Jacobi
Ambulatory Care Service
Jacobi Primary Care Internal
Medicine Track
Steven R. Hahn, MD
Director
Primary Care Internal Medicine Track
• Formed in 1982
• Directed by Dr. Steven Hahn (steven.hahn@nbhn.net)
• Intensive focus on ambulatory medicine & principles of
primary care medicine
• Focused training especially useful for:
– Primary care medicine
– Continuity of care specialties
– Health outcomes research, health policy & administration
Jacobi
Ambulatory Care Service
Primary Care Program Perspective
• Psycho-social factors influencing adaptation to
chronic disease
• Advanced doctor-patient communication skills
• Mental disorders and behavioral dimension of
disease including
–
–
–
–
Depression & anxiety
Substance abuse
Cognitive disorders
Adherence to medication and lifestyle management
• Emphasis on a learning community
Jacobi
Ambulatory Care Service
Primary Care Ambulatory Block Curriculum
• Behavioral sciences seminars – four 8-week courses, one per
semester in a two-year rotation
–
–
–
–
Epidemiology and management of psychopathology (psychopharmacology)
Counseling and behavior change in primary care
Family-systems medicine in primary care
Healthcare systems and the determinants of health
• Team meeting – weekly block-time lunch meeting
– Moral support and camaraderie
– Case discussion and mini-didactics
– LUNCH
• “Balint” case discussion group – weekly block time activity
– Facilitated peer discussion of emotionally and professionally challenging
cases
• Ambulatory Morning Report – case discussion and self-learning
session
• Outpatient specialty rotations
Jacobi
Ambulatory Care Service
Primary Care Block Schedule: All Primary
Care Residents Scheduled Concurrently
Year
Summer/Fall
PGY 1 1 contiguous month:
2 weeks ambulatory
2 weeks primary care elective
PGY 2 2 contiguous months:
1 month ambulatory
1 month primary care elective
PGY 3 2 contiguous months:
1 month ambulatory
1 month primary care elective
Jacobi
Ambulatory Care Service
Winter/Spring
1 contiguous month:
2 weeks ambulatory
2 weeks primary care elective
2 contiguous months:
1 month ambulatory
1 month primary care elective
3 contiguous months:
1 month ambulatory
2 months primary care elective
Primary Care Special Features
• Gero-Med-Psychology and Medicine-Psychology clinic
– Available to all residents, but integrated into PC curriculum
– Patients evaluated in collaboration with 2-3 graduate
psychologists participating in a gero-psychology externship
• Hazelden substance abuse training program
– Available to all residents, integrated into PC curriculum
– World-famous substance abuse treatment center in
Manhattan with structured week-long training program
• Opportunity to do relevant research during each of the
six Primary Care Blocks
• Collaborative research projects – this year, a study of
cycle-time in our medical clinic
Jacobi
Ambulatory Care Service