In the mid 1980s, Columbia University Medical Center created the Ambulatory Care Network Corporation in response to the need for primary care services in the Washington Heights/Inwood section of Manhattan. This network of neighborhood-based health centers includes one that functions as the primary teaching site for the Residency Program: the Family Medicine at Herman "Denny" Farrell, Jr. Community Health Center, located on 158th Street and Morgan Place.

The Health Center employs a team approach in its care. Each team comprises attending faculty family practitioners, family nurse practitioners, patient representatives, medical assistants, nurses, and residents--each member an equal partner. Patients and their families are assigned to a single provider who is responsible for the management of their health care. Other team providers function just as members of a group practice do: covering patient phone calls, seeing patients in emergency situations, and sharing on-call responsibilities. Throughout their training, residents work alongside the same providers and support staff. During their first year, they spend an entire month at the Community Health Center, acquainting themselves with the team, the patients, and the rest of the system, as well as seeing patients. This method offers the residents both didactic and experiential education, focusing on the complementary strengths of the various team members.

The Community Health Center provides residents with fully equipped examination rooms, each with a computer workstation. It also furnishes a specially equipped procedure room where residents learn numerous skills, including skin procedures, colposcopy and other gynecological procedures. In addition to general family medicine experiences, residents have the opportunity to participate in home visits, musculoskeletal clinic, adolescent medicine and HIV/AIDS care. Residents also benefit from one of the few Web-based clinical information systems in the country, which permits immediate access to laboratory results and inpatient activity.

Residents also have the opportunity to use an electronic medical record. This exciting technological innovation eliminates cumbersome paper charts and allows providers to keep electronic charts that offer numerous advantages. Providers can retrieve patient information and laboratory results 24 hours a day from any location within New York-Presbyterian Hospital. Access to medical literature, demographic data bases, and the Internet are also at one's fingertips.

Family Medicine core curriculum lectures are given in the Community Health Center Conference Room. Residents can take advantage of other resources, including numerous reference books and a new teaching video system.