Ambulatory Training

Primary Care Clinic

Resident speaking to parentWe value primary care at Tufts Medical Center and prioritize primary care education for our residents. Each resident has a continuity clinic consisting of their own panel of patients. All clinics are at Tufts Medical Center Primary Care Boston, which is our on-site primary care practice at the hospital. Our clinic is a large practice serving a very diverse patient population with access to services such as case management, addiction psychiatry, and community health workers. Each resident has a dedicated primary care preceptor and team, working directly with a resident clinical coordinator, nurse practitioner, physician assistant, social worker, and nursing team.  

Interns have several weeks of concentrated primary care under the 3+1 model. Second and third year residents have a dedicated three week primary care block each semester. We have structured our blocks to ensure that residents rarely have continuity clinic during ward rotations. Residents also have opportunities to rotate through other subspecialty clinics relevant to primary care such as orthopedics and dermatology.  We also have a satellite practice in Quincy, MA where second and third year residents are able to do a three week rotation to learn how primary care is delivered in a community based clinic.

We have a robust primary care curriculum, consisting of core primary care topics, pharmacy teaching, online learning modules, Resident as Teacher workshops, and quality improvement (QI):  

  • Primary care lectures:  These didactic and interactive lectures are led by our primary care faculty and cover high yield primary care topics such as diabetes, hypertension, hyperlipidemia, healthcare maintenance/cancer screenings as well as application of shared decision making and communication with patients.
  • Online learning modules:  We subscribe to and assign residents learning modules developed by the Johns Hopkins Hospital (PEAC modules). These modules cover core primary care topics and are an excellent way to augment primary care education though self-directed learning.
  • Resident as Teacher curriculum:  Our primary care faculty lead a series of workshops aimed at improving our resident’s teaching skills. Topics include teaching at the bedside, giving succinct and high-yield chalk talks, and giving effective feedback.
  • Quality Improvement (QI) curriculum: Residents work closely with our Quality Improvement leadership and learn patient panel management and how to conduct PDSA cycles to improve targeted quality metrics. 

Internal Medicine Subspecialty Clinics:  

In addition to primary care clinic, all residents rotate through Endocrinology and Rheumatology clinics to further gain knowledge that we believe is essential for internists. Other clinics that residents rotate through (based on interest and career goals) include nephrology, hematology, oncology, infectious diseases, gastroenterology, pulmonology, and cardiology. In addition, third year residents have a 3 week neurology rotation (inpatient and clinic) at Newton Wellesley Hospital. Our schedules are flexible enough to accommodate special interests which have recently included addiction medicine, palliative care, and dialysis/kidney transplantation. 

The subspecialty clinic schedule is designed to maximize subspecialty education and fundamentals for internists through patient encounters and divisional educational conferences that include clinical and research presentations along with journal clubs.