A longitudinal subspecialty experience for internal medicine residents

Objective: Market and technology innovations have greatly changed the teaching and practice of medicine in the past 10 years. This report describes an innovation in the ambulatory education of internal medicine residents: a subspecialty continuity clinic. Methods: A subspecialty continuity clinic was developed to improve the training of internal medicine residents in caring for complex ambulatory patients, The clinic structure is discussed from the perspective of patients, residents, and subspecialists, Logistical challenges and solutions are described. Results: Two and one-half years into the program, feedback from residents and subspecialists has been positive. In-training examination scores are relatively higher in the involved specialties, and residents are managing illnesses they rarely saw in an outpatient setting before this program. Conclusion: This experience suggests that a subspecialty continuity clinic is worthwhile and practical in educating primary care residents.