Primary Care Track

Since 1989, the Primary Care Residency Program has been graduating academic general internists. While the program is fully integrated into the larger Categorical Residency Program, it has a separate match through its unique program number. The primary care residents rotate through most of the same inpatient and clinical rotations as categorical residents, but with additional dedicated time devoted to primary care internal medicine in the academic faculty practice of the Weill Cornell Internal Medicine Associates (WCIMA). Primary care PGY1s spend two months on ambulatory block time, which expands to six months in both the PGY2 year and the PGY3 year. Each primary care senior resident serves the role of a clinician-educator in WCIMA during their assignment as the Ambulatory Chief Resident for two to three months. This unique opportunity teaches trainees about outpatient teaching and clinical administration and leadership skills. This robust ambulatory education is in contrast to the two months of WCIMA blocks spent each year by categorical residents. 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.

 

The goal of the primary care track 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 the 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 — Assistant 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 socioeconomic 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, and 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 attend to enhance the discussions.

 

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, endocrinology, and neurology. 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 by Dr. Erica Phillips-Caesar, our research director. These sessions include both didactic lectures and small group sessions designed specifically to discuss residents’ projects in detail. Primary care residents also have one session per week dedicated to independent work on their research project each WCIMA block.

Noon Conference — Evidence-Based Questions: Every Friday during ambulatory block months, 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:

  • Forming an answerable clinical question
  • Searching the appropriate databases
  • Appraising the literature critically
  • Applying the results to the patient
  • 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 R. Morales, a nationally renowned teacher, leads psychosocial rounds to 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 House Staff, 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 the Center for Special Studies (CSS: an NYPH-based ambulatory care center for patients with HIV/AIDS), Endocrine, GYN, and Long Island City Health Center.

 

Society of General Internal Medicine: 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 the national agenda for general internal medicine. Residents are encouraged to get involved in the wide activities offered through the society. 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.

 

Additional Opportunities

 

Rural Health: Our primary care residents are encouraged to spend four weeks on the clinical elective at Cayuga Medical Center in Ithaca, New York, which offers opportunities in hospital medicine, rural health, and student health services.

 

Community Medicine: Residents who are interested in community medicine can select to have their primary continuity site at the Long Island City Health Center, a federally qualified health center that is located in the northwest section of Queens. The LIC practice is a multidisciplinary practice that offers adult medicine, pediatrics, and obstetric/gynecology services to a diverse patient population including a large urban immigrant population. Residents who practice at LICHC, as well as other interested primary care residents, can participate in community health education sessions based in the Queensbridge Houses public housing development.

 

Social Activities: The primary care residents and faculty enjoy good eating and casual socializing as often as possible! The Ambulatory Chief Resident organizes the group together about every three months to foster camaraderie among resident years and between residents and faculty. Other, more formalized gatherings include the intern welcome party, the alumni reunion, and the 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:
  • PGY1 Year: Dermatology
        PGY2 Year: Cardiopulmonary, Women's Health, and Neurology
  • PGY3 Year: Musculoskeletal, Endocrinology, and Geriatrics 
  • Development and execution of a research or scholarly project for presentation at a national meeting spring of PGY3 year 
  • Focused research methods curriculum 
  • 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 research mentor
  • Second continuity clinic in an area of interest for the resident 
  • Attendance at the national meeting of academic generalists, Society of General Internal Medicine (SGIM) 

Frequent social gatherings including intern welcome dinner, Weill Cornell Internal Medicine Associates retreat, senior graduation party

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