Longitudinal Ambulatory Experiences

Primary Care Experience

Pacifier girl

Longitudinal primary care clinic experiences at a variety of urban sites allow BCRP residents to foster the physical, intellectual and emotional growth of their own panel of patients, as well as to manage the course of certain diseases and therapies over an extended period of time. Residents care for children of all ages and children with diverse medical problems.

Continuity sites are available in both hospital and community settings. From the primarily Spanish-speaking clinics at Martha Eliot Health Center and East Boston Health Care Center to the Young Parent Program (YPP) continuity clinic at Boston Children’s Hospital, residents may choose to tailor their longitudinal experiences based on their interests while enjoying exposure to a diverse, multi-cultural patient population.

Residents in the Categorical track devote one afternoon each week throughout the three years to their primary care practice. Similarly in the first year, Urban Health and Advocacy track (UHAT) residents spend one afternoon each week in their continuity sites. Throughout the second and third years of residency, UHAT residents select an additional half-day experience to augment their scholarly or advocacy interests; these may take the form of a second continuity clinic or “project” afternoon.

Academic Innovations Collaborative

Children's Hospital Primary Care Center (CHPCC) and Martha Eliot Health Center (MEHC) are two of the continuity sites available to residents. Both are engaged in a patient-centered primary care redesign effort through the Academic Innovations Collaborative (AIC), established by the Harvard Medical School Center for Primary Care. The AIC was created to foster rapid transformations in care delivery and education within Harvard-affiliated primary care teaching practices.

CHPCC and MEHC's redesign is focused on four major transformation areas: multidisciplinary patient care teams, population management, complex disease management, and patient empowerment. Areas of active innovation include the creation of primary care teams, development and use of patient registries to facilitate population and complex care management, and the implementation of new technology, including clinical decision support and discharge and care plan summaries.

As a result, the resident education curriculum is actively evolving to include topics related to team-based care delivery and population management. Residents are integrated into the care teams, attend and lead team huddles, and engage in team communication regarding patient issues. Residents’ input is routinely solicited through surveys and informal feedback sessions for iterative improvement.

Longitudinal Subspecialty Experience

The BCRP is invested in developing a longitudinal subspecialty experience whereby residents can achieve early and sustained exposure to outpatient subspecialty medicine. The BCRP is currently piloting this experience for all three residency classes.

During the PL-1 and PL-2 years, a select number of Categorical residents will participate in a subspecialty clinic in addition to their primary care continuity clinic. During the PL-3 year, residents may choose to participate in a longitudinal subspecialty clinic in place of their primary care clinic. In 2015-2016, residents will participate in longitudinal subspecialty experiences at both affiliated hospitals in subspecialties including allergy/immunology, cardiology, endocrine, genetics, gastroenterology, hematology, nephrology, neurooncology, neurology, oncology, pain medicine, pulmonary and rheumatology.