The primary care track curriculum includes the following:

• Additional outpatient medicine rotations, particularly in Geriatrics, Palliative Medicine, and primary care.
• Additional experience in the traditional non-Internal Medicine areas of Psychiatry, Dermatology, Otolaryngology, Gynecology, and Orthopedics.
• One module in the office of a practicing physician outside the Cleveland Clinic to gain experience in office management and community based practice
• Longitudinal care practices one to two half-days per week supervised by members of the Department of General Internal Medicine.
• Primary Care Block rotation which includes extended time in the Longitudinal Care Clinic, seminars on topics and procedures relevant to primary care, and the opportunity to care for patients in underserved areas.
• The Free Clinic of Greater Cleveland
• Care Alliance Health Center
• Residents spend 60% of their time on inpatient services and 40% in outpatient clinics.

Residents in the Primary Care Track participate in a dedicated longitudinal care practice with supervision from General Internal Medicine staff. Residents spend one half-day each week in Longitudinal Care Clinic during their first year and durin g supervisory months in the second and third years. During elective and consult months in their second and third years, residents spend two half-days per week in their practice

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First-year Primary Care Track
First-year residents typically work as part of a health care team which includes a supervising second or third-year resident, an attending physician, and medical students. First-year residents spend the majority of the year providing primary care for Internal Medicine patients admitted to one of the geographic medical units. Residents gain critical care experience in the Coronary or Medical Intensive Care Unit, ambulatory care experience in block outpatient rotations, and experience in the Emergency Department. Primary Care Track residents also have one module dedicated as a Primary Car e Block in the first year.

Typical PGY-1 Schedule

• Emergency Department: 1 module
• General Medicine Services: 3 modules
• Medical Intensive Care Unit or Critical Intensive Care Unit: 1 module
• Outpatient Clinic: 2 modules
• Primary Care Block : 1 module
• Subspecialty Services: 4 modules
  • Cardiology Inpatient
  • GI/Hepatology (Green)
  • Hematology/Oncology Inpatient
  • Nephrology
  • Neurology
• Vacation: 1 module, includes a float week

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Second-year Primary Care Track
Second-year residents act as supervising residents for four modules, including one module on a General Medicine Service and one module as a Night Float. Second-year residents rotate on subspecialty and general medicine consult services, gaining expertise in consultative medicine. Junior residents work one module in either the Coronary or Medical Intensive Care Unit, under the supervision of a senior resident, subspecialty fellows, and a full-time intensivist. Second-year Primary Care Track residents have three consecutive modules as a dedicated Primary Care Block. The primary care block includes additional geriatric lectures and experiences. Lectures include falls, urinary incontinence, advance care planning, management of glycemic control in the frail elder, and others. During the 3-month primary care block, the residents spends one half-day at Fairfax Nursing Home, an inner-city nursing home within walking distance of the Cleveland Clinic. Residents evaluate patients receiving rehabilitation, assess ability to return to the home, evaluate disease management, participate in a Quality Improvement project, and provide an “in-service” to the nursing staff on a clinic topic.

Typical PGY-2 Schedule

• Consult Services: 3-4 modules
  • General Medicine and Subspecialty
• Medical Intensive Care Unit or Critical Intensive Care Unit: 1 module
• Night Float Supervisor: 1 module
• Outpatient Clinic: 1 module
• Primary Care Block : 3 modules
• Supervisor: 2-3 modules
  • General Medicine Service
  • Cardiology
  • Hematology/Oncology
• Vacation: 1 module, includes a float week

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Third-year Primary Care Track
Third-y ear residents act as supervising residents for five modules, including two to three modules on General Medicine Services and one module as a Night Float. Senior residents act as supervisors for one module in the Medical Intensive Care Unit. Third-year residents work one module in the Emergency Department. Senior residents have a three-month block dedicated as a Primary Care Block.

Typical PGY-3 Schedule

• Electives: 1 module
• Emergency Department: 1 module
• Medical Intensive Care Unit: 1 module
• Night Float Supervisor: 1 module
• Primary Care Block : 3 modules
• Psychiatry Consult/Liaison: 1 module
• Supervisor: 3-4 modules
  • 3 General Medicine Service s
  • 1 Subspecialty Service
• Vacation: 1 module, includes a float week

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Longitudinal Continuity Clinic

All categorical res idents are responsible for ambulatory outpatient clinic half a day per week throughout the three years of training. Residents have clinic either at the Cleveland Clinic main campus or at a Cleveland Clinic Family Health and Surgical Center. These Family Health and Surgical Centers are located throughout the greater Cleveland area and make up the Division of Regional Medical Practice. These Family Health and Surgical Centers provide an excellent setting in which to experience the delivery of primary care to the community.

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