Outpatient Experiences

Y blocks – primarily outpatient services

General Internal Medicine (GIM and VA GIM)

Residents spend 2 blocks per year (inclusive of PAD and Geriatrics) in outpatient general medicine clinics. The majority of this time is spent at the site where the resident has their primary care continuity clinic allowing them to learn both general principles and site specific subtleties of outstanding general internal medicine care. A longitudinal didactic teaching program half a day per week when on these rotations builds outpatient knowledge and skills over the course of the 3 years.

Pain, Addiction and Disability

GIM blocks with an additional focus on pain, addiction and disability. Residents spend time with GIM faculty who have a specific interest in these areas and in relevant subspecialty clinics.


A 3 or 4 week experience in Geriatric Medicine including time in outpatient clinics, subspecialty clinics relevant to geriatrics, and in skilled nursing facilities.

Neurology, Ultrasound and Research Training Module

A 4 week experience in the first year comprising 2 weeks on the neurology consult service and 2 weeks in which interns can complete mandatory CITI training, learn about research at Dartmouth and the IRB process, identify projects and mentors, and learn the basics of bedside ultrasound.

Endocrinology, Infectious Disease, Nephrology, Palliative Care, Rheumatology

2 week experiences in the above subspecialties are built into the 3 year resident schedule and include both inpatient and outpatient learning experiences. Any resident who wishes to do additional elective time in these subspecialties is able to do so.

Formal Instruction in Resident Education (FIRE)

A 2-week experience in which residents learn concepts and skills related to effective teaching and lead teaching sessions with a variety of learners (students, interns, residents). Each resident is observed in their teaching by a faculty member with an interest in medical education and specific feedback on how to improve their teaching is provided immediately after each session.


Each year every resident is allocated to approximately 2 weeks of coverage. During this time the resident works on any scholarly projects and attends scheduled conferences. If needed the coverage resident is “pulled” to cover for any resident absences on a clinical services – for instance if a resident is sick, at a conference, taking their STEP 3 exam etc. Over the last few years residents are “pulled” to cover on about a third of their allotted coverage days.


Elective experiences are available in all the medicine subspecialties and residents may also use elective time to gain further experience in general medicine in either the inpatient or outpatient setting. Residents may use a portion of their elective time for scholarly work in line with the Accreditation Council for Graduate Medical Education (ACGME) program requirements.