UWMC General Internal Medicine

UWMC Resident Ambulatory Education

Mission

To create an educational environment and curriculum that allows residents to maximize their development as physicians and leaders in medicine
To use an evidence-based approach to provide patient-centered primary care and learner-centered education

Overview

UW General Internal Medicine is a community of health care providers offering outstanding care to a diverse patient population.

Patient care visits are the core educational activity, supported by enthusiastic and knowledgeable attendings. Clinic attending is aimed at assisting the residents in giving good care while maintaining the primacy of the resident patient relationship.

To facilitate resident learning about ambulatory medicine, we have a 3-year evidence-based curriculum presented via case-based interactive pre-clinic conferences, led by the residents using teaching material prepared by mentoring attendings.

Education is also fostered through weekly chart reviews, reviews of videotaped patient encounters and regular meeting with mentoring attendings.

The UWMC program has begun to offer more community-oriented heath care opportunities and a greater public health perspective through partnerships with organizations like Safelinks, a mobile care unit for homeless adolescents and with the UW Mulitcultural Affairs office.

The program continually strives to provide a supportive and nurturing environment for residents while offering top quality ambulatory education to prepare residents for practice.

Theory & Practice

What does it mean to be a physician?

Practicing medicine is not just a job but rather a profession. The basic tenet of the profession is that physicians, in practicing medicine, should act in the best interest of their patientsí and in the best interest of the health of the population in general.

In practice, this necessitates altruism, knowledge, skill, and duty.

Altruism: be compassionate, honest, empathetic, able to deal with the dying, able to make decisions in the context of differing beliefs and values		Skill: be highly skillful in providing appropriate care to individual patients, able to communicate with patients and colleagues orally and in writing
Knowledge: understand the scientific basis of medicine and be able to apply that understanding to the practice of medicine; be prepared and willing to learn throughout their lives.		Duty: feel obligated to collaborate with other health care professionals and to use systemic approaches for promoting, maintaining & improving the health of individuals & populations

What does it mean to be a general internist?

The curriculum

Pre-Clinic Conference

Safelinks

Safe Links is a multidisciplinary health care effort whose mission is to reduce the harm to and improve the health and safety of homeless youth traditionally marginalized by sexual orientation, culture, addiction and mental health disorders.

Working within a harm reduction model, Safe Links provides mobile medical outreach services to homeless youth in the Capitol Hill and University districts. Basic medical services, including, but not limited to, HIV, STD and pregnancy testing, wound care, immunization administration and health education, are provided. Safe Links provides medical and counseling services to homeless youth with a special focus on those who have been victimized by, or are at risk of, sexual abuse or partner violence. Providence Seattle Medical Center supports the program through the donation of medications and supplies. Physicians from the community, including residents from GIMC, and the Providence Family Practice Residency volunteer their time to deliver the medical care services. Residents currently have the opportunity to provide medical services one night a month.

This is a unique learning opportunity for residents while modeling how a collaborative, multidisciplinary approach can be utilized to improve the delivery of health care services to, and ultimately, the health of, at risk communities.

PERL: Portfolio of Evaluation and Reflection on Learning

Portfolio Evaluation and Reflection on Learning (PERL) is a compilation of residentís goal setting, reflection, observed activities and self-assessment continually refined through comparison with external feedback. The primary outcome of the evaluation project is for each resident to create a portfolio that includes a comprehensive collection of various types of feedback and self-assessment. The components of the portfolio may vary, but are based on specific activities to assure broad coverage of skill areas. They include: worksheets on goal setting, tracking and self summary of learning, teaching self-evaluation, colleague feedback; critical incident type narratives; mini-CEX observations; videotaped encounters of residents with patients, directed self-evaluation, a summary of resident/attending meeting, and overall department evaluation. There is a Working Portfolio for the residentís use and work-in-progress, and a Performance Portfolio for highlighting core competencies and strengths at the end of each year and upon completion of their residency.

Amidst the rapid rate of change in health care, PERL addresses crucial aspects, (adaptation and evaluation,) in a physicianís ability to address some of the significant challenges faced by health professionals. Personal ability to self-assess is key in facing increasingly diverse populations, greater emphasis on health promotion and disease prevention, new practice settings and partnerships, as well as successfully adjusting to economic and systems restructuring.