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Primary Care Pathway

What is the Primary Care Pathway?

The mission of the Primary Care Pathway is to provide training to residents who are interested in primary care or ambulatory-based subspecialties of medicine. The Pathway provides a broad exposure to general internal medicine, with a greater emphasis on outpatient training.

Who should consider the Primary Care Pathway?

Anyone who might consider keeping career options open for primary care, academic general internal medicine fellowship, geriatrics fellowship, or other primarily ambulatory-based subspecialty fellowships.

Also, to clarify, all residents training for three years in our program are “categorical” residents, regardless of the pathway chosen. This means all residents successfully completing our residency qualify for the same American Board of Internal Medicine (ABIM) certification exam and complete the program with the same credentials. Thus, all residents in any of our pathways are equally capable of entering any type of internal medicine practice, subspecialty fellowship training, academics, and medical education.

How will the Primary Care Pathway enhance my training?

How will the Primary Care Pathway enhance my training?

There are additional training and peer collaboration opportunities unique to the Primary Care Pathway. These opportunities include:

  • Your continuity practice will be in the 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 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.
  • Primary Care Block Rotations – You will have one Primary Care Rotation in each year of training, with an additional Primary Care Selective Rotation in your junior year. These 5 Primary Care Rotations are in addition to the 3 Ambulatory Rotations that all categorical residents have during training. These rotations combine practice in your continuity practice with training in ambulatory subspecialties selected to enhance knowledge and skills in primary care practice. The primary care rotations are also designed to immerse you in your continuity clinic, so that you can better experience what it’s like to practice as a primary care physician and have more time to get to know your panel of patients.

Your schedule as a primary care intern or resident includes additional PC Rotations. For instance, as an intern, the PC1 rotation replaces either a cardiology or MICU rotation. However, you will still have ample opportunities to work in these inpatient rotations during your training. For example:


  • Primary Care Rotations – You will be immersed in your continuity clinic and have experiences in outpatient ambulatory medicine during the Primary Care Rotations:
    • Primary Care 1 Rotation: PGY1
      • Morning sessions: 
        • Complex Care Management sessions once/week: clinical pharmacy, behavioral health coach, transitions, homecare, elder services
        • Shadowing Dr Carmody once/week: Dr Carmody is PCP in the PCC beloved by his patients, and this provides the opportunity to learn some of his communication skills
        • AM Continuity clinic once/week
        • Housecalls: geriatric primary care for homebound patients 
        • Friday Ambulatory Conference
      • Afternoon sessions:
        • QI/scholarly activity once/week
        • PM Continuity clinic four/week
    • Primary Care 2/3 Rotation: PGY2 and PGY3
      • Morning sessions: 
        • Community-based practice session once/week: opportunity to form mentorship relationship with private-practice PCP
        • AM Continuity clinic once/week
        • Dermatology: once/week
        • Walk-In-Center: urgent care clinic once/week
        • Friday Ambulatory Conference
      • Afternoon sessions:
        • QI/scholarly activity once/week
        • PM Continuity clinic four/week
    • Primary Care Selective Rotation: PGY2 
      • Morning sessions: 
        • Options for morning sessions (choose 1 or 2 of the following): 
          • Ortho, Genetics, Physical Therapy, Physiatry
          • Urology/Urogyn, Integrative Health, ENT, Ophthalmology
          • Neurology, Psychiatry, Neuropsychology
          • Other (elective)
        • Friday Ambulatory Conference
      • Afternoon sessions:
        • QI/scholarly activity once/week
        • PM Continuity clinic four afternoons/week
    • Complex Care Management (CCM) Rotation: PGY3
      • Boston Healthcare for the Homeless
      • Somerville-Cambridge Elder Services Program
      • Palliative care
      • Home hospice
      • Geriatrics housecalls
      • IMPACT: housecalls transitions program
      • Friday Ambulatory Conference
    • Ambulatory Conference: You will attend the weekly Friday Ambulatory Conference during your 4 months of Primary Care, 3 months of Ambulatory, and CCM Rotations. Experiences offered in the Friday Ambulatory Conference include:
      • Primary Care Curriculum, with topics including:
        • Care of special populations: LGBT adults, homeless, transgender adults, immigrants
        • Behavior change/motivational interviewing: tobacco, substance abuse, alcohol, obesity
        • Medication adherence
        • Genetic counselling
        • End-of-life care/palliative care
        • Community medicine
        • Cross cultural care
        • Health care policy
        • Intimate partner violence
        • Sexual health
      • Quality and Safety Curriculum: 9 topics facilitated by the Chair of the Department of Quality and Safety
      • Ambulatory report led by faculty experts:
        • General Medicine
        • Infectious Disease
        • Dermatology
        • Psychiatry
        • Neurology 
      • Communication and Interviewing Skills: formal curriculum that provides focused feedback on interviewing skills, utilizing online modules and videotaped interviewing
      • Art and Medicine Series: fieldtrips to local museums facilitated by hired museum educators to use art as a medium to teach empathy
  • Primary care dedicated seminar - You will be given the time and coverage during your intern and junior years to attend Harvard Medical School’s Department of Continuing Education six day national conference, PRIMARY CARE INTERNAL MEDICINE: Principles and Practice, given each October.
  • Primary Care Mentor - You will be provided a list of primary care clinicians and educators who have volunteered to be mentors.
  • Leadership Conferences – You will have options to attend courses that will develop your health care leadership skills. HMS invites our residents to attend an intense 4-week elective called “Navigating the Complex Seas of Health Care: The Physician as Leader.” 
  • Quality Improvement - You will participate in projects related to quality and/or innovation in health care delivery systems. These projects can be the source of your residency scholarly project and/or lead to poster presentations at the Innovations Conference, or other local/national meetings.
  • Networking – As a member of the Harvard Medical School community, you will be invited to be part of the Center for Primary Care at HMS. You will also have the opportunity to participate in Primary Care Progress@ Harvard, the founding chapter of a national network of students, clinicians and educators working together to revitalize primary care delivery and education.
  • Society of General Internal Medicine – Junior residents are provided coverage and receive funding to attend the annual national meeting.
  • Primary Care Quarterly Meeting – The primary care residents and faculty meet quarterly to discuss upcoming events and provide an open forum for residents to discuss what’s on their mind.

What if I change my mind about my career goals?

The advantage of pathways, and not separate tracks, is that from year to year, residents have the flexibility to participate in any of our pathways without limiting any potential career options in the field of Internal Medicine.

Opportunities within the Primary Care Pathway.

The following table outlines the experiences in the Primary Care Rotations.
Primary Care Pathway
Center for Primary Care at Harvard Medical School

Apply Today

Learn about deadlines and application requirements for the Internal Medicine Residency at Mount Auburn Hospital.

Lydia Barlow“Mount Auburn provides outstanding patient-focused and evidence-based medicine in a genuinely friendly environment. People truly care for their patients, and as a young physician here you have many great role models from whom to learn the art and science of medicine. The attendings and senior residents are fantastic mentors and a source of great support through the many challenges of intern year. I feel fortunate to have the opportunity to work and learn at Mount Auburn.” Lydia Barlow, MD

Mount Auburn Hospital

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