Outpatient or ambulatory internal medicine immerses the learner into the evaluation and therapeutic management of adult outpatients. Patients present to their physician with acute problems, visits for chronic problems, visits for monitoring and management of complex medical conditions, visits for age- and gender-appropriate preventive care, visits to discuss life transitions (e.g., moving to assisted living or nursing home, end-of-life discussions and counseling for shared decision making) and visits that may not be as much "medical" but related to a patient's health and life function or quality. Patients may be accompanied by family members, friends, or significant others. Thus, the entire spectrum of adult patients, aged 18+ may be encountered. Medical care that 20 years ago might have had to be delivered in the hospital setting is now managed and coordinated by a patient's primary internist. The relationship between the physician and patient can be decades long, or recent. The privilege to be invited into this special relationship cannot be taken lightly. Students are expected to develop a sense of responsibility for continuity of care and the unique characteristics of an internal medicine practice. The highest level of professionalism, character, and integrity is expected. The student will attend weekly Grand Rounds and Internal Medicine block conference, after speaking with the preceptor.