PGY3 Ambulatory Experience FAQs

THE PGY3 AMBULATORY EXPERIENCE

 - Yes. This clinic is mandatory as it counts toward one of the 12 months of Medicine that each trainee needs in order to be certified as having finished Core Internal Medicine. The program director will not be able to sign off the "CITER" at the end of PGY3 if this clinic is not attended satisfactorily. Failure to complete the full 12 months of longitudinal PGY3 clinic could jeopardize finishing the Core Internal Medicine program on time. 

 - Each PGY3 trainee has two 6-month clinics. Clinic assignments for July to December 2010 have been made. Clinic assignments for January to June 2011 will be available by the end of September. 

 - Residents must attend their clinic half day as a priority above other commitments occurring at the same time. For example, if rotation teaching, rounding, or other events occur during the clinic time, residents must leave to go to their clinic, and forgo the other events. Residents should leave their rotation in sufficient time to arrive at their clinic half day ready to see their first patient, on time. This will include travel time and 10 minutes to set up and review records prior to seeing the patient. Residents should ensure sufficient handover of all outstanding clinical issues on their rotation before leaving for their longitudinal clinic. Residents should not miss their clinic half day unless excused (see below).

4. When are residents excused from clinic?

 - Residents do not attend clinic when on vacation or conference leave. Residents must inform their clinic of any scheduled vacation time. Clinics can also check this with Hospital Administrative Assistants and are encouraged to do so monthly; however, it is the final responsibility of the resident to communicate leaves (and any alterations in dates) to their clinic supervisor and administrative assistant promptly.

 - Residents do not attend clinics when post call. Residents know their post call days as of 2 weeks before their next month’s rotation. Clinics and residents should ensure that all post call days are marked in the clinic schedule to avoid booking patients for those times. It is best to treat “home call” as identical to “in house” call, although this is up to the discretion of the resident and attending.

 - Residents on ICU, CCU and Team Medicine DO come to clinic on half days, except when ON call or POST call. ICU, CCU and Team Medicine rotations have been notified of residents’ clinic half days, and that residents will be absent for them. Clinics and residents should ensure on call days and post call days are marked as above in the clinic schedule. Residents should be given a fair opportunity to attend their clinic half days when not on call or post call for ICU, CCU or Team Medicine.

 - Residents do not attend clinics when the supervisor is absent or the clinic is otherwise cancelled. Clinics should make every effort to inform residents when clinics are cancelled.

5. What about other rotations - for example Medical Consults? 

 - All other rotations should allow residents to leave to attend clinic, unless post call. 

 - If you are post call, you do not come to clinic. Make sure your clinic supervisor and administrative assistant both know of your post call dates as soon as you know them.

 - On other days, you must attend your PGY3 clinic. You should alter your community medicine responsibilities on your clinic day to ensure you can get to clinic. For morning clinics, go to your rotation once your clinic is over, especially if you are on call. If not on call, you and your rotation supervisor should decide if it is worth it for you to go back to the rotation. For afternoon clinics, you should ensure you leave your rotation early enough to get to clinic. You may want to schedule lighter clinical activities on that morning to facilitate this. In either case, be sure your rotation is aware of your clinic responsibilities and negotiate the way in which it will work. 

 - Once the resident has missed 2 clinics apart from the reasons noted above, the Core Program Director, Dr. Heather McDonald-Blumer, should be notified by the clinic supervisor, to assess the reasons for missing clinic.  Her email address is as follows:

 - The only other regular academic half day is the monthly CRISP session. If your academic half day coincides with CRISP, you should attend your clinic as the first priority. The PGY3 CRISP days do not all occur on the same day of the week, so this should not be a recurring problem. 

 - There are no other academic half days apart from special events that the Core Program will announce to you individually. Residents do not get other protected time for teaching, research etc on a weekly basis in the PGY3 year. 

 - Residents should see both new patients and follow ups, representing the types of problems commonly seen in that clinic’s setting. Residents should see their patients in follow up visits subsequent to the initial visit when they did the initial consultation. 

 - Residents should be given the responsibility of determining when the patient is best seen next.

 - Clinic supervisors should find that they are able to book extra patients for the days when the resident will be present.

 - This will vary greatly depending on the nature of the clinic and patients, and the need for other patient-related work (phone calls, multidisciplinary conferences, forms, etc.) It is expected that residents will increase in competency with time, and be able to see greater numbers of patients in a half day as the months go by.

 - Time should be allotted to allow residents to complete all tasks during the half day (ie. residents should not have to return the next day for dictations, etc.)

- Residents and faculty should meet and decide the date and time of the first clinic in early July. If this has not happened yet, or there is difficulty reaching each other, please email Ken Locke to assist, using the following email address:

 - Clinic supervisors are encouraged to give residents brief feedback at every session, and residents are encouraged to ask questions about how the supervisor perceives the work they are doing. 

 - At the midway point, a formative assessment exercise will be sent to supervisors and residents to facilitate discussion on strengths and areas to improve. 

 - A clinic ITER will be available on POWER during the final part of the clinic placement to allow a final (summative) assessment to be done.

 - For other questions, or issues, please email Ken Locke directly at: