Clinical Triennium - PGY 2/3 Long Block
The Long Block begins in the 17th month of residency for a total of 12 consecutive months. We chose this time because we felt it was important for you to consolidate your inpatient skills as team leaders and care givers prior to the Long Block.
In developing our model, we felt that one year of true continuity would be better for care and education than three years of sporadic interactions. The results have been extremely positive. Our work was recently cited in a New England Journal of Medicine article entitled, Experiments in Continuity — Rethinking Residency Training in Ambulatory Care.
Other recognition we have received includes:
During the Long Block, you will transition from inpatient-based rotations to an expanded outpatient experience and your patient panel expands to approximately 120-150 patients.
You will see patients in the ambulatory practice three half-days per week, but are required to be present in the practice or check the electronic medical record (to answer messages, etc.) at least once every day. In short, you will act like practicing physicians.
We have designed scheduling systems to prioritize continuity of care. For example, your daily schedule of eight appointments has two slots protected for acute patients, and we make every effort to match your patients with you when they need care.
When not seeing patients in the practice, you will rotate on inpatient or ambulatory electives as well as research experiences with minimal overnight call (two to four weeks of inpatient night-float).
You can take up to three different electives in any one field of medicine, and up to three months dedicated time for research. You also receive protected time to learn during the Advanced Ambulatory Practice and Board Review sessions.
During the Long Block, you will learn how to function within a highly effective Level III NCQA certified patient-centered medical home. The ambulatory group practice consists of residents, attendings, nurses, social work, pharmacists, and administrators. The entire team has a retreat at the start of Long Block focusing on quality improvement and patient-safety where you learn basic tools and a common approach to quality and safety problems.
The team (including all Long Block residents) meets weekly to review performance (patient care outcomes, satisfaction, through-put, financial) and you will receive monthly data reports drilled down to your specific patients. Your data is compared to the team as a whole and national benchmarks. We then use these data as part of your formative and summative evaluation.