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the ambulatory experience
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Our Residency Program offers extensive, well-structured longitudinal ambulatory experience. Its main component is the Continuity Clinic, which is set in Nesset Pavilion situated within the hospital campus.

In 1976, concurrently with the start of our program, Drs. Donald P. Rubino and Rush Priest, two respected general internists from the community, brought the nucleus of their practice to the Nesset Pavilion for the express purpose of sharing their practice with the Residents. The concept of creating a shared Faculty/Resident practice for the teaching purpose was an unusual innovation at the time, and predated by at least a decade of similar developments in other teaching institutions. Since then the Internal Medicine practice at the Nesset Pavilion has grown to over 25,000 visits per year. Its main goal is to provide excellent patient care within a longitudinal experience for Internal Medicine Residents. During their three years of training, Residents build their own clinical practices and are identified as their patients' primary care givers.

Eight General Internist chosen by their excellent quality of care and dedication to teaching make up the Internal Medicine Teaching Faculty. This well balanced faculty group are the following; Dr Thomas Holmes M.D., Dr Robert Zimmanck M.D., Dr Stuart Oserman M.D., Dr Mark Conley D.O., Dr Maribeth December M.D., Dr Helen Maciorowski M.D., Dr. Evan King M.D., and Dr Jill Patton D.O. These faculty educators have a close collaboration with the residents in the provision of care of patients in the office as well as in Lutheran General Hospital. PGY1 Residents receive special instruction and preparation for the practice of Ambulatory Medicine through the Mentoring Program. A group of three Residents work closely one half day per week with the same experienced faculty member throughout the year. In the PGY II and III years the ratio of resident to faculty is 4:1 and they meet one full day on elective rotations and one half day on most call months. Within these half day sessions are thirty minutes ambulatory didactic sessions utilizing John Hopkins Ambulatory Curriculum.

The patients who receive their care at the Nesset pavilion are as diverse as the community where we are located. We enjoy and ideal mix of ages, genders, ethnic backgrounds, and various insurance providers that closely mimic the pattern seen in today's practices of office medicine. The Faculty also makes a special effort to ensure that all Residents become proficient and knowledgeable about the requirements of Managed Care practice, honing their skills and developing efficient and cost-conscious habits of clinical practice. As a consequence of their thorough preparation, it is not surprising that our residents often contact up shortly after completion of their training, to let us know how well prepared and comfortable they feel in their own practice. Perhaps the best testimonial of the preparation our Residents receive is the large number of Residents who are recruited by established medical practices.

Supplementing the longitudinal ambulatory experience at the Nesset Pavilion is the exposure to office practice while on subspecialty elective rotations. Whereas the bulk of learning on these rotations takes place in the hospital, all Residents are exposed to significant office experience by working alongside of experience specialist while rotating through electives such as Gastroenterology, Endocrinology, Oncology and Rheumatology. To broaden the skills and experiences of the residents we also offer rotations in non-traditional internal medicine specialties. This is a specific one month office-based rotation during which Residents develop knowledge and obtain procedural skills in Dermatology, ENT, and Urology.  We also offer outpatient experiences in Gynecology and Women’s Health as well as Sports Medicine Clinic.


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