The heart of the ambulatory curriculum is each resident's continuity clinic, which consists of one half-day clinic per week throughout residency. Each resident is assigned to the clinic corresponding to their team - Daniels, Powell, or Remmers. Many patients are seen by a resident in the hospital and subsequently followed by the same resident (at that team's clinic) after discharge. This allows for a smooth transition of care. These patients belong to the residents and are followed by a single resident primary care provider throughout his or her training at UTMB.
In the continuity care clinics, categorical residents will see an average of 5-6 patients per half-day clinic and interns will see an average of 3-4 patients per half-day clinic. The housestaff are also supported in the clinic by general medicine faculty, registered nurses, a social worker, and health care technicians (phlebotomist, medical assistants). Clinic is preceded by a 30-minute clinic conference dedicated to the practice of outpatient medicine.
The continuity clinics are held in three locations. The Primary Care Pavilion is across the street from Jennie Sealy Hospital. Residents may also choose to hold their clinic at Victory Lakes Multispecialty Center in League City or Texas Excellence in Academic Medicine (TEAM) clinic in Texas City (see description below). Patients with diverse backgrounds are present at each site giving residents a robust outpatient training experience. At every site, all patient rooms are equipped with necessary medical equipment and individual computer stations. We also have large team rooms at all of the clinic sites that function as a work space for residents to use while awaiting the arrival of their patients, discussing cases with faculty preceptors, placing orders, or completing any necessary documentation.
Starting in 2016, categorical interns spend one month of their intern year on a clinic selective rotation. During this month, interns experience an extended continuity clinic with half-days in their team's clinic. This allows them to become familiar with the flow of the clinic and to boost their patient panel for their future years of residency.
Subspecialty / Nonmedicine Opportunities
UTMB is a large academic institution, with the ability to offer our residents a broad array of medicine, medicine subspecialties, and opportunities outside of Internal Medicine. Residents can rotate with UTMB General Internal Medicine faculty in their personal clinics. Furthermore, medicine outpatient subspecialty elective opportunities include: Cardiology, Endocrinology, Rheumatology, Geriatrics, Gastroenterology, Allergy/Immunology, Pulmonary, Oncology, and Weight Management. Electives outside of Internal Medicine include: Dermatology, Anesthesiology, and Radiology. Residents may also set up their own on-campus and off-campus electives, with approval from our department and the GME office.
The Community Adult Clinic (aka TEAM Clinic) opened in 2014. This clinic serves adult primary care needs in the context of a patient-centered medical home. The scope of this practice includes: preventive care, chronic disease management, health promotion, and diagnostic/treatment capability. The residents who rotate at this clinic, along with trainees and staff, are dedicated to working as a team with patients to improve their health. We strive to partner with patients by empowering them to take ownership over their health and providing the necessary support and tools to do so. Towards this end, patients are linked to important community resources after the identification of their immediate needs - whether it is medical, social, cultural, or economic. The TEAM clinic is embedded in the greater Texas City community and offers services such as chronic disease support groups, nutrition classes, and yoga sessions to patients and the broader public. This clinic is not only a patient-centered medical home, but also an education-centered home. A cohort of 3rd year medical students is present in the clinic as well. By way of combining innovations in medical education with patient care, we are training the next generation of healthcare professionals to work in a high-functioning inter-professional team that places the patient at the center.
UTMB is a tertiary-care center made up of three hospitals: the newly finished Jennie Sealy Hospital, John Sealy Hospital as well as the Texas Department of Corrections Hospital - Hospital Galveston. With this mix, residents are exposed to all disease processes from the common presentations of “bread and butter” Internal Medicine to the uncommon presentations of rare, “zebra” illnesses. These hospitals are conveniently located on the same campus, connected via an interior tunnel, and utilize the same electronic medical records system.
The new Jennie Sealy hospital gives patients an updated room that is more comfortable for them as well as their families. In addition, residents have clean, modern call rooms to use during their time on Night Medicine.Jennie Sealy has numerous updated conference rooms for team rounding as well as family meetings. The view of the gulf is second to none!
Ward opportunities include: general internal medicine wards, oncology ward, HIV/infectious disease ward, geriatrics, cardiology/CCU, and MICU.
We also provide numerous inpatient consult rotation opportunities such as: Cardiology, Endocrinology, Hematology/Oncology, Pulmonary, Gastroenterology, Nephrology, Rheumatology, Infectious Disease, Transplant Medicine, and Palliative Care as well as consult rotations outside of Internal Medicine if desired.
The academic year is broken down into 13 four-week blocks. They are scheduled by PGY years as shown below for categorical residents. Residents can take up to 3 weeks of vacation per year. Vacation time rolls over to the next year.PGY 1
- General Medicine / Subspecialty Wards: 5-6 Blocks
- Medical Intensive Care Unit: 1 Block
- Cardiology: 1 Block
- Emergency Medicine: 1 Block
- Neurology: 1 Block
- 2 weeks Night Medicine with 2 weeks Continuity Clinics: 1-2 Blocks
- Elective: 2 Blocks
- Clinic Selective: 1 Block
- General Medicine / Subspecialty Wards: 3-4 Blocks
- Medical Intensive Care Unit: 2 Blocks
- Cardiology: 0-1 Block
- 2 weeks Night Medicine with 2 weeks Continuity Clinic: 3-4 Blocks
- Elective: 3-4 Blocks
- General Medicine / Subspecialty Wards: 1-2 Blocks
- Medical Intensive Care Unit: 1 Block
- Cardiology: 0-1 Block
- Medicine Consults: 1 Block
- 2 weeks Night Medicine with 2 weeks Continuity Clinics: 3-4 Blocks
- Elective: 5-6 Blocks