Outpatient Medicine | Continuity Practice
The fundamental training experience in outpatient medicine for categorical and primary care residents is a supervised continuity experience managing a panel of primary care patients. Residents see their own patients in a weekly continuity practice in partnership with attending physicians. Over half of our residents maintain a practice at the Internal Medicine Associates, the largest internal medicine practice at MGH. Other resident clinic sites include group practices at the main campus and health centers affiliated with MGH in the greater Boston area.
Incoming categorical and primary care interns inherit a panel of approximately 75-100 patients from a graduating resident and supplement their panels with new patients who are referred to these practices from the inpatient medical service, the emergency room, or the MGH Medical Walk-In Unit. Referrals may also come from family members already in the resident's practice, MGH physicians, or the MGH Physician Referral Service. Over the course of three years, residents build their practices to approximately 100-125 patients. Because residents remain at the sites for three years, this continuity allows residents to develop long-term relationships with their patients.
Residents see patients one-half day per week when on inpatient rotations throughout the three years of training. Whenever residents are "on-call” or “post-call" from inpatient rotations, their clinics are flexibly scheduled to an alternate day to assure they are well-rested when practicing outpatient medicine and to limit the strain between duties as a primary care doctor and as a member of an inpatient care team. During ACR, residents have 3-4 clinic sessions per week and on electives or ASRs, residents have 2 clinic sessions per week.
At each practice site, residents work with a team of health care professionals that includes patient care coordinators, nurses, and nurse practitioners. Nurse practitioners often follow many patients along with the residents, particularly if the patient has a need for frequent visits, education, or other services. This collaboration provides residents with valuable experiences working closely with a team of healthcare personnel.
Residents are supported by faculty physician preceptors. Preceptors supervise no more than four residents during a clinic session and generally do not see their own patients concurrently. Residents and preceptors typically work together for the duration of training. Over the three years of training, residents progress to working more independently and enhancing their outpatient management skills.
For more information about Continuity Sites, please click on the page link below:
For more information about the Ambulatory Care Rotation and Outpatient Medicine, please click on the following page links below:
MGH Practice Websites | Main Campus
Practice Websites | Community Health Centers and Neighborhood Sites