all patient lab and imaging results, assess and manage social stressors as well as the emotional well being of their patients- essentially we must view the patient as a whole package. The Internal Medicine Residency Program has outpatient clinics connected to three hospitals. This allows for superior coordination of social work, adjunct services, nursing, communication during and after inpatient admissions, and coordination of care across specialties. Training of competent and confident internists is essential to high quality medical care for all patients.

Program Structure:

  • Continuity Clinic - Half-day continuity clinic with each resident’s own patient panel every week for 3 years. Interns have 1.5 hours with new patients and 45 minutes for follow-up for the first six months; after the first six months of residency, interns and residents have 1 hour with new patients and 30 minutes for follow-up appointments. This time allows for history taking, physical exam, care plan development, precepting with an attending physician, and counseling the patient.
  • Primary Care Blocks - Primary care rotations are embedded in each of the three years. The rotations consist of 4 weeks at UConn General Medicine Associates clinic seeing patients for chronic and acute issues in the mornings. Residents will learn skills such as office triage, and may see other providers’ patients for acute issues, as would happen in a group outpatient office. Afternoons are spent in primary care-related specialty blocks. A sample schedule is listed below:
  PGY-2 PGY-3
Week 1 Hypertension Urology
Week 2 Hypertension Ophthalmology
Week 3 Sports Medicine Osteoporosis
Week 4 Sports Medicine Business of Medicine*
*optional lifestyle modification clinic twice a week if interested
  • Ambulatory Elective Blocks - Ambulatory rotations will be structured to increase exposure to special ambulatory medicine topics commonly encountered by primary care physicians. Residents will have the freedom to structure these blocks to ensure they receive exposure to as many aspects of primary care medicine as possible. Rotations may include specialty topics outside of internal medicine such as ophthalmology, dermatology, non-operative orthopedics/sports medicine, and ENT. Additionally, residents can choose outpatient medicine specialty rotations such as cardiology, gastroenterology, endocrinology, or nephrology. Each “mini” rotation can last from 2-4 weeks.
  • Urban Health Rotation - Residents interested in urban medicine will be able to rotate through local community health centers in Hartford County as well as working at the Department of Public Health. This rotation can create a skill set for addressing the unique needs often seen in urban health populations.
  • Suburban Medicine - Residents will also have a choice of suburban outpatient medicine practices to rotate through. As in the urban health rotation, residents will have the opportunity to “try-on” a future career while learning outpatient medicine and skills for office management, coding, and billing.

      A resident can choose one locale or both in order to experience medicine in a real-world setting prior to finishing training. This option allows a resident to enter into the workforce with a realistic impression of primary care. In addition, having experienced multiple systems of practice, residents are better equipped to join a practice, set-up their own practice, or take on a leadership role in the future.

  • Preventative Health - Primary Care doctors are the champions of preventative health. A special rotation that reviews the different screening guidelines, discusses evidence-based medicine interpretation, and how to apply all we know to the real world patient is also available.
  • Scholarship Block - All interns are required to do a Scholarship block. Medical informatics, evidence-based medicine, quality improvement, and research development are topics covered during this rotation.
  • Women’s Health - During the Scholarship block, two weeks of afternoons are spent in a women’s health clinic.
  • Neurology - Similar to women’s health, during the Scholarship block, the second two weeks of afternoons are spent in the neurology clinic.
  • Other Mandatory Electives - Similar to the categorical program’s main track, residents would have the following mandatory rotations at some point during their three-year residency:
    •  Emergency Medicine - 4 weeks
    •  Geriatrics - 4 weeks
    •  HIV - 4 weeks
  • Inpatient Electives - Residents would have additional choices for inpatient elective blocks as they would if not specifically in the Office-Based Medicine track. These range from IM specialties such as cardiology and nephrology, to additional time in relevant outpatient topics such as sleep medicine, dermatology, gynecology, psychiatry, allergy, rehabilitation medicine, and hypertension clinic.

Office-Based Medicine Track Breakdown

PGY 1 PGY 2 PGY 3
5 Wards 3-4 Wards 3-4 Wards
3 Units 2 Units 1 Unit
1 Geriatrics 1 Hospitalist 1 Hospitalist
1 Scholarship 1 Emergency Medicine 1 MOD
1 Ambulatory
(Primary Care)
1 Ambulatory
(Primary Care)
1 Ambulatory
(Primary Care)
2 Electives 3-4 Electives
(2-3 Outpatient, 1 HIV)
3-4 Electives
(Outpatient)
  1 Ambulatory/
Hematology/Oncology