A continuity clinic is a structured outpatient setting where physicians-in-training deliver primary care services under the supervision of experienced faculty physicians. This clinical experience is a mandatory component of residency programs in primary care fields, such as Internal Medicine, Family Medicine, and Pediatrics, as required by the Accreditation Council for Graduate Medical Education (ACGME). This model ensures residents gain practical experience managing the ongoing health needs of patients outside of a hospital environment.
The Dual Purpose of Continuity Clinics
Continuity clinics serve two main functions: providing necessary primary care and offering a structured training environment. First, they provide care to a patient population, often serving as a medical home for individuals who lack access to consistent medical services. The clinic structure contributes to the overall healthcare delivery network of the affiliated academic center.
The second function is to offer a structured, long-term environment for physician training, which differs from the acute nature of hospital rotations. Residents transition from focusing on short-term issues to understanding the complexities of long-term health management. By managing their own patient panel, residents begin to function as independent primary care providers, preparing them for practice. This setting allows residents to develop skills in systems-based practice, including coordinating care with specialists and managing chronic conditions.
Defining Longitudinal Patient Care
The defining characteristic of a continuity clinic is longitudinal patient care. This means the resident follows the same patients over the entire course of their three-year residency. This consistent relationship allows the patient and provider to build history and trust, which is rarely possible in acute care settings. The resident manages all aspects of the patient’s health over time.
This care focuses heavily on managing chronic diseases like diabetes, hypertension, and hyperlipidemia, tracking progress and adjusting treatment plans. Preventative health is also emphasized, including routine wellness checks, vaccinations, and age-appropriate cancer screenings. This longitudinal focus contrasts sharply with the episodic care common in inpatient rotations.
Supervision and the Resident Role
The staffing model combines the resident’s role as the primary provider with faculty supervision to ensure patient safety and quality of care. The resident is responsible for managing their own “panel,” typically 75 to 100 patients. Residents usually dedicate one half-day per week to the clinic, although some programs utilize block schedules with more frequent clinic time.
The resident conducts the patient visit, formulates a diagnostic assessment, and proposes a treatment plan. Following the encounter, every case is presented to an attending physician, who serves as the faculty preceptor. The attending physician reviews the resident’s findings, confirms the proposed plan, and signs off on all decisions and prescriptions, maintaining responsibility for the care delivered. This interaction promotes continuous learning and guarantees that patient care is performed under the guidance of an experienced, licensed physician.