1. Jacobi Ambulatory Care Service Overview of Intern Ambulatory Block Why Are We Here?

2. Jacobi Ambulatory Care Service Agenda Orientation: What are interns? What is intern ambulatory block? Goals and Objectives of intern block Curriculum Schedule Reminders Faculty/ intern opinions New horizons

3. Jacobi Ambulatory Care Service Life of an Intern

4. Jacobi Ambulatory Care Service Goals/Objectives Get to know each other Learn to work together Ask questions Relax and sleep Unify the playing field Enjoy patients and learning process EBM in action

5. Jacobi Ambulatory Care Service Intern Block SkillsTopics Medical Interviewing ( Purpose of Interview, Patient- Centered Approach, Genograms) Pelvic Exams/ Pap smears Breast Exam Medical Record, Review Queue EKG reading Medline Diabetes Registry EBM Diabetes Coronary Artery Disease/ CHF Back Pain URI Dizziness Headache Hypertension Asthma/ COPD Medical Ethics Obesity Musculoskeletal exams UTI/ STD/ Vaginitis

6. Jacobi Ambulatory Care Service Format Disease- and Organ System-based Topics Reading assignments from journal articles on line Case-based discussion format, usually led by intern Powerpoint presentations on website “Show and tell” with nurses for diabetes Lectures with medical students Medical culture, insurance, ethics Discussions led by attending Readings available on block website

7. Jacobi Ambulatory Care Service Format continued… EBM Lectures/ Discussion “Clinical Question” by interns Medical Interviewing Lecture/ discussions EKG reading – Cardiology, with EKG test at end of rotation with Chiefs Medline – AECOM librarian Home Visits

8. Jacobi Ambulatory Care Service Current Schedule MondayTuesdayWednesdayThursdayFriday Didactics Clinic Clinic (starting at 10:00) Didactics Lecture (with med students)

9. Jacobi Ambulatory Care Service Reminders Be on time for all sessions! The didactic sessions will be held in the conference rooms indicated. Didactic sessions will require some preparation before the sessions. Medline Class: you must go to the Forchheimer library to obtain your Medline password before the Medline training session. EKG packets: in order to take full advantage of this wonderful experience, you must review EKG’s before the sessions and have written notes on the EKG’s or you will not reap the benefits of this teaching session. Don’t miss this opportunity! There will be a short EKG quiz at the end of the rotation.

10. Jacobi Ambulatory Care Service Reminders (con’t) Pelvic exams: Please use this opportunity to schedule patients for routine pap smears for quick return visits, for the patients’ benefit (it’s increasingly difficult to obtain routine Gyn appointments) and for yours (it is a residency requirement that you be certified in pap smears.) This is an important opportunity for you to learn these skills and should not be missed. It’s best if you schedule only 1 at a time, on Monday or Tuesday afternoons. You must be supervised by an attending, and must record this in MyEvaluations to get credit (you will need the patients’ MR numbers.)

11. Jacobi Ambulatory Care Service Reminders (con’t) CEx’s: The Residency Review Committee (RRC) requires that each resident perform a supervised history and physical exam, and receive appropriate feedback. Your scheduled “Clinical Evaluation Exercise (CEX)” serves this purpose. You should think of this as your chance to get one-on-one teaching for your benefit, not as a grading exercise. Don’t give a performance: do whatever you normally do when seeing a patient. You will be receiving a schedule from Dr. Gutwein; usually there will be one scheduled during your ambulatory block. Please contact the person who is scheduled to do this with you and make arrangements.

12. Jacobi Ambulatory Care Service Reminders (con’t) Systems-Based Practice/ Practice-Based Learning: You will be doing a small project in Systems-Based Practice/ Practice-Based Learning during this block. We will discuss this later.

13. Jacobi Ambulatory Care Service We are all thrilled to have you joining us in Ambulatory Care, and are here to help you with any problems. Please feel free to come to us with questions, comments, problems, and we will be happy to help in any way we can!

14. Jacobi Ambulatory Care Service