During this elective, residents will participate in the provision of primary healthcare to patients between 10 and 26 years of age. Common complaints include STI's, contraception, sports injuries, acne, and IVDU, at sites as diverse as a homeless shelter for youth, school-based clinics, La Clínica Tepeyác, High Street, and the 16th Street Mall.
"The adolescent medicine rotation provides a unique experience for residents to become comfortable seeing patients as young as twelve years old in a variety of settings, ranging from poor underserved, school based clinics, and homeless youth. Relive the drama and awkwardness of your youth! During this rotation, many issues such as STD's, teen pregnancy, depression, obesity, and adolescent development are tackled. The attendings are some of the best in this program and love to teach. I now feel comfortable seeing patients younger than 21 in my primary care clinic after this rotation and look forward to taking care of this unique population in the future." Hannah Hall, M.D., Class of 2013
The AUCC is located at Denver Health and offers residents a wide variety of cases in medicine, surgery, gynecology, orthopedics and others. Resident autonomy and independent decision-making are stressed. Residents will see a broad spectrum of acute and sub acute conditions that will present to offices and urgent care centers requiring entirely different management skills than you have acquired on the wards or in continuity clinics.
This course focuses on the development of advocacy and leadership skills to better serve the needs of the underserved and vulnerable populations. This elective is designed to provide participants with a basic understanding of our current healthcare system and training on specific strategies that can be used to advocate on behalf of patients—through legislation, written pieces, media, coalitions, and community organizing.
Residents can elect to take a 3-4 month block of rotations at the Denver Veteran’s Affairs Hospital in their 3rd year. Several different clinics are available to rotate through on a regular basis including, but not limited to, urology, rheumatology, dermatology, ENT, ortho, pulmonary, renal, and more.
This elective is designed to help residents develop a broad understanding of complementary and alternative therapies. Residents work with the University, Kaiser and community providers who specialize in various alternative healing disciplines, including acupuncture, naturopathy, yoga therapy, hypnosis, meditation, and shamanism.
Clinical Nutrition: With the majority of chronic diseases having a lifestyle component, residents have the option to spend two weeks learning more about clinical nutrition. Experiences may include spending time with dietitians and physicians in nutrition specialty clinics such as obesity, type II diabetes, eating disorders, nutrition and oncology, and general nutrition counseling. The majority of the experiences are ambulatory, though inpatient nutrition training can be arranged with advance notice.
This one month of out-patient dermatology clinic in a multi-specialty group setting is one of our most popular! Residents achieve independence with basic dermatology diagnosis, treatment and biopsy procedures. We also offer dermatology clinics at VA and UCH in combination with podiatry. Private practice - Open to primary care 3rd year residents only.
"The dermatology elective at Kaiser helped me develop important skills that I use frequently now that I am in practice, especially considering the wait time for routine dermatology where I am is several months! I became comfortable with shave and punch biopsies after doing over 30 during the course of a month. I rotated with different dermatologists and I learned a lot about diagnosis and management of various skin conditions and skin cancers. The knowledge I gained has been invaluable for primary care practice!" Alison Landrey, M.D., Class of 2012
This elective focuses on cardiac stress testing: picking the right stress test, testing protocol, reasons for testing, interpretation of data and safety considerations. At the end of the course, you should be able to conduct exercise testing independently and we will certify you as ready to do this if you have proctored at least 50 stress tests and taken the pre and post tests. Many physicians who have completed this rotation are now performing treadmills in their practice settings!
During this unique rotation, residents will learn pedigree construction and interpretation, become familiar with available genetic tests, develop genetic counseling skills, and become familiar with the ethics and legal implications of genetic testing. Several clinic sites will be used to capture an array of diseases and styles of practice, and there are curricular offerings throughout the month to enhance learning built into the schedule. The main thrust of the month is to help Internal Medicine residents develop the skillset to understand and how medical genetics relates to Internal Medicine and to prepare for the continued evolution of clinical genomic medicine as applied to adults.
During this elective, residents will learn chronic care of HIV-infected individuals with a focus on the primary care of this population. Residents will gain the knowledge and skills to provide guideline-based preventive care specific to HIV patients, initiate anti-retrovirals, manage complications of treatment including viral resistance, and manage chronic co-morbidities. This is a required rotation for PC residents who wish to enter the HIV program, but is open to all interested residents.
“I chose to take the HIV primary care elective in my 2nd year after having a long interest in HIV and the underserved population it disproportionately affects. It was an excellent experience combining diverse didactic sessions, getting to know community and public health resources, and clinical experience with experienced and passionate faculty with backgrounds in both general internal medicine and infectious disease. I had one of the more unique experiences in my residency when I spent an afternoon in the Denver Health Tuberculosis Clinic with an ID attending. Since the elective, I have done an HIV primary care continuity clinic and been able to see many patients multiple times, counsel patient on starting antiretroviral therapy, and see the strong relationships that Dr. Adams has forged with her HIV patients over the years. I will be able to sit for the HIV provider exam when I complete residency and hope to incorporate that into my future primary care practice. I would highly recommend the HIV elective to anyone interested in learning more about caring for patients with HIV in the primary care setting - it has been an awesome experience and an opportunity that is quite unique to our residency program.” Kelly Evans-Hullinger, M.D. Class of 2015
"This elective provides a comprehensive overview for caring for patients with HIV. During this month, residents gain exposure to providing care for patients with HIV, including general healthcare maintenance, management of medications, identifying and managing common infections, and so much more! In addition, residents have the opportunity to participate STI-screening and counseling, as well as, substance abuse counseling and treatment in the inner-city. After completing this elective, I was motivated to continue learning HIV-medicine and complete the HIV-track. Truly, the best elective of my residency training!" Tierney Sparks, M.D., Class of 2013
Residents can take advantage of wonderful opportunities in Arizona and New Mexico with the Indian Health Service. Several CU graduates serve as preceptors. Residents will practice the full spectrum of internal medicine including outpatient clinics and inpatient rounding in this unique practice setting. During this rotation, residents live on the reservation affording them an opportunity to become fully immersed in the unique culture and community found on the reservations.
"Rotating at the Northern Navajo Medical Center in Shiprock, NM was a fantastic opportunity to see how high quality, academic-oriented primary care clinicians can continue to provide outstanding evidence-based care in a community setting. The hospital in Shiprock serves a VERY large geographic area, encompassing most of the Navajo reservation. It was an amazing opportunity to learn about the Navajo culture and meet the wonderful people who live in the Four Corners area. I loved having the opportunity to care for patients in the outpatient clinic, the walk-in clinic, the general medicine ward, and the ICU. They also have some unique clinics to serve the unique needs of the patient population, such as a Uranium Miner Clinic, TB clinic (common on the reservation), group diabetes clinic, and very busy rheumatology clinic (a lot of rheumatologic diseases run in Navajo families). The internal medicine physicians in Shiprock were a blast to work with and exceptional clinical educators. On the weekends (yes, you do get weekends off) you have the chance to explore amazing places such as Canyon of the Ancients, Hovenweep, Chaco Canyon, Mesa Verde, Moab, the Grand Canyon, Taos, Santa Fe, Durango, and more! This rotation had a huge and positive impact on my career decisions." Kathryn McCaffrey, MD, class of 2013
Kaiser Permanente is a non-profit integrated health system (primarily HMO with some PPO and high-deductible plans) caring for more than 450,000 members in 17 clinics throughout Denver and Boulder. Primary care internists host residents at their clinic site where the resident will work with 2-3 internists seeing patients, performing clinic-based procedures, attending CMEs and business-related meetings of interest.
“The University of Colorado does an excellent job at providing its residents the opportunity to work in several different hospital settings: academic, county, private, and the VA. However, the ambulatory experience is usually in the setting of an academic center with providers who are involved in research, administration, etc. Personally, this seemed somewhat daunting to undertake and I was interested in what primary care looked like in a non-academic setting. The Kaiser Preceptorship provided me this opportunity and it was wonderful. I was able to work with several different providers from a variety of backgrounds: some previously worked in an academic center while others were from a traditional private practice. It was a great opportunity to hear them compare and contrast the different settings while experiencing life as a Kaiser provider. The Kaiser Preceptorship allowed me to see and feel what the day-to-day life was like for a full-time non-academic primary care provider. I was able to work on my time efficiency and towards seeing the number of patients expected of an attending. The Kaiser rotation also reassured me that interesting patient pathology exists outside of an academic center. Overall, this was a great rotation and exposed me to yet manner in which to practice primary care.” Allison Wolfe, M.D., Class of 2015
This popular rotation has been rated as one of the most valuable outpatient experiences offered at CU. Practical experience with a personable, superb clinician-educator. Residents will master joint exam skills and injection techniques. Available to primary care residents only.
“The opportunity to rotate with an orthopedic surgeon during residency is a very unique option but proved to be invaluable. Dr. Parks is invested in teaching primary care providers appropriate strategies for managing orthopedic issues. He focuses on teaching the essential physical exam skills and how to perform them properly. He also wants us to give the training to do joint injections in our own clinics with confidence. Part of this training happens in the OR. As a medicine resident I never thought I would be back in the OR but it proved to be a beneficial experience. After the patient is prepped for the surgery, Dr Parks allows you to insert a needle into the joint space and he opens the joint so you can see if you were in the right location. Also, seeing what is involved with many orthopedic procedures allows me to have more meaningful conversations with my patient regarding what they can expect from the surgery. I now feel much more confident in when to refer, how to perform the relevant physical exam maneuvers and how to do therapeutic injections of the knee and shoulder.” Joel Jorgenson, M.D., Class of 2015
This month is designed to provide the resident with exposure to both palliative care and hospice experiences, including inpatient hospice care centers (Lutheran Hospice), home hospice care (Lutheran Hospice), and hospital palliative care consultative services (University Hospital). The focus of the rotation is on care for the seriously ill and their loved ones. Skills covered include acute pain and non-pain symptom management, advanced communication/complex family meetings, goals of care clarification, advance care planning and end-of-life transitions. Residents will integrate into the interdisciplinary team approach for the care of patients. Didactic education sessions occur at least weekly, in addition to weekly palliative medicine conferences. There are no weekend or evening call responsibilities.
"The elective was a great time for me to really improve my skills in the management of common but distressing symptoms at the end of life. I left feeling more comfortable initiating and managing PCAs, titrating pain medications, and I had more tools for treating nausea and constipation. Probably the most important skill I obtained was seeing and understanding the process of dying. When patients and their families ask, "what will it be like," I can provide some answers and make a very scary and unknown process a little more comfortable." Rachael Dirksen, M.D., Class of 2012
PC Selective is a new rotation for our third year residents. During this rotation, residents will learn and experience in community health at different clinics, hospitals and community centers. For example, transitional care experience will allow residents to receive handoff from inpatient colleague on a patient who will then have a home visit by the “community resident.” This will include feedback to inpatient resident on how it is going at home, use of a standard med rec form. Other sites and activities include; Care team, Palliative care clinic, Telehealth clinic, InnovAge (day care for seniors), Homeless and refugee clinics.
An excellent opportunity to participate actively in a busy 3 internist community-based practice with a variety of managed care plans (HMOs, PPOs, POS, and indemnity insurance). Learn to code, refer, pre-authorize, use superbills and understand the myriad variations of insurance reimbursement. Residents will also be exposed to overhead and traditional office expenses. Opportunities to attend peer review, medical staff leadership and quality management meetings. A terrific opportunity to get accustomed to practicing in the real world.
We will make every attempt to accommodate educational requests and individualized learning objective during this elective. Clinic experiences can include: intake evaluations, common psychiatric diagnoses such as anxiety and mood disorders, addiction and substance abuse clinics, women’s health clinics, eating disorders clinics, geriatric clinics, and motivational interviewing. Internal medicine residents will get experience in diagnostic formulation, assessing for suicidality and violence, pharmacotherapy, and some basic principles of psychotherapy.
"In the primary care psychiatry rotation, I was able to spend time seeing patients with senior psychiatry residents and faculty, observing firsthand the types of patients who are referred to and followed by psychiatrists as well as learning management pearls directly from them. This was a valuable experience that improved my management of psychiatric patients in several specific ways, and was enjoyable as well. I highly recommend it!" Mark Learned, MD, class of 2012
The objective of participating in primary care research is to allow residents exposure to the process of conducting research while allowing them to explore issues that are relevant to them. As a secondary objective, we encourage presentation of research results at a national meeting as well as publication in a peer-reviewed journal. See PC Research
Residents may choose from a large number of rural clinical sites that incorporate both inpatient and outpatient medicine. Most of these sites qualify for loan repayment and are looking for new internists to join their group.
For rural in Colorado, we have funds to support traveling to the site, housing service is available thru the Colorado AHEC (area health center) Office.
"Rotating at Parkview Medical Center in Pueblo, CO was a fantastic opportunity to experience giving excellent inpatient and outpatient care in a smaller community in Colorado. The hospital serves a large geographic area and as a result has many interesting cases. Additionally, the hospital has a lot of visiting medical students and a brand new internal medicine residency program, so you have ample opportunity to improve your teaching skills on the wards and during AM/noon conferences. All of the attendings, medical students, and new interns were very enthusiastic and welcoming to a visiting resident. This rotation proves that it is still possible to pursue a career as a primary care clinician who cares for their patients in the clinic as well as the hospital...meanwhile you can still be involved in medical education and teaching. My favorite part of the rotation is witnessing the strong bonds that form between patients, families, and physicians in this setting of great continuity. On the weekends you can go to the Chilifest, State Fair, drive-in movie theatre, or go hiking. The month flew by; it was a blast!" Kathryn McCaffrey, M.D., Class of 2013
Residents learn about the health care system, participate in quality improvement projects and meet many of the people around town who make policy decisions. It will change the way you read the newspaper, watch the news, and interact with patients and multidisciplinary health care teams. This elective is well-suited for those who like topics such as understanding healthcare systems, what’s Medicare/Medicaid, who pays, how do you define “quality”, what is a quality improvement plan? The month is largely non-clinical in nature.
Available at Stout Street Clinic providing care to the homeless population in Denver, Denver Health and Hospitals Clinics and many others. Having the opportunity to spend a month at a single site will allow residents to experience the rewards of providing primary care to underserved populations.
“Rotating at Eastside Clinic was a fantastic opportunity that solidified my interest in primary care for the underserved. I met many patients who were obtaining medical care for the first time in several years and feel very grateful to have been involved in their care. The attendings were outstanding clinician-educators who are clearly passionate about their work and very committed to providing evidence-based care in a community setting. They also allowed me to tailor the rotation to reflect my interest in women's health. Throughout the month, I was able to participate in a Pap Clinic and Title X Family Planning Clinic. I was also able to refine my skills in several office-based procedures. I was very lucky to have had this rotation early on in intern year and look forward to working at Eastside Clinic in the future!” Andrea Ma, M.D., Class of 2017
"I was lucky to spend a complete month during my second year at Westside, the Denver Health community clinic where my continuity clinic is based. I really enjoyed building my patient panel, working closely with multiple attendings who love their careers and teaching residents, and getting a better sense of what a primary care career for an underserved population would entail. Additionally, I was able to spend time with the nurses at the clinic doing weight loss visits, a psychiatrist who treats difficult mental health cases within an integrated model, and an endocrinologist who assists with specialty care which gave me a broader sense of the clinic's activities." Mim Ari, M.D., Class of 2013
This elective provides residents exposure to several diverse outpatient clinical experiences including gestational diabetes, metabolic bone disease, breast and thyroid clinics, high risk OB, and pelvic pain clinics. Each schedule is crafted according to individual interest. All residents will gain exposure in the diagnosis and treatment of sexually transmitted infections, performance of well-woman examinations, contraception, treatment and management of abnormal pap smears, workup of abnormal and dysfunctional uterine bleeding, diagnosis and work-up of incontinence, including urodynamics, and hormone therapy counseling.
"This outstanding elective is individually designed to meet the educational goals of residents. After completing this elective, I am able to perform many gynecological procedures independently, including endometrial biopsies, IUD insertions, and biopsies. I am prepared to offer these services as a future primary care provider." Tierney Sparks, M.D., Class of 2013