The goal of ambulatory training is to give Osler residents the skills to provide the highest quality longitudinal ambulatory care for patients. This goal is accomplished through development of clinical expertise, leadership of multidisciplinary teams, and integration of IT resources and data to inform clinical care decisions. Residents care for their own panel of general internal medicine patients in their contionuity clinic as well as see a variety of ambulatory patients in sucspecialty clinics.
Residents build their panel of primary care patients over the course of three years, allowing them time to develop close relationships with their patients and experience and manage common acute and chronic illnesses. Residents devote one or two half days per week to continuity clinics depending on their clinical rotation. Patients are seen either in the Johns Hopkins Outpatient Center adjacent to the main hopsital or in a Johns Hopkins affiliated community clinic. In each setting, residents work with a team of nurses, medical assistants, case managers, social workers, and PharmDs to provide a team care approach. Interns and junior residents are paired with a senior resident within their Firm to enhance continuity of care for their patients.
Experienced faculty preceptors support the resident practice at each clinical site: teaching, supervising, and mentoring. In addition to preceptor-resident teaching interactions, an ambulatory medicine curriculum is delivered through didactic sessions during noon conference, resident-led afternoon case discussions, and independent work using a nationally renowned online case-based curriculum. Quality measures for each resident's panel are generated twice yearly and help residents to tailor their learning and practice in evidence-based patient care.
Residents experience a variety of ambulatory subspecialty experiences. Many of the core inpatient subspecialty rotations include time with the attending physicians in their ambulatory clinics. In addition, outpatient-based subspecialties are showcased in the "CASE I" rotation. CASE I consists of eight weeks of outpatient time dedicated to Rheumatology, Endocrinology, and Geriatrics. These rotations provide the housestaff with the opportunity to work one-on-one with senior faculty to master subspecialty skills. Elective outpatient rotations are also available in every subspecialty.