Residents have no inpatient responsibilities during the ambulatory block, enabling them to give their undivided attention to learning ambulatory medicine. Trainees participate in weekly Ambulatory Morning Report during the ambulatory block as well as take courses on the patient-doctor relationship, medical ethics, and management of drug and alcohol abuse. The patient-doctor relationship course, which continues throughout the residency, emphasizes basic interviewing skills during the first year. As part of the course, medical interviews are videotaped and evaluated by primary care faculty. In the second and third years, this course focuses on specific issues identified by the house staff.
Trainees also complete a course in medical ethics during their first year.
Taught by physicians and scholars from UPMC's Center for Medical Ethics, this course uses a case-centered approach to examine critical issues in ambulatory medicine, such as informed consent, advance directives, and bedside rationing. Each second-year primary care resident now spends three months on an ambulatory block. Subspecialty clinics include endocrinology, rheumatology, gastroenterology, and pulmonary medicine. Residents continue with the longitudinal clinic during these months and also spend one half-day per week attending Grand Rounds, Ambulatory Morning Report, and seminars on common problems in ambulatory medicine. The second year also includes a block of rotations in non-internal medicine subspecialties, including orthopaedics, gynecology, and dermatology.