Ambulatory Education

Top Photo (Refugee Clinic): Yale Internal Medicine Residents supervised by an attending provide a first health screening with in-person translators for refugees arriving to the United States.

Bottom Photo (Refugee Clinic) left to right: Dylan Duchen (Patient Coordinator), Aniyizhai Annamalai (Adult Refugee Clinic Medicine Attending), Joshua Bilsborrow (Resident Volunteer), Gregory Madden (Resident Coordinator), Anne Mainardi (Resident Volunteer), and Eva Bryant (IRIS Health and Wellness Coordinator Intern)

Resident Continuity Clinics

Residents learn to manage common ambulatory problems under the supervision and guidance of faculty preceptors. After residents have matched into the Traditional Medicine Program, they will have the opportunity to rank their preference for a primary continuity clinic at one of the following sites.

  1. Yale Primary Care Center: The majority of residents will care for patients in the Yale-New Haven Hospital-based Primary Care Center Clinic (PCC). This is the site where many of the local population of New Haven receive their primary care.  Residents assigned to this location will have an equal balance of men and women patients with a variety of medical conditions. Residents here will have exposure to a highly ethnically diverse patient population, including refugees. In addition, residents will witness first hand the impact of social and economic stressors on medical issues in this predominantly indigent patient population.
  2. Yale Refugee Clinic: All residents rotate through the Yale Refugee Clinic as part of their ambulatory experience. The Yale Refugee Clinic, located within the Y-NHH PCC, is a resident-run clinic that provides medical care to newly arrived refugees from various countries including Afghanistan, Congo, Cuba, Eritrea, and Iran. We work in collaboration with Integrated Refugee and Immigrant Services (IRIS), a non-profit organization based in New Haven that resettles over 200 refugees every year. The refugee population offers a unique global health experience for residents which focuses on psychological trauma, tropical infectious diseases, and routine preventative care. All Yale internal medicine residents are encouraged to volunteer.
  3. The VA Connecticut Healthcare System (VACHS) Primary Care Firm System: A significant number of residents also care for patients in the VA Connecticut Healthcare System’s primary care clinics at the West Haven campus. In addition to the typical medical conditions seen in primary care, the VA clinics provide exposure to a population of patients with unique health issues related to their service in the military. To supplement the primarily male patient panel that residents care for at this site, residents also spend afternoons in the Women’s Clinic at the VA hospital, which cares for women veterans and a select number of male veterans’ spouses.
  4. The VA Connecticut Healthcare System (VACHS) Center of Excellence (COE) in Primary Care Education : A handful of residents will participate in this team-based, patient-centered care teaching model. The COE is unique in that it involves dedicated clinical care months (in place of elective time) that include learning, implementing, and practicing inter-professional collaboration, health policy, leadership, and quality improvement, which are necessary skills to function in today’s health care system. The patient population served is identical to that in the VA Primary Care Firm System.
  5. Community-Based Practices: A few residents have their continuity clinics in community-based centers that range the spectrum from private internal medicine practices to a federally qualified health center. Each of these clinics provides an intimate interaction between the resident and their primary provider and each has its own unique patient population that it serves.

** Please see the Yale Office-Based Medicine Curriculum site for more details about the Ambulatory Resident Education.

Ambulatory Block Rotations for Interns

The Ambulatory Block rotations in each of the three years of residency training provide the corner stone of the Program’s ambulatory education for its residents. 

  • Categorical interns have two 4-week block rotations at Yale or the VA.  
  • Second year residents spend 4 weeks of their ambulatory time at the VA in subspecialty clinics of their preference as well as Yale ambulatory clinic.  
  • Third year residents will participate in urgent care visits at both the Yale and VA Primary Care Clinics in the role of supervising interns to prepare them for the role of attending.

Emergency Medicine Rotations

Residents and interns will all spend 4 weeks over the course of their residency working under the supervision of the full-time Emergency Department faculty in Yale Emergency department.   During this experience they will manage a vast variety of emergency care issues as well as learning how to triage patients home, to a hospital floor bed, or to the intensive care unit.