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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 continuity clinic as well as see a variety of ambulatory patients in subspecialty 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.
Patients are seen either in the Johns Hopkins Outpatient Center adjacent to the main hospital or in a Johns Hopkins affiliated community clinic. In each setting, residents work with a team of nurses, medical assistants, case managers, social workers, behavioral therapists, and PharmDs to provide a team care approach.
During intern year, every intern has three Ambulatory Blocks, two-week rotations dedicated to developing outpatient skills. During the first two weeks, the interns spend mornings learning fundamentals of outpatient internal medicine and care for their continuity patients in the afternoons. During the second and third Ambulatory Blocks, they receive ambualtory training in endocrinology and rheumatology as well as continue care of their outpatient panel. In addition to their Ambulatory Blocks, interns have interval continuity clinics while they are on oncology and Osler services. Residents devote one or two half-days per week to continuity clinics, depending on their clinical rotation. 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 case discussions, and independent learning through 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. Elective outpatient rotations are available in every subspecialty. In addition, many of the core inpatient subspecialty rotations include time with the attending physicians in their ambulatory clinics. These rotations provide the housestaff with the oppportunity to work one-on-one with senior faculty to master subspecialty skills.