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Primary Care Programs

Residents in primary care officePrimary Care Training Options

Internal Medicine residency training historically has emphasized inpatient medicine. While internists need to be well-trained in the management of inpatients, internal medicine has evolved and is now primarily practiced in the ambulatory setting. Our “6+2” block model emphasizes the practice of outpatient medicine, and allows flexibility with elective time for residents to emphasize the type of training that best suits their career objectives. A survey of our residents after our first two years in the block model shows very high rates of satisfaction with their ambulatory training, their ability to focus on ambulatory education, and with their training in ambulatory subspecialties.

Our primary care residents also have a specialized primary care curriculum in addition to the ambulatory educational sessions in which all residents participate. These education sessions are a mixture of specialist-led didactics and skills-based training. We have had specialists from endocrine, psychiatry, and sleep medicine, for example, give a deeper and more nuanced discussion on their management of common chronic medical conditions.  We have done training in joint and bursa injections, etonogestrel implant (Nexplanon) placement, buprenorphine prescribing, and motivational interviewing.

Primary care residents also have the option of choosing a “4+4” schedule during the R2 and/or the R3 year. The “4+4” schedule not only gives residents additional time in the primary care clinic, but also provides the residents with additional longitudinal elective time with specialists in the ambulatory setting. Alternatively, residents can also elect to participate in 2 or 4-week block rotations in local primary care office or rural primary care practices in the Adirondacks, Finger Lakes region, or in rural Maine.

Specific changes relative to our standard categorical internal medicine residency can be customized, but an example of scheduling options for a Primary Care Program resident are listed below and summarized in the Primary Care Program detailed description:

  • R1 year: opportunity to customize community-based primary care site and elective time for different types of primary care experiences.
  • R2 and R3 years: 1) 2 to 4-week block experiences in local or rural primary care practices or 2) a 4+4 ambulatory block schedule.

Primary Care ProgramResident with preceptor, Marc Berlian, MD

Beyond the usual flexibility of our block model, we also offer 4 Primary Care Program positions per year for residents who intend to pursue a career in primary care internal medicine (note that this program has a separate match number). The Primary Care Program is similar to our usual “6+2” categorical residency curriculum, but has a somewhat reduced commitment to inpatient rotations in the second and third years to allow additional ambulatory and primary care-based experiences to better prepare residents for primary care practice. Primary care residents have the additional option of having their continuity panel of patients within a community-based primary care office rather than in the hospital-based teaching practices located at Strong Memorial Hospital or Highland Hospital.

Our primary care residents also have a specialized primary care curriculum in addition to the ambulatory educational sessions in which all residents participate. Topics include joint and bursa injections, cognitive behavioral therapy, etonogestrel implant (Nexplanon) training, buprenorphine training, cryotherapy in dermatology, lifestyle management, and motivational interviewing among others. 

Primary care residents also have the option of choosing a “4+4” schedule during the R2 and/or the R3 year.  This allows a resident to have additional time in the outpatient practice and participate in more ambulatory electives. Residents can also elect to participate in a primary care long block rotation, rural primary care in locations in the Adirondacks, Finger Lakes region, or in rural Maine.

Specific changes relative to our standard categorical internal medicine residency can be customized, but an example of the schedule changes for a Primary Care Program resident are listed below and summarized in the Primary Care Program detailed description:

  • R1 year: opportunity to customize community-based primary care site and elective time for different types of primary care experiences.
  • R2 and R3 years: 3-4 fewer inpatient blocks (from a mixture of rotations, including floors, CCU, and heme-onc floors) to allow either 1) a primary care long block experience and an elective in a rural primary care office, or 2) a 4+4 schedule.
  • Note that primary care residents in their second and third years have the option of pursuing a "4+4" schedule for both years or either year, allowing additional primary care and ambulatory electives.
Ian

Affiliate FF Thompson Hospital in Canandaigua, NY

Rural Primary Care Internal Medicine Program

The University of Rochester's Rural Primary Care Internal Medicine Program aims to help expand the workforce of primary care physicians in under-served rural locations. Interested residents can easily access multiple different rural clinical opportunities, ranging from 30 to 60+ minutes away. Our flexible scheduling allows residents to have rural experiences in primary care and/or subspecialty settings within their ambulatory blocks and/or built into 2- or 4-week elective experiences, allowing residents to either commute from Rochester or stay near the rural healthcare site. We also have affiliations with more remote sites in upstate New York and Maine that residents may choose for electives, and we allow residents to pursue electives through the Indian Health Service. We have dedicated funds to help support travel and housing costs associated with resident experiences in rural settings.  

Additional information about our Rural Primary Care Internal Medicine Program can be found here

Additional information about the smaller hospitals in UR Medicine where residents can rotate can be found here.

Rural Pathway ResidentsRural Pathway ResidentsRural Pathway Horse scene

 

 

 

 

 


 

 

Kriti Thapa, MD, MPHThe URMC internal medicine residents, staff, and faculty are incredibly supportive of each other, while promoting education and wellness. Additionally, the program takes resident feedback seriously. Furthermore, there are always mentors who are ready to work with us on research or QI projects."

Kriti Thapa, MD, MPH
Primary Care Resident Class of 2021