摘要：Expanding primary care and ambulatory experiences in internal medicine training programs is limited by insufficient resources devoted to their development and implementation, heavy inpatient service demands and loyalty to the traditional inpatient based training model. Overcoming these barriers is a challenge likely to create new approaches to ambulatory education. The Pilot Education and Ambulatory Care (PACE) program at the Sepulveda VA is one such initiative that represents a multidisciplinary approach to primary care services, improving quality and access to patient care services, as well as the quality of primary care education. We describe the development of a similar model for resident training and primary care service, also funded through the Veterans Affairs (VA), but implemented with fewer resources. The program redirects faculty and administrative resources to a new clinical environment centered around primary care. We believe this educational model has broad implications for the future of medical training because it is achievable and thus exportable to other programs.
