Primary Care Track

The primary care residency program has been in existence since 1989. While the program is separate with regard to the match process, it functions as a subset of the larger categorical residency. Residents rotate through most of the same in-patient and clinical rotations as categorical residents, but they have more time dedicated to primary care via Weill Cornell Internal Medicine Associates (WCIMA) ambulatory block rotations. Primary care PGY-1's have two months of ambulatory block time, PGY-2's have six months and PGY-3's have six months; two or three of which spent are serving as the Ambulatory Chief Resident (ACR), a unique opportunity to lead outpatient teaching and administration. This schedule is in contrast to the two months of WCIMA blocks spent each year as a categorical resident. To allow for the additional months in ambulatory care, primary care residents spend less time at Memorial Sloan-Kettering Cancer Center and on inpatient specialty electives.

Our goal is to train residents to develop excellence in clinical practice and to foster areas of interest within the scope of academic general internal medicine. These areas include clinical research, medical education, medical ethics, public health, and health policy among others. The program accomplishes these goals through a rigorous educational curriculum, intensive clinical practice, structured research projects, service as ambulatory chief resident and exposure to a wide range of one-on-one mentors. Graduates of our program are well poised for careers as general internists, clinician-educators, and clinician-investigators.

CORE PRIMARY CARE FACULTY:
  • Judy Tung, MD - Director, Primary Care Track; Director, WCIMA
  • Christina E. Harris, MD - Associate Director
  • Erica Phillips-Caesar, MD - Research Director
  • Susana R. Morales, MD - Psychosocial Curriculum
  • B. Robert Meyer, MD
  • Suzanne Wenderoth, MD
  • Johanna Martinez, MD
  • Amanda Carmel, MD

Components Of The Primary Care Program

Practice at WCIMA: Faculty and residents practice side by side at WCIMA, a truly diverse and comprehensive general medicine practice. Patients come from a breadth of cultural, ethnic, and socio-economic backgrounds. Residents serve as true primary care physicians for all aspects of a patient's care. Residents become proficient in the essential components of ambulatory medicine including chronic care, urgent care, telephone medicine, prevention and screening, and patient education.

Ambulatory Didactic Curriculum: An extensive ambulatory curriculum is delivered in a morning lecture series to ensure all residents graduate with a solid foundation in general medicine. Topics include Hypertension, Diabetes, Knee Pain, Bronchospastic Disease, Age Specific Screening to name just a few.

Ambulatory Morning Report: In addition to the ambulatory lectures, time is dedicated three mornings a week to the presentation of outpatient cases. These sessions are led by the Ambulatory Chief Resident; both generalist and specialist faculty are invited to attend.

Specialty Electives: The educational curriculum is organized around clinical themes covered in each WCIMA block. A combination of stated objectives, rotations in specialty clinics, a syllabus of readings, and case-based conferences serve to concentrate the learning experience around essential topics in primary care. In the first year, interns have an elective block in dermatology. In the second and third years, blocks include cardiopulmonary, musculoskeletal medicine, women's health, geriatrics, endocrine, neurology and ENT. Time is also set aside for individual specialty electives of the resident's choice.

Research Methods Course: All primary care residents are expected to carry out a research or other scholarly project over the course of their residency. Structured preparation for research is taught at the beginning of the second year in an intensive eight to twelve week course. This course is taught by the faculty in the Department of Public Health and in the Division of General Medicine. In addition, Dr. Erica Phillips-Caesar, our research director, facilitates small groups sessions designed specifically to discuss resident's projects in detail. Primary care residents also have a session per week dedicated to independent working on their research project each WCIMA block.

Noon Conference - Evidence-Based Questions: Every Wednesday during months on block, residents and faculty lunch together and discuss an evidence-based "answer" to a clinically relevant question formulated during the previous week of practice. Two residents are chosen to identify a focused clinical question, demonstrate their literature search strategy, and summarize the relevant article(s). The main skills developed during these seminars include:

  1. Forming an answerable clinical question
  2. Searching the appropriate databases
  3. Appraising the literature critically
  4. Applying the results to the patient
  5. Self-evaluation
By keeping these searches focused and succinct, residents develop the skills necessary to incorporate evidence based searches into their standard practice.

Psychosocial Rounds: Dr. Susana Morales, a nationally renowned teacher, leads these weekly sessions, which provide a foundation in psychiatric and psychosocial care for primary care clinicians. Various other dimensions of medical care are explored including cross cultural medicine, working with difficult patients, evaluation and management of addictions, screening for domestic violence, etc. Attention is also given to the subtleties of doctoring including the challenges of residency, physician burnout, and the balance of professional and personal lives.

Ambulatory Chief Resident: All senior primary care residents serve as ambulatory chief resident, a wonderful chance to assume a leadership role and to refine teaching skills. The main function of the ambulatory ACR is to arrange and present morning report three days per week for all WCIMA residents. Additional responsibilities include administration for the primary care program, supervised precepting of housestaff, and supervision during PAP clinic. The ACR also serves an important role as the liaison between residents and faculty at WCIMA.

Second Continuity Clinic: Senior residents have an opportunity to have a second weekly continuity clinic outside of WCIMA. Sites vary widely and have included Center for Special Studies (CSS: a NYPH-based ambulatory care center for patients with HIV/AIDS), Endocrine, GYN, and Long Island City Community Practice to name a few.

SGIM: The primary care program funds primary care residents to attend the national Society of General Internal Medicine (SGIM) conference each year. The conference is an exciting meeting of leaders in academic general medicine, and a great opportunity for residents to learn about and get involved in the wide variety of work. Residents use this as a time to develop ideas for their own projects, explore career options, make contacts, and learn about primary care internal medicine.

Social Activities: The primary care residents and faculty enjoy good eating and casual socializing as often as possible! The ACR organizes the group together about every three months to foster camaraderie between resident years and between residents and faculty. Other more formalized gatherings include: intern welcome party, alumni reunion and senior graduation party.

Distinguishing features of the Primary Care Program:

  • Intensive clinical practice at Weill Cornell Internal Medicine Associates, a diverse and comprehensive general medicine practice.
  • Ambulatory didactic curriculum of core outpatient topics.
  • Ambulatory morning report led by the ambulatory chief resident.
  • Concentrated learning around clinical themes:
  • PGY-1 Year: Cardiopulmonary Testing and Dermatology
  • PGY-2 Year: Women's Health, Neurology and Geriatrics
  • PGY-3 Year: Musculoskeletel, Endocrine and Cardiopulmonary
  • Development and execution of a research or scholarly project for presentation at a national meeting spring of PGYIII year.
  • Research methods course taught by the faculty in the Department of Public Health and the Division of General Medicine.
  • Lunch conferences where evidence-based reviews of clinical questions from the prior week are presented by residents.
  • Increased emphasis on psychosocial aspects of doctoring, including weekly morning conferences.
  • Service as the Ambulatory Chief Resident, a leadership position with teaching and administrative responsibilities.
  • Dedicated faculty mentor for mentoring in research
  • Second continuity clinic at the Center for CSS, an integrated practice for patients with HIV/AIDS and Long Island City Community Practice.
  • Attendance at the national meeting of academic generalists, Society of General Internal Medicine (SGIM).
  • Frequent social gatherings including intern welcome BBQ, Weill Cornell Internal Medicine Associates retreat, senior graduation party.
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