The Massachusetts General Hospital Primary Care Program in the Internal Medicine Residency Program emphasizes leading-edge patient care, direct advocacy and outreach efforts in the communities we serve. The program trains residents to collaborate and innovate across the spectrum of care delivery – from longitudinal primary care of patients to inpatient care for acutely ill patients. Coupled with individualized mentoring, leadership training and coaching, residents acquire the skills to succeed in the career of their choice.

Dr. Natalia Festa

"“The Mass General Primary Care Program delivers on its commitment to innovating, cultivating and democratizing best practices in primary care. Beyond the merits of the program, I am constantly humbled by the ways in which my peers have leveraged primary care as a tool for social justice."

 - Natalia Festa, MD 
   Primary Care resident

Ambulatory Medicine

Over the three-year curriculum, ten months are devoted to ambulatory education, either in Ambulatory Care Rotations (ACR) or Ambulatory Subspecialty Electives (ASEs). In addition, primary care residents can choose to spend their elective time in the ambulatory setting, creating up to 15 months of ambulatory education opportunities during their training. Almost all resident continuity clinics are scheduled during non-inpatient rotations.

As increasingly complex medical care is migrating to the ambulatory setting, the skills developed in the ambulatory rotations are valuable in all careers our residents pursue. Direct clinical experience is supported by the didactics delivered in the theme-based ambulatory curriculum. All primary care residents participate in both content creation and delivery during the theme blocks, including a dedicated Primary Care Teaching Rotation in the senior year.

Mass General primary care residents are grouped together as a class through their ambulatory rotations in the PGY-1 and PGY-2 years. This enhances learning opportunities and allows for special Primary Care Program-focused activities such as retreats, team building, reflection sessions, group projects, attendance at Society of General Internal Medicine meetings, career development seminars, social events and special learning symposiums with the program director. A sense of community develops each time a class returns to ambulatory as a group and is immersed into their continuity panel and ambulatory learning.

Continuity Practices

Primary care residents select a location for their primary outpatient experience at a continuity practice on the Mass General main campus or at a Mass General community health center. Applicants who match to the Mass General Primary Care Program submit practice site preferences before they arrive and are encouraged to talk or visit with residents and staff at the practice sites before internship begins. Continuity clinics are assigned to primary care residents first, to ensure best fit of practice site and preceptor based on the resident's career and clinical interests.

Programming and Initiatives

The Mass General Primary Care Program s dedicated to training leaders in clinical innovation, research, medical education and physician advocacy.

Advocacy Initiatives

  • ASE - Physician Advocacy: A two-week boot camp open to all residents to develop critical advocacy skills and network with non-profit leaders working on current legislative campaigns
  • Mass General Asylum Clinics: A resident-run clinic providing the opportunity to perform asylum evaluations and write affidavits
  • Buprenorphine Training: In response to the opioid epidemic, primary care interns and their categorical peers are provided with Buprenorphine training during the Substance Use Disorders and Psychiatry ambulatory learning blocks
  • Social Justice Interest Group: Through an innovative lecture series, advocacy days at the state house, biannual mentoring dinners and all-class advocacy projects, primary care residents jump-start their careers as physician advocates

Self-Design Blocks and Away Rotations

Self-Design Block/Away Rotation Examples

 Description

Scholarly Project

Mass General primary care residents receive mentoring on their personal scholarly projects and routinely present their projects at local and national meetings.

Indian Health Service Rotation

Residents have an opportunity to design an away rotation at the Indian Health Services Center in Rosebud, South Dakota. Residents provide direct patient care and develop a community outreach project during their two-week rotation.

Designer Block

Primary care residents have a two-week designer block in junior year and a four-week designer block in senior year. This time is completely unscheduled with the exception of the continuity clinic, and residents are free to explore learning opportunities that expose them to new mentors or skills, complete an academic project, or better prepare themselves for the careers that lay ahead

Longitudinal Second Site

Primary care residents engage in a longitudinal second site during their ambulatory blocks in each academic year. Examples of longitudinal second sites include Women’s Health Procedures Clinic, Prison Health, Benson-Henry Institute for Mind Body Medicine, Medical Ethics, the Massachusetts State House, the Massachusetts Department of Public Health and Boston Health Care for the Homeless Program.

Retreats and Conferences

Occurring twice a year, the Primary Care Program retreats provide a unique space for residents to reflect on their past experiences and directly shape curricular and clinical initiatives for the upcoming academic year. Often these retreats include skills-based programs, like IUD or Nexplanon placement. In addition, national leaders in primary care research and innovation participate in round tables or lead workshops for residents.

During cohort ambulatory blocks, primary care residents participate in Special Programming Half-Days dedicated to expanding their skill set, including: Panel management, thriving in an interprofessional team, negotiation, CV writing and engaging in a meaningful job search for life after residency.

Primary care junior residents receive funding and clinical coverage to attend the national Society of General Internal Medicine (SGIM) meeting. This is an unparalleled opportunity to meet leaders and valuable mentors in general medicine, gain exposure to outstanding research and become involved in national and local committees.

The Global Medicine Curriculum is offered to all primary care interns, examining the full arc of global health care delivery, from governmental policy and planning to local people and communities. Speakers share comparative lessons across a diversity of country and resource settings and learners develop a project that addresses the broader socioeconomic and political context of health.

Career Development in Primary Care

Mass General Primary Care Program graduates have become leaders in academic general internal medicine as well as primary care practice and industry. They pursue careers in clinical practice combined with medical education, research, health care administration, social justice, practice innovation and community leadership roles. The Mass General Primary Care Program has no one "model" for a successful career in general internal medicine. While many graduates go on to obtain additional training in health services research, clinical epidemiology, geriatrics, public health, health policy and health care management, others continue directly into primary care practice or general internal medicine faculty positions.

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