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 Categorical resident is away from their clinic for greater than six weeks (three weeks for Primary Care residents). 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, Primary Care, Global Medicine and PSP residents
  • Three half-days of continuity clinic per block
  • A mix of subspecialty clinics
  • Primary Care junior and senior residents have additional designer blocks

Ambulatory Subspecialty Electives:

  • Three two-week blocks each year for Categorical, Primary Care, Global Medicine and PSP residents
  • Two half-days of continuity clinic per block
  • 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.

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
  • Correctional health
  • Dermatology
  • Endocrine
  • Gastroenterology
  • Geriatrics and palliative care
  • Global medicine course
  • Health care for the Homeless 
  • Hematology and oncology
  • HIV
  • Nephrology
  • Neuroendocrine
  • Neurology
  • Obesity medicine
  • Pulmonary
  • Refugee, immigrant and global health
  • Resident as a teacher
  • Rheumatology
  • Self design
  • Substance Use Disorder and 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 Mass General Asylum Clinic.

Continuity Practice Sites

Massachusetts General Hospital Internal Medicine Residency Program participants are placed in a continuity practice from one of the sites listed below. Residents may also practice at four Mass General Community Health Centers: Charlestown HealthCare Center, Chelsea HealthCare Center, North End Waterfront Health and the Revere HealthCare Center. The health centers have strong ties with their local communities and provide primary care and some specialty services. These centers serve as the major source of patients for the medical teaching service.

Practice Sites

Beacon Hill Primary Care

  • Primary Care and Categorical Tracks
  • Residents placed: 2-10
  • Close to the Mass General main campus, Beacon Hill Primary Care is a busy practice that provides comprehensive adult primary care

Bulfinch Medical Group (BMG)

  • Primary Care and Categorical Tracks
  • Residents placed: 20+
  • Bulfinch Medical Group (BMG) is a primary care and consultative internal medicine practice located on the Mass General main campus, featuring an award-winning diabetes management program, cardiovascular wellness program and patient education center

Mass General Internal Medical Associates (IMA)

  • Primary Care and Categorical Tracks
  • Residents: 60
  • The Internal Medicine Associates (IMA) is a patient-centered primary care practice on the Mass General main campus, offering comprehensive care for more serious medical issues, on-site case managers, an internal urgent care unit and diabetic counseling. Ninety percent of IMA patients come from Boston and the surrounding areas, spanning a broad range of diverse backgrounds. IMA residents are fully integrated members of the collaborative care team and have the same level of support as that of veteran faculty. The IMA is also one of the two sites for the Crimson Care Collaborative, a Harvard Medical School student-run clinic. Residents have the opportunity to join the teaching staff of the clinic and help precept the students on a weekly basis

Mass General Broadway Primary Care – Revere

  • Primary Care Track
  • Residents placed: 2-10
  • Broadway Primary Care-Revere provides high-quality adult primary care to patients who live in Revere and its neighboring communities. They have multilingual staff that speak Spanish, Italian, Hindi and Tamil, and also offer interpreter services in languages, including but not limited to Arabic, Khmer, Portuguese and Spanish
  • The health center is actively involved in community-based programs to help enhance the public health of residents in Revere and is committed to population health management through innovative programs in diabetes and hypertension. Each dedicated health care team at Broadway-Revere includes a physician, a nurse practitioner, nurses, a social worker and administrative staff

Charlestown HealthCare Center

  • Primary Care and Categorical Tracks
  • Residents placed: 2-10
  • The Charlestown HealthCare Center is located 1.3 miles from the Mass General campus. Charlestown is geographically distinct and more like a small town with its own community identity. About 16,000 people live in just 1.5 square miles. The population served by Mass General Charlestown is economically and culturally diverse, including large segments of low-income, working class and middle class residents. The Charlestown ambulatory care facility sees 26,000 patients annually in its adult internal medicine practice and offers a wide range of services on site. On-site subspecialty services include neurology, dermatology, cardiology, rheumatology, physical therapy and podiatry. Charlestown also works with a number of community outreach programs that include a home-visit program, the Charlestown Interagency of Aging, Senior Home Care and an adolescent task force. The health center is also actively engaged in addressing substance use disorders in Charlestown

Chelsea HealthCare Center

  • Primary Care, Categorical and Global Primary Care tracks
  • Residents placed: 2-10
  • The Chelsea HealthCare Center opened in 1971 as a part of the incredibly diverse and vibrant city. Mass General Chelsea HealthCare Center includes a walk-in clinic and services in adult medicine, pediatrics, mental health and social services, prenatal care, physical therapy, nutrition, speech and language therapy, and several medical and surgical specialties. In recognition of the diversity and needs of the patient population, the health center has built a large staff of interpreters and outreach workers, and multidisciplinary programs to address issues such as substance abuse, HIV, hepatitis C, diabetes, tuberculosis, cancer screening and refugee health. It is also a site for the Crimson Care Collaborative, Harvard Medical School’s student-run clinic

MGH Downtown Primary Care

  • Categorical Track
  • Residents placed: 2-10
  • MGH Downtown Primary Care is a group practice conveniently located in downtown Boston. The clinic offers a complete range of medical services including routine physicals and health screenings, diagnostic work-ups and treatments and initial consultations for more complex conditions

Revere HealthCare Center (RHC)

  • Primary Care and Categorical Tracks
  • Residents placed: 2-10
  • The Revere HealthCare Center (RHC) is located in a beautiful office space overlooking Revere Beach. Revere is seven miles north of the Mass General main campus, and is easily accessible to Boston by car or MBTA subway. Revere is a diverse and medically underserved community. Thirty-one percent of visits to the adult medicine practice are from patients with Medicaid or without health insurance. The range of services available to patients on site includes a laboratory, radiology for plain films and digital mammography, and echocardiography once a week. On-site subspecialty services include surgery, OB/GYN, neurology, cardiology, nephrology, dermatology, physical therapy, podiatry and speech therapy

Mass General Waltham

  • Categorical Track
  • Residents placed: 2-10
  • Mass General Waltham is a group practice that provides comprehensive adult and pediatric primary care. A focus of the group is prevention with active patient involvement in care and treatment. Conveniently located off Route 128 in Waltham, the practice serves the diverse communities west of Boston and handles over 27,000 visits per year ranging in age from newborn to geriatric. As the Mass General Waltham facility has expanded, there is now on-site access to multiple medical and surgical sub-specialists, physical therapists, pharmacy, laboratory and diagnostic imaging

Massachusetts General Medical Group (MGMG)

  • Categorical Track
  • Residents placed: 2-10
  • Located adjacent to the Mass General main campus, the Massachusetts General Medical Group (MGMG) is a busy, thriving practice of general internists who provide primary and hospital care to patients from all walks of life. Our medical residents are incorporated into a team-based system that includes ten faculty physicians along with nurse practitioners, registered nurses, medical assistants, administrative staff and others. Residents at MGMG work with a core-group of preceptors who have a keen interest in medical education both at the residency and division level

North End Waterfront Health (NEWH)

  • Categorical Track
  • Residents placed: 2-10
  • North End Waterfront Health (NEWH) is a community health center practice about a mile from Mass General. The North End is the most densely populated part of the city and its rich heritage goes back to pre-revolutionary times. Other than primary adult and pediatric care, services include podiatry, ophthalmology/optometry, OB/GYN, dentistry, behavioral health, social work, urgent care, lab and x-ray and a child care center for the public. Adult medicine providers have an opportunity to see urgent care patients in addition to continuity patients

Primary Care Associates, Mass General Waltham

  • Primary Care Track
  • Residents placed: 2-10
  • Located in Waltham, Primary Care Associates provides residents with an opportunity to serve patients from Newton-Wellesley Hospital, a Mass General Brigham health care affiliate and another key site in resident training. The clinic has on-site phlebotomy in the clinic, as well as comprehensive radiology services and physical therapy. Primary Care Associates works with the Collaborative Care Team to regularly provide a psychiatrist on-site for medication consultation

Women's Health Associates (WHA)

  • Primary Care and Categorical Tracks
  • Residents placed: 2-10
  • Women’s Health Associates (WHA) is located in the Yawkey Ambulatory Care Center on the Mass General campus and is a group practice of primary care physicians with a focus on women’s health. WHA provides comprehensive primary care, internal medicine and routine gynecology in an environment that encourages communication, education and prevention. Educational conferences with a focus on the care of women are held monthly