Weill Cornell Medical College

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Primary Care Track

• Primary Care Track
• Medical Research 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. We urge only those committed to primary care to apply to this program.

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).

For primary care upper level residents, the ambulatory time expands to six months in both the PGY2 year and the PGY3 year. As part of this time, each primary care senior resident serves as the Ambulatory Chief Resident for two to three months and acts as a clinician educator in the practice. In addition, this unique opportunity teaches trainees about managing an outpatient practice, clinical administration and leadership skills.

The primary care track trains 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 comprehensive educational curriculum, intensive clinical practice, structured research projects, 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

• Lee Shearer, MD -- Co-Director, Primary Care Track
• Byron Demopoulos, MD -- Co-Director, Primary Care Track
• Erica Phillips-Caesar, MD
• Susana R. Morales, MD
• Judy Tung, MD
• B. Robert Meyer, MD
• Fran Ganz-Lord, MD
• Johanna Martinez, MD
• Amanda Carmel, MD

Primary Care Program Overview

* Outpatient Practice is scheduled as 2-week blocks of time, 6 times through the year (at 8 week intervals) for a total of 12 weeks continuity practice.
+ Inpatient Subspecialty Medicine includes cardiology and oncology services. It may also include the renal service.
° Inpatient Medicine includes inpatient geriatrics unit and general medicine wards.
^ Night Float is scheduled as 2 different 2-week assignments during the year.
VAC = vacation

Highlights of the Primary Care Program

Practice at WCIMA

Faculty and residents practice side by side at WCIMA, a fully integrated general medicine practice providing comprehensive care to a diverse patient population. Residents become proficient in the essential components of ambulatory medicine including chronic care, urgent care, telephone medicine, prevention and screening, and patient education.

Three Outpatient Practice Sites

All three of the outpatient practice sites are fully integrated with faculty practices; both residents and faculty see a broad payer mix of patients side by side, including private insurance, Medicare and Medicaid patients. Two of them are practice sites for the Weill Cornell Internal Medicine Associates (WCIMA) while the third site, Long Island City Health Center, is a federally qualified health center embedded in its community in Queens. Patients are multicultural given the international flavor of New York City's population.

• WCIMA Helmsley Medical Tower 4th Floor is the hospital-based office practice of Weill Cornell Internal Medicine Associates. The practice is divided into three different but integrated practices: Red, Blue, and Green.
• WCIMA Wright Center is a smaller general internal medicine practice shared with our geriatrics faculty and is located just 7 blocks north of campus. The Wright Center is otherwise identical to the Helmsley Tower practice.
• Long Island City Health Center (LIC) is 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 LIC can participate in community health education sessions based in the Queensbridge Houses public housing development.

Ambulatory Morning 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, asthma, women's health, travel medicine, and age-specific screening, to name just a few.

Sub-Specialty Electives

The sub-specialty educational curriculum is organized around clinical themes covered in each WCIMA block. A combination of rotations in specialty clinics, syllabus 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, endocrinology, and neurology. Time is also set aside for individual specialty electives of the resident's choice.

Research Methods Course

All primary care residents participate in a structured research course as preparation for their required research project. Both didactic lectures and small group mentoring sessions to discuss residents' projects in detail are specifically designed to direct the efforts towards a published end-product. Primary care residents during PGY2 and PGY3 have time dedicated to independent work on their research project.

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.

Ambulatory Chief Resident

All primary care residents serve as the Ambulatory Chief Resident during 2-3 months of their senior year, 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 two 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 are invited to participate in a second weekly continuity clinic outside of WCIMA. Sites vary widely and have included the Center for Special Studies (an NYPH-based ambulatory care center for patients with HIV/AIDS), Endocrine, GYN, Renal, Rehab Medicine, Adolescent Medicine, Weight Management, and Long Island City Health Center.

Society of General Internal Medicine

The primary care program funds all junior and senior primary care residents to attend the annual national meeting of the Society of General Internal Medicine (SGIM) each spring, provided the resident submits an abstract or clinical vignette. The SGIM conference is an incredible 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 and to use the meeting time to develop ideas for their own projects, explore career options, make contacts, and learn about primary care internal medicine. Primary care interns may attend the regional SGIM meeting.

Rural Health

Our primary care residents are encouraged to participate in the clinical electives at Cayuga Medical Center in Ithaca, New York, offering opportunities in adolescent medicine, hospital medicine, rural health, and student health services. The experience provides an introduction into real life primary care embedded in a smaller community.