Internal Medicine Residency

The Four Aims

The Primary Care program at Penn is a multifaceted training program that provides residents with tailored experiences to be leaders in internal medicine. The program provides the opportunity for residents to work and learn in a variety of diverse and unique environments while keeping the Four Aims of the program in mind – Care of the Community, Clinical Excellence, Continuous Improvement and Medical Education.

Care of the Community

The Primary Care program is dedicated to providing superior medical care to the patients of West Philadelphia. To answer this call, we have developed a Care of the Community Curriculum, run by Dr. Robin Canada. Dr. Canada has spent her professional career caring for patients in resource-poor environments. Partnering with Dr. Canada, Dr. Rachel Truchil splits her time between caring for patients at the PCPC, as well as at one of the city health centers in West Philadelphia serving under-and uninsured patients.

Longitudinal Didactic Series: Leaders in policy, economics, administration, and education combine to provide Primary Care Residents with exposure to the social, community, and policy issues that surround caring for vulnerable populations.

Intensive Community Medicine Clinical Month: Residents rotate at Health Center #4, one of the city’s safety-net clinics, and United Community Church, a medical student run clinic located in a church basement for one month. Residents will see patients and participate in a research or quality improvement project.

Longitudinal Second Clinic in the Community: Sites have included a low-cost clinic for undocumented Latinos (Puentes de Salud), a needle exchange clinic (Prevention Point), the Lax Center (HIV Primary Care), Health Center #4, Chinatown Medical Services as well as suburban practices.

Refugee Clinic: Providing a rewarding experience in international medical problems, the Penn Center for Primary Care (PCPC) houses the Refugee Clinic, overseen by Drs. Garland and Rusk. Our clinic is a designated site for providing initial primary care to refugees coming to Philadelphia. Our patients are largely Burmese, Bhutanese, and Sudanese.

Global Health Curriculum: Patients in West Philadelphia face many of the same issues as those living in resource poor nations. In this way, global and community health are linked. Many of our primary care residents take part in Penn’s Internal Medicine Global Health Track. Headed by Drs. Joe Garland and Carol McLaughlin, this track provides an opportunity for didactic learning, practical skill development, and international travel for medical training. Whether or not you choose the global health track, all primary care residents are included in much of the global health didactic curriculum and have the opportunity to travel to one of Penn’s international sites in their senior year.

"Global health is primary care in the developing world. Community Medicine is Global Health in ourown backyard."

Clinical Excellence

Our mission is to train superb primary care physicians to pursue careers in clinical practice, academic medicine, research, or administration. The faculty at the PCPC, who all work in the inpatient and outpatient setting, are consistently among the highest rated faculty in the department. Given their educational roles in both venues, they are uniquely positioned to educate future leaders in primary care. Through one-on-one mentorship and clinical coaching, our residents learn the prerequisite skills necessary for clinical excellence.

All of the primary care faculty are very active in the didactic curriculum and coach our residents in their continuity clinic. All are recognized as superb clinicians and educators. As a testament to the superb clinicians with which our residents work, Drs. Matt Rusk and Stephen Gluckman also see patients at the Consultative Internal Medicine Practice at the Perelman Center for Advanced Medicine. This innovative practice functions as a consultative service to which physicians refer their patients with unknown or elusive diagnoses or medically complex issues.

Continuous Improvement

The practice of medicine is changing - dramatically. While the doctor / patient relationship is still paramount to providing effective, patient-centered care, there is a growing need to recognize, appreciate, and help mold the systems and environments in which we practice. This requires new graduates to have a firm command of systems of care, quality and process improvement, and transitions of care. All of the PCPC faculty continue to practice and teach medicine in both the inpatient and outpatient arenas. This has been a high priority for the faculty as insights from one arena help with care in the other and allow for more effective transitions of care. All primary care residents rotate at least once each year on the general medicine services at Penn Presbyterian, with the PCPC Faculty, allowing them to actively participate in the continuity of care for our patients.

Drs. Robert Cato and Kevin Fosnocht are founding members the PCPC and have molded careers centered on high-quality care. Dr. Cato is currently the lead physician at the PCPC and serves as the Chief of General Medicine at Presbyterian Hospital. He leads the Patient-Centered Medical Home initiatives and drives much of the quality improvement and systems changes at the PCPC. Dr. Fosnocht serves as the Chief Medical Officer at Penn Presbyterian. As clinicians with administrative roles, both are great resources for residents who wish to pursue careers in practice, physician administration, or quality improvement.

Drs. Laura Kosseim and Marty Bohnenkamp have been very active in improving the care of our patients’ as well as the patients of other physicians’. Dr. Kosseim has led the PCPC’s improvement initiatives in preoperative and perioperative medicine. Through collaboration with the departments of orthopedic surgery and anesthesia, Dr. Kosseim has streamlined the preoperative process, enhanced the care of these patients while in-house, and helped transition these patients back to home. Dr. Bohnenkamp is a leader in the Quality Assurance Program at Penn Presbyterian and serves to review and optimize systems of care and teach about these issues through interactive and interdisciplinary conferences. Both physicians have helped make the processes of care for patients easier, more effective, more patient-centered, and, most importantly, safer.

Medical Education

Many of our graduates from the Primary Care residency go on to pursue careers in medical education. In addition to the wonderful mentors to help coach our residents, we believe the rich academic environment and exposure to mentors of regional and national prominence aid in their career decision-making process. The emphasis that the PCPC faculty place on education is exceptional and includes strong involvement at both the medical student and resident level. Primary Care residents receive a specific didactic curricula on improving their teaching skills and providing feedback. In addition, residents are also taught by leaders in medical education, policy, and accreditation which allow them to learn the “language” and national trends in medical education.

Dr. Jack Ende, through decades of experience as a national leader in medical education, is a vital resource for the residents and the Primary Care program. Dr. Ende is extensively involved and is a leader in many national organizations. This has afforded him a large network of colleagues who visit the PCPC to provide educational perspectives from outside of the walls of Penn.

One of the newest members of our team, Dr. Rani Nandiwada, is passionate about resident education and curriculum innovation. She has strong interests in lifelong learning through evidence based practice and high value care, developing the primary care pipeline, and teaching to teach.

In addition, Drs. Aba Barden-Maja and Anita Lee are deeply engaged with the mission of educating the medical students at Penn. Drs. Barden and Lee both serve as course directors in the medical school and provide our residents with keen insights that help improve their teaching skills. For example, under the direction of Dr. Lee, many of our primary care residents help teach medical students the basics of patient care in the preclinical course “Introduction to Clinical Medicine.” This unique opportunity provides residents with a practical way to practice the skills they are taught in the Primary Care program.