Ambulatory Training

Residents' ambulatory experiences come in several forms. It is through the composite of these experiences, where the residents attain and develop the knowledge and skills that are necessary for delivering outstanding ambulatory patient care. The bulk of these experiences occur in the general medicine continuity clinics, where residents develop long-standing relationships with a panel of their own patients. In addition, during several structured Ambulatory Block rotations, residents acquire additional knowledge and skills in primary care, sub-specialty, and specialty outpatient medicine.


Learning and caring for the "whole patient", can only occur when the patient feels comfortable enough to allow the physician to understand his/her life, not just as a patient, but as an individual. This is achieved over time, in the continuity clinic, where residents take on first-contact, primary responsibility for a group of patients who are referred or recruited into the residents' own practices. These patients are drawn from a variety of settings; some are discharged from the hospital by the same resident, some are referred to the practice from other specialty clinics, some are recent visitors of our emergency/urgent care centers, and many are self-referred from our surrounding communities just for primary care. This diversity of patient origin, allows our residents to learn the ambulatory diagnostic and therapeutic approaches to patients with acute illnesses, and the longitudinal delivery of high quality care to patients with chronic medical conditions. Faculty members from the Division of General Medicine supervise residents at all times in the general medicine clinics. All resident clinic offices are equipped with computers with access to electronic medical records, clinical management resources, UpToDate, and Medline.



During these blocks, residents spend all of their time in the ambulatory setting, and have no inpatient responsibilities. At present, PGY-1 residents have one ambulatory block, while junior and senior residents have 2 blocks. During these blocks, residents will act as office-based physicians, and spend a large portion of their time seeing patients in the general medicine clinics. In addition, they will also rotate to nearly 40 specialty and subspecialty experiences located both on and off the CUMC campus. Aside from these practical experiences, several structured and comprehensive didactic series fill out the rest of the Ambulatory Block. These include a basic primary care lecture series, a formal epidemiology curriculum, several case-based teaching reports, and a weekly Division of General Medicine conference. In addition, all residents also attend teaching sessions on primary care psychiatry, addiction medicine, and quality improvement.


For more information, refer to the Ambulatory Clinics homepage.

From Our Residents

Residency at Columbia has given me the opportunity to be part of a system that welcomes diversity and quickly makes you feel at home. It has certainly been a privilege to work in a setting that fosters underserved communities and mediates exposure to treat a wide array of disease in a challenging learning environment driven towards growth as well-rounded physicians while providing high quality patient care.

- Dennis De León, MD 


  University of Puerto Rico 

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