Each categorical resident spends three years in a continuity practice. We have a 4+1 “X+Y” block schedule, which allows dedicated and protected time in ambulatory training for 1 week, every 5th week, for a total of 10 Ambulatory Y weeks each year of residency. During the Ambulatory Y weeks, residents have clinic 5 sessions/week, in addition to other ambulatory experiences and didactics, as described below. We are pleased to offer a variety of practice settings for this longitudinal experience, and every effort is made to match residents to their preference. We strive to have residents function as the primary care provider for a panel of patients who they follow throughout residency.
The types of practice settings include:
- Primary Care Center: A hospital-based Level 3 NCQA-accredited patient centered medical home where residents and attendings practice in an innovative setting that focuses on team-based care, population management, patient engagement, and quality improvement. The practice serves a diverse patient population. Roughly 20-22 residents have their practice in this site, with about 10 preceptors. Most days there are 5-7 residents per afternoon session working with 2 preceptors. While residents may work with several preceptors on a regular basis, they are also paired with a Primary Preceptor who helps provide individualized feedback and guidance.
- Affiliated practices: These sites are Mount Auburn affiliated practices, located on the hospital campus or within the surrounding Cambridge area, with 1-2 primary care providers who precept 1 to at most 4 residents. Most of these practices are also patient-centered medical homes.
All residents use the Yale Office-Based Outpatient Medicine Curriculum for a formal curriculum with high-yield primary care topics. We supplement this curriculum with additional topics critical to outpatient training. For instance, we have a Psychiatry Series facilitated by the Department of Psychiatry. Residents attend the preclinic conference prior to the start of clinic twice per Ambulatory Y week to discuss the weekly topic, which is facilitated by faculty, and a resident assigned to lead the discussion. Residents also complete a performance improvement project twice a year, which provides an opportunity to self-audit your panel of patients and make efforts to improve the health of your patients.