Educational Activities/Teaching Conferences Educational Activities/Teaching Conferences Med-Peds residents participate fully in the teaching rounds and educational conferences of both the Pediatric and Internal Medicine categorical programs. In addition to these opportunities, the Internal Medicine-Pediatrics residency program also offers some unique educational experiences. These include: Conferences Med-Peds Noon Conference—Once per month a combined noon conference is held for the categorical pediatric, internal medicine, and Med-Peds residents. These conferences usually address a medical topic that affects both pediatric and adult populations. A common focus of the conference is the smooth transitioning of adolescent patients with chronic disease from pediatric to adult medical practice. Med-Peds Journal Club— Eight evenings per year the Med-Peds residents and faculty meet to appraise and discuss a recent medical journal article. An R4 chooses the article and leads the discussion. This forum provides residents with the opportunity to review basic concepts of evidence based medicine, to practice the skill of critical appraisal, and to gain understanding of the process of incorporating new research into practice. Med-Peds Ambulatory Conference—For one half-hour prior to each resident clinic session, residents and their faculty preceptors meet to discuss the clinical presentation, diagnosis, and management of a common ambulatory problem. The curriculum alternates yearly in order to cover a wide spectrum of both pediatric and adult primary care topics. Class Curriculum Meeting—Periodically throughout the year, each class meets as a group with the program director to discuss their residency experiences. This forum enables residents to provide direct input into the curricular and logistic structure of the residency program. Special Rotations Skills Blocks Med-Peds—In late fall, all eight Med-Peds R1s are scheduled for a two-week skills block rotation. During this distinct rotation, the interns are exposed to a variety of medical and psychosocial themes. Experiences include interactive sessions on child development, advanced directives, professionalism, telephone medicine, billing and coding, mentoring, and evidence based medicine. There are also workshops in ECG, PFT, and casting/splinting. Internal Medicine—The few days prior to assuming the R2 role are spent learning about teaching techniques and running a floor team Pediatrics—In the fall of the R2 year two weeks are spent learning about teaching, managed care, life skills for after residency, and refreshing pediatric surgical subspecialty skills. Combined Electives—We offer pre-arranged electives in gastroenterology, rheumatology, pulmonary, neurology, heme/onc, and endocrinology that involve faculty in both adult and child subspecialty services. Other combined experiences are encouraged and can be arranged. Practice-Based Experience—Residents are assigned to two one-month blocks of practice-based experience (PBE) in a Med-Peds office over the course of their PGY2 and PGY3 years. During these months, the resident functions as a junior partner of the practice, seeing both inpatients and outpatients, thus emulating the "real life" of a primary care Med/Peds practitioner. Some residents have chosen to spend these months with graduates in locations outside of Rochester. Medicine-Pediatrics Links to the Community (M/PLC)—M/PLC is a two-week community advocacy educational rotation that introduces first-year residents to local advocacy and public health resources through site and home visits. Ambulatory Experience A continuity experience in an ambulatory setting is a fundamental part of the Med-Peds program. Residents begin continuity experiences in a combined Med-Peds practice and continue in that practice throughout their four years. In the first postdoctoral year, one half day each week is spent in the practice. In the remaining years, this increase to two half days per week, except during intensive care and overnight rotations when residents do not attend their ambulatory clinic. There are two combined ambulatory sites where the Med-Peds residents receive their ambulatory training. CULVER: Seven residents out of each class are assigned to the Culver Medical Group (CMG ), where the seven full-time Med-Peds faculty teach residents in addition to seeing their own ambulatory patients. Some of Culver's Nurses and staff: RIDGEWOOD: One resident out of each class is assigned to a private Med-Peds office, run by John Chamberlain, M.D. and staffed by four Med-Peds practitioners and a Pediatrician. Dr. Chamberlain graduated from Rochester's Med-Peds program in 1974, and is a wonderful resource to the residents and faculty. He is the former Chair of the Med-Peds section of the American Academy of Pediatrics, and teaches in the Culver Medical Group on a part-time basis. Evidence-Based Medicine Evidence-based medicine (EBM) is defined as the explicit and judicious use of current best evidence to inform decisions about individual patients. To help residents learn the principals and practice of evidence-based medicine, we have developed an EBM curriculum - two-week skill blocks offered in the first and second years - that touch all major aspects of our program. Residents also have the opportunity to participate in the EBM elective. This 2 week rotation, offered twice a year, allows residents to learn advanced skills in searching the medical literature, statistics, critical appraisal, and putting evidence into practice. The Agency for Health Research Quality (AHRQ) has stated that we are among the top nine residencies programs in the country at teaching EBM.