The residents’ continuity clinic during dedicated ambulatory block rotations represents the cornerstone of their ambulatory experience. In addition to continuity clinics, residents will have the opportunity to participate in transitions of care clinics for out patients who have been recently discharged, many of whom were cared for by resident teams while inpatient, substance use disorder clinic, and urgent care clinics.

Continuity Clinic

Residents provide ongoing continuity care for their own panel of patients at the Henry S. Chase Outpatient Center under the supervision of experienced faculty. Before each clinic session, residents participate in a pre-clinic conference, led by both a peer teacher and a core faculty member.

During the residents' continuity session, the faculty devotes their time exclusively to precepting. Typically, each resident will see 3-5 patients as PGY 1's, 4-6 as PGY 2's, and 5-6 as PGY 3's.

The Henry S. Chase Outpatient Center is located across the street from Waterbury Hospital. An electronic medical record allows for seamless documentation and sharing of patient information among providers. Resources include two examination rooms and facilities for minor procedures. The practice sees greater than 20,000 visits per year, providing care for a large portion of numerous medically underserved and underinsured communities.

Skills and Behaviors

Residents will:

• Evaluate and manage patients with the range of problems encountered by primary care physicians
• Address health care maintenance issues for adult patients
• Cultivate the robust set of physical examination skills essential to the practice of outpatient internal medicine
• Perform primary care procedures, such as cerumen impaction removal and women's health examinations
• Demonstrate communication skills necessary for effective medical interviewing and patient counseling
• Orchestrate the longitudinal care of primary care patients, including follow-up, telephone medicine, and collaboration with consultants and various community services
• Develop systems to convert their emerging information needs into well-formed clinical questions and to efficiently acquire, appraise, and apply medical information
• Exemplify the highest standards of ethics in patient, professional, and interpersonal interactions
• Efficiently provide patient-centered care as part of an interprofessional team within a practice microsystem
• Accurately document and code for care provided in an electronic medical record

Knowledge

Residents will:

• Understand the presentation, evaluation, and management strategies of chronic diseases and acute illnesses encountered by primary care physicians
• Understand the basic principles for interpreting diagnostic tests, including probability revision and cost-effectiveness
• Understand the health care system in the United States and Connecticut (and proposed reforms) and its impact on the provision of primary care

Attitudes

Residents will:

• Appreciate the rewards and responsibilities of assuming the primary care of a group of patients, including the importance of patient advocacy
• Consider their role as primary care physicians in the larger contexts of medicine in general, society, and their family and social networks