Training Outstanding Internists
For medical residents who are interested in a career in primary care, we offer the Primary Care Track, which provides exciting and innovative opportunities for clinical training in outpatient medicine.
The innovative centerpiece of the primary care track is the ambulatory long block, which is a six-month intensive experience during the junior and senior years. Unique in its structure, residents spend six consecutive months in their junior year, and again in their senior year, working in outpatient primary care and subspecialty clinics. They become adept in general outpatient clinical practice and develop expertise in their specific areas of interest, from medical education to hypertension management to the care of individuals with HIV. Simultaneously, they serve as an “innovation lab” within our practice, spearheading meaningful improvements in care delivery that have lastingly changed the faculty-resident practice where they see patients. The primary care long block offers residents unparalleled flexibility to shape their training in accordance with their self-identified educational goals as well as clinical and academic interests.
Our primary care program, which is over 40 years old, was one of the first in the country. Over the past decade, we have graduated 120 primary care residents, many of whom have become leaders in clinical medicine, education, and research.
Mission
The mission of our Primary Care Track is to train outstanding general internists who will provide future leadership as clinicians, educators, practice and quality innovators, and/or researchers in this evolving field.
What Makes Our Program Distinctive
Beth Israel Deaconess Medical Center has received two substantial grants that support innovation and leadership training in primary care:
- $2 million from the Center for Primary Care at Harvard Medical School through their Academic Innovations Collaborative to transform our ambulatory teaching practice into a patient-centered medical home
- $8 million from the Linde Family Foundation to teach primary care leadership and management skills to medical residents and fellows
Through these grants, Primary Care Track residents will have the opportunity to become integral members of the team involved in practice redesign and to participate in seminars and mentored projects to enhance their leadership and management skills.
Primary Training Site
Healthcare Associates (HCA), our hospital-based teaching practice, is located in the Shapiro Clinical Center on the BIDMC East Campus. It is currently being transformed into a patient-centered medical home, and Primary Care Track residents are directly involved in ongoing innovation and quality improvement projects. Over 50 clinician educator faculty practice alongside residents and serve as their preceptors. Our faculty have expertise in chronic disease management, geriatrics, women’s health, minority health, student health, HIV medicine, addiction medicine, preventive medicine, health policy, and health services research. Physicians work closely with nurse practitioners, clinical nurses, mental health therapists, and community resource specialists to provide multidisciplinary care.
While many Primary Care Track residents choose Healthcare Associates for their primary training site, residents with specific interest in community health, LGBT health, veterans care, and private practice have the opportunity to select another clinic as well.
We definitely get a great diversity of patients, from all socioeconomic backgrounds.
- Current BIDMC Resident
While many Primary Care Track residents choose Healthcare Associates for their primary training site, residents with specific interest in community health, LGBT health, veterans care, and private practice have the opportunity to select another clinic as well.
Program Structure
Primary Care Track residents spend extended periods of time in ambulatory practice while still receiving rigorous training in inpatient medicine. They are responsible for providing primary care for their outpatients in collaboration with other team members.
Curriculum
Primary Care Track residents receive a supplementary curriculum, in addition to the standard internal medicine ambulatory curriculum, focusing on special issues unique to the field of primary care. Topics include:
- periodic health exam
- medication adherence
- patient disability
- mental health issues
- palliative care
- complementary/alternative medicine
- quality improvement (QI)
- practice redesign
- travel medicine
Year 1
- Two-week orientation to ambulatory care
- Three 2-week ambulatory blocks spread throughout the rest of year
- Once weekly continuity clinic at HCA or another site
Year 2
- Six-month ambulatory long block (see below for sample schedule)
- Weekly continuity clinic at HCA or another site during non-call block rotations
- Second continuity clinic at an additional site
- Ambulatory and primary care curriculum
- Primary care innovation project
- Fundamentals of clinical education course
- Community health elective
Year 3
- Six-month ambulatory long block (see below for sample schedule)
- Weekly continuity clinic at HCA or another site during non-call block rotations
- Second continuity clinic at an additional site
- Ambulatory and primary care curriculum
- Quality improvement project
- Participating in leadership training
Other Distinguishing Features
- Quarterly primary care interest group/social events
- Society of General Internal Medicine regional and annual meeting participation
- Mentorship and career counseling
- Development of scholarly project
Overview of the Ambulatory Long Block
- Two 6-month blocks during junior and senior years
- Three half-day continuity clinics at HCA or another site per week
- One clinic per week at second continuity clinic
- Active participation in patient-centered medical home
- Providing team leadership
- Involvement in practice innovation
- Standard Electives
- Three half-day clinics per week
- Examples include dermatology, endocrinology, and orthopedics
- Chronic Disease Electives
- Weekly half-day clinic lasting three months with assigned preceptor
- Examples include chronic renal disease, congestive heart failure, and hepatitis C
- Home visits once per month
- Shared medical visits with diabetic patients once per month
- Precepting in medical student clinic once per month
- Overnight HCA call and participation in Saturday urgent care clinic once per month
- Participation in primary care innovation project
- Participation in a longitudinal QI project
- Participation in Linde leadership fellowship
- Participation in one-week community health elective
- Primary care curriculum one half-day per week
- Panel management one half-day per week
Sample One Month Schedule for Ambulatory Long Block
We have established a separate match number for this program and will recruit four interns each year. Applicants interested in the Primary Care Track should specify this program but are also strongly encouraged to apply for the BIDMC categorical program. Invited applicants will meet with our primary care faculty and have the opportunity to participate in an introduction to the Primary Care Track.
Primary Care HIV Training Opportunities
For interested residents, there is an opportunity to pursue a “track within a track”
- Paired with HIV primary care physician preceptor at Healthcare Associates
- Second Primary care site at Fenway Health, an HIV enriched clinic site
- Subspecialty clinics with experts in the field
- Attend weekly HIV multidisciplinary conference
- Annual Harvard HIV conference
- Board certification as an American Academy of HIV Medicine (AAHIVM) specialist
How to Apply
For how to apply, check out our Frequently Asked Questions.
To learn more, please email Primary Care Program Director
Dr. Kelly Graham or call her at 617-667-3001.
