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Ambulatory Medicine

Dr. Rachel Ramirez

Rachel Ramirez, MD
Director, Ambulatory

General internal medicine training is not complete without robust instruction in outpatient medicine. Effective July 2016, Abington’s Categorical Internal Medicine Residency will use an “X plus Y” model of block scheduling. It consists of 2 weeks’ ambulatory medicine and 6 weeks’ inpatient or other rotations. The benefits of this shift from the traditional “half-day” clinic experience are two-fold. First, the residents are fully immersed in the ambulatory setting for two full weeks. During these two weeks, residents will work closely with nurses, staff and preceptors to care for their patients in the ambulatory setting. The immersion enables the residents to fully grasp the importance and learning opportunities that outpatient medicine offers. Faculty members are able to spend more time observing and counseling the residents as well. Resident hours are less strenuous and they have more weekends off. Second, while they are on inpatient rotations, they do not have to balance the demands of a busy inpatient service with their clinic patients’ needs. While they are still required to check on their labs and other outpatient results, they have more time to do so.


The shift in ambulatory education is affording more time dedicated to education with formal modules and team-based learning. Our faculty is utilizing an ambulatory curriculum based out of Yale University which uses case-based modules. Together with the chief residents, all are involved in learning several modules at least one half day a week.

Working together with the Director of Abington’s Center for Safety and Quality, Dr. Doron Schneider, they learn about healthcare safety and quality as well as engage in quality improvement projects to better the ambulatory clinic.

Nurse Practitioners

ASU Nurse Practitioners

Residents also have opportunities to spend time with our geriatricians at nursing homes periodically throughout the year to gain better insight to long-term care facilities and patient care therein. Additional exposure to palliative care and hospice education is included in these two weeks. Finally, the residents also spend time with some of our Physical medicine and Rehabilitation Faculty for further instruction in this important field of medicine.

ASU Clinical Staff

The Clinic Staff of Hartnett Health Services