Primary Care Pathway

The Internal Medicine Residency is offering a newly designed primary care pathway for approximately eight residents per year. Residents interested in primary care medicine will participate in a curriculum specifically designed to teach the unique aspects of outpatient medicine and population health that are essential in our rapidly evolving healthcare system. Residents will be exposed to exciting aspects of the future ambulatory healthcare delivery system, including a model Patient Care Medical Home, the latest care management systems, and developments in outpatient palliative care. Residents will also be introduced to “Extensivist Medicine,” a newly defined field in internal medicine that focuses on providing comprehensive and coordinated care to patients with multiple complex medical conditions. The Extensivist practitioner is a team leader who helps direct patient care and strives to simplify it across multiple consulting care providers in different healthcare settings.

Residents will choose between a community-based indigent patient clinic, a model full-service VA ambulatory clinic, or a large multispecialty medical group to serve as their home base for primary care training. Additionally, all residents will have the flexibility to train at several other ambulatory sites to experience different patient populations and different systems of practice. Residents in this pathway will receive ongoing mentorship from experienced and skilled outpatient physicians at their home site.

Over the course of the three years, residents in the primary care pathway will spend an increasing proportion of time in the ambulatory clinics. Rotations in the ambulatory setting can occur at a variety of clinical sites and will include rotations in nonmedical subspecialty areas that cover common outpatient conditions (e.g., women’s health clinic, dermatology, ENT). The primary care pathway is integrated into a new 4-plus-1 structure in our internal medicine residency program that provides one-week blocks of continuity ambulatory clinics every fifth week throughout the three-year residency. These one-week experiences are supplemented by an additional 38 weeks of block ambulatory medicine clinical and quality improvement rotations.

Residency applicants interested in this primary care pathway should apply through our categorical internal medicine program (no separate match number for this pathway), which allows residents who develop an interest in primary care to move into this path after matching into our program.