Explore the Ambulatory Care Program

Overview

The Internal Medicine Residency Program at Massachusetts General Hospital is committed to growing residents’ skills and knowledge across the continuum of care. Our curriculum, along with the ambulatory clinical rotations, has adapted to reflect an evolving outpatient care delivery model—becoming more team-based, demanding a broader skill set of providers, and increasingly community-focused.

Team-Based Learning and Care

During morning ambulatory didactics and the ambulatory half-day sessions, nearly all content is delivered via cases with team problem-solving, peer teaching and simulation making up the majority of sessions. 

With the help of a team of professionals that includes patient care coordinators, nurses, nurse practitioners and population health managers, residents manage a panel of approximately 70 patients that grows as residents link patients seen on the wards into their panel. Residents work with a dedicated faculty preceptor at their Continuity Clinic for the duration of their residency.

Almost all resident clinics are scheduled during non-inpatient rotations spread throughout the year. To ensure continuity, no primary care resident is away from their clinic for greater than three weeks. Ambulatory time is divided into either Ambulatory Care Rotations (ACRs) or Ambulatory Subspecialty Electives (ASEs).

Ambulatory Care Rotations: 

  • Three two-week blocks each year for Categorical and Primary Care residents
  • Three half-days of continuity clinic
  • A mix of subspecialty clinics
  • Primary Care junior and senior residents have additional designer blocks and Primary Care seniors have a teaching block

Ambulatory Subspecialty Electives:

  • Three two-week blocks each year for Categorical and Primary Care residents
  • Two half-days of continuity clinic
  • Exposure to a variety of clinic experiences in the block’s subspecialty
  • One self-designed ASE per year

Expanding the Skill Set of Residents

The academic year is divided into six learning blocks, each with a different theme. Residents rotate through every theme over the course of the year, and new themes are in development for the 2018-2019 academic year.

The complexity of residents’ continuity panels demand in-depth, skills-based sessions. For example, in the Substance Use Disorders and Psychiatry Block, all residents receive training to prescribe Suboxone. The Ambulatory Subspecialty Electives (ASEs) provide residents with exposure to unique clinical experiences and one-on-one teaching with subspecialty faculty.

Current Ambulatory Subspecialty Electives (ASEs):
  • Allergy
  • Cardiology
  • Community Medicine
  • Dermatology
  • Endocrine
  • Gastroenterology
  • Geriatrics & Palliative Care
  • Healthcare for the Homeless 
  • Hematology & Oncology
  • HIV
  • Nephrology
  • Neuroendocrine
  • Neurology
  • Pulmonary
  • Refugee & Immigrant Health
  • Resident as a Teacher
  • Rheumatology
  • Self Design
  • Substance Use Disorder & Psychiatry 
  • Urgent Care
  • Vascular Medicine
  • Women's Health

Community Medicine

Many residents have their continuity clinic at one of the Mass General continuity practice sites. The Mass General community health centers have strong ties with their local communities and provide residents with opportunities for community-based participatory research and advocacy.

Residents also have the chance to teaching and co-precept at the student-run Crimson Care Collaborative Clinics and residents performing evaluations and developing affidavits through the MGH Asylum Clinic.