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Primary Care Track

The Department of Medicine at Lenox Hill Hospital recognizes the urgent need for primary care physicians and proudly supports the development of the Primary Care Track for the Internal Medicine Residency. This track complements our internal medicine residency program providing enhanced and focused training for physicians with a desire to practice community-based General Internal Medicine. The aim of this program is to develop and support primary care providers who provide compassionate, efficient, and evidence-based comprehensive care to the communities they serve.


LEADERSHIP

DIRECTOR OF THE PRIMARY CARE TRACK: Becky Mazurkiewicz, MD, MPH Dr. Mazurkiewicz completed her undergraduate training at the University of Michigan and medical school at Georgetown University School of Medicine before moving to the Mount Sinai Hospital in New York, NY to complete an Internal Medicine Residency and a General Internal Medicine Fellowship as well as obtain a Masters in Public Health. She is currently the Director for the Primary Care Track of the Internal Medicine Residency and the Site Director for the Acting Internship at Lenox Hill Hospital in New York, NY. She can be contacted at rmazurkiew@nshs.edu.CHIEF SENIOR RESIDENT (AY 2014-2015): Shanna Levine, MD Dr. Levine graduated from University of Florida before attending Stony Brook Health Sciences Center School of Medicine. She is currently a third year resident in the primary care track at Lenox Hill Hospital. Her interest includes the intersection of oncology and primary care. This year, she will be the chief senior resident, serving as a liaison between the residents and the primary care faculty, coordinating and mentoring primary care residents� academic endeavors, and keeping our residents up to date with the latest in evidence-based primary care via a monthly chief's newsletter and journal club .

ELIGIBILITY

Three Primary Care positions will be offered at each academic level. Trainees may enter the Lenox Hill Primary Care Track through the NRMP Match or apply to transfer into the program by the completion of PGY1 if space is available at the discretion of the Director of the Primary Care Track. Participants should be prepared to engage in all aspects of the track and are required to attend all didactics when not on vacation, nightfloat, or ICU and participate in all track projects.

CERTIFICATION

Trainees will fulfill all ACGME requirements and become eligible for American Board of Internal Medicine certification by the completion of the three years of their training. In addition to the internal medicine residency completion certificate, a certificate will be granted indicating completion of the Primary Care Track. Letters of reference and career development for future professional positions will indicate the unique focus of the Primary Care Program.

TRACK OBJECTIVES

Provide systematic clinical and didactic training in health maintenance, disease prevention, and culturally competent diagnostic and therapeutic care in the outpatient setting
Provide opportunities to work with sub-specialists and a range of practitioners in multi-specialty settings
Provide longitudinal private physician mentorship
Provide career development and support
Provide ample exposure and guidance in performing common ambulatory procedures
Develop skills in qualitative research, practice improvement, and quality improvement
Develop skills in patient and community education
Support individual development and implementation of a practice or quality improvement project for our main ambulatory site
Support group development and implementation of a longitudinal patient education experience at our main ambulatory site

CLINICAL EXPERIENCE

Primary Care Track participants have the same number of required inpatient blocks as the Categorical residents do; however, during ambulatory blocks PGY2 and PGY3 Primary Care residents have 4 continuity sessions, 1 private office session, 2 specialty sessions, and 2 academic sessions.

Private Office Sessions

During ambulatory block, PGY2 and PGY3 primary care track participants will spend one session per week in the office of a seasoned private practitioner. Such an experience will allow residents another opportunity for continuity in ambulatory patient care as well as the ability to view and participate in the inter-workings of a private office.

Primary Care Senior Resident

While on ambulatory block, senior residents in the primary care track will precept categorical interns at LHM one session per week when not otherwise committed to patient care. Categorical interns will present patients to the resident for initial precepting, teaching, and assistance with procedures and paperwork prior to being precepted by an ambulatory attending. During this time, primary care senior residents will also be able to directly observe interns performing histories, physical exams, procedures, and patient counseling in order to provide interns with feedback on their performance.

PRIMARY CARE TRACK DIDACTICS & WORKSHOPS

Monthly, primary care track residents meet as a group in order to participate in track-specific education, support and guidance. The content of meetings varies on a monthly basis but can include primary care-related didactics, skill- and career-building workshops, and guidance on ambulatory academic projects that are not otherwise covered in such depth in the categorical ambulatory curriculum. Meetings last roughly 1.5 - 2 hours and generally begin at 5pm to facilitate attendance. Meetings are mandatory except for those rotating in the ICU, nightfloat, or vacation.

Didactics

Previous topics for primary care didactics include: health literacy, smoking cessation, diabetic teaching, and needs assessment and academic project proposals. Planned future didactics include: nutrition and weight management, wound care, women's and men's health, sports medicine and pre-participation physicals, pre-employment physicals and PPDs, pre-operative evaluation, outpatient pain management, community medicine and resources, practice management, billing and coding, and patient satisfaction. Preventive medicine, management of chronic disease, and telephone medicine are taught by the track director as part of the categorical ambulatory curriculum.

Skill-Building and Career Development Workshops

Previous topics for primary care workshops include: resident teaching skills, CV dissection, job search and interviewing, finger stick glucose checks and insulin administration, incision and drainage, basic ambulatory suturing, and dermatologic shave and punch biopsies. Lenox Hill Hospital is in the process of purchasing a patient care simulator for ambulatory procedures, the use of which will be incorporated into primary care track monthly didactics. Planned future workshops include: leadership skills, advanced evidence-based medicine, contract negotiation, vaccinations and PPDs, ear irrigation, pelvic exam with pap smears, straight catheterization, arthrocentesis, and splinting, bracing, and taping.

Individual Ambulatory Quality Improvement or Practice-Based Learning Improvement Project

Primary care track participants are required to choose an ambulatory topic as the subject of one of their two required academic projects during their residency. Participants are given an introduction to quality improvement and practice-based learning improvement initiatives, evidence-based medicine, qualitative research to assist them in this endeavor. Mentorship on such a project will be provided by any member of the ambulatory faculty and time is provided during primary care track monthly didactics to discuss progress and obtain feedback from group. It is expected that the results of this project will be submitted as an abstract to a regional or national conference if not for publication.

Primary Care Track Project: Primary Care Reading Curriculum Each primary care track participant will contribute to the development and maintenance of a primary care-themed reading curriculum that will be displayed on our website. Each member will choose a discipline within primary care (i.e. preventive medicine), develop critical objectives regarding the topic (i.e. vaccination against VZV is recommended for adults > 60 years old), and find a link to an article supporting that objective. Other appropriate links may be to diagrams, vaccination schedules, management algorithms, etc. One track member will oversee the project, which will be uploaded to our website along with track information, meeting presentations and handouts, and other useful information

MENTORSHIP AND CAREER DEVELOPMENT

In addition to the skill- and career-building workshops mentioned above, Primary Care Track participants meet with the Director of the Track individually biannually for feedback related to meeting track objectives and to ensure he or she is appropriately progressing towards his or her career goals.