Training Internists in Primary Care
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 addiction treatment to hypertension management to the care of individuals with HIV. During long block, residents serve as an "innovation lab" within our practice, learning about quality improvement and spearheading meaningful improvements in care delivery that have lasting change within the faculty-resident practice where they see patients. All residents participate in the Social Justice Pathway, and they may pursue additional training and experiential learning in areas including geriatrics, medical education, research, health care leadership, and sexual and gender minority care. 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. There may also be opportunities for loan forgiveness.
Primary Training Site
Healthcare Associates (HCA), our hospital-based teaching practice, is located in the Shapiro Clinical Center on the BIDMC East Campus. HCA is recognized by the National Committee for Quality Assurance (NCQA), as a Patient-Centered Medical Home and provides care to more than 41,500 patients. Our teams include more than 60 faculty physicians and 145 rotating medical housestaff, who work closely with nurse practitioners, clinical triage nurses, licensed practical nurses, clinical social workers, community resource specialists, pharmacists, medical assistants, and other support staff to provide multidisciplinary care. HCA faculty have expertise in chronic disease management, geriatrics, women's health, minority health, student health, HIV medicine, addiction medicine, preventive medicine, health policy, quality improvement, medical education, and health services research.
While many Primary Care Track residents choose Healthcare Associates as their primary training site, residents with specific interests in community health, LGBTQ+ health, veterans’ care, and private practice have the opportunity to select another primary training site and work at HCA as their second continuity clinic site.
We definitely get a great diversity of patients, from all socioeconomic backgrounds.
- Current BIDMC Resident
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. Primary Care Track residents also receive a supplementary curriculum, in addition to the standard internal medicine ambulatory curriculum, focusing on special issues unique to the field of primary care.
Year 1
- Two-week orientation to ambulatory care during the Intern Orientation Program
- Three 2-week ambulatory blocks spread throughout the rest of year
- Once weekly continuity clinic at HCA or another site
- Career planning and advising meetings with primary care leadership
- Connection to mentorship in areas of academic interest
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 during non-call block rotations
- Ambulatory and primary care curriculum
- Primary care innovation project development
- Participation in Social Justice Pathway
- Healthcare leadership training with the Linde Fellowship for Primary Care
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 during non-call block rotations
- Ambulatory and primary care curriculum
- Primary care innovation project implementation
- Social justice advocacy project implementation
- Participation in HCA Quality Improvement Committee
- Participation in Social Justice Pathway
Other Distinguishing Features
- Quarterly primary care interest group/social events
- Society of General Internal Medicine regional and annual meeting participation
- Mentorship and career counseling
- Opportunity for protected research time and development of a scholarly project
- Additional training opportunities in medical education, health care leadership, and sexual and gender minority health
Overview of the Ambulatory Long Block
- Two 6-month blocks during junior and senior years
- Continuity Clinics
- 3 half-day continuity clinics at HCA or other primary training site per week
- 1-2 clinics per week at second continuity clinic
- Active participation in patient-centered medical home
- Providing team leadership
- Requiring clinical experiences
- Junior Year: Core Skills for Primary Care
- Three half-day clinics per week
- Rotations include:
- Addiction Medicine
- Obesity Medicine
- Hypertension Clinic
- Advanced Diabetes Clinic
- Dermatology
- Musculoskeletal Medicine
- Senior Year: Applying Core Skills to Manage Specific Populations
- Three half-day clinics per week
- Rotations include:
- Urgent Care
- Palliative Care
- Geriatrics
- Elective Opportunities
- Weekly half-day clinics lasting 2-3 months with an assigned preceptor
- Individualized learning plan tailored to residents’ clinical interests
- Rotations include cardiology, gastroenterology, benign hematology, oncology, allergy, rheumatology, endocrinology, infectious diseases, pulmonology, nephrology, orthopedics, ENT, OB-GYN, podiatry, integrative health, urology, and women’s health
- Medical student clinic precepting once per month
- Overnight HCA call and participation in Saturday urgent care clinic once per month
- Primary care innovation project development and implementation
- Participation in HCA Quality Improvement Committee
- Leadership training with faculty and staff from the Linde leadership fellowship
- Procedural training in common outpatient procedures
- Participation in the Social Justice Pathway
- Two-year curriculum
- Didactic sessions and experiential learning
- Primary care curriculum one half-day per week
- Panel management one half-day per week
Sample Two Week 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 information on how to apply, check out our Frequently Asked Questions.
To learn more, please email Primary Care Program Director
Dr. Kelly Graham or email Associate Primary Care Program Director
Dr. Katherine Wrenn.
