A unique feature of our Pediatric Residency Program is the pairing of each resident with one preceptor in a primary care practice for all three years. Before the beginning of the PL-1 year, residents visit several pediatricians in their offices and select their preferred continuity practitioner (in their words, “the pediatrician I want to be.”) Practice sites include independent offices, solo and group practices, health maintenance organizations and hospital-associated practices.
PL-1s see patients in their practice one half-day per week during all rotations; PL-2s and PL-3s spend one to two half-days per week. Time is protected for this activity: residents sign-out their other clinical responsibilities during all their continuity practice sessions.
In addition, one block rotation each year provides concentrated time for learning ambulatory care, building a patient panel, and exploring the intricacies of the practice and the community it serves. During the PL-3 year, residents are given the opportunity to compare different types of practices with their own.
UMass was one of the first programs in the country to establish one-on-one precepting in community offices. We have a cadre of preceptors who take residents year after year, some since 1988! Before taking a resident, community preceptors participate in a nationally-recognized, year-long faculty development program. Preceptors continue to attend frequent meetings and retreats while a resident is in their practice. The program provides an organized curriculum with a strong emphasis on good teaching and mentoring.
Residents rate the community-based continuity clinics as an exemplary feature of the residency program. They describe their practices as “a place I return to each week that feels like home”. Surveys of UMass graduates who choose careers in primary care say they “hit the ground running”. Graduates who choose subspecialty fellowships say the continuity clinics give them an important perspective on what primary care pediatricians need from specialists. They also are grateful for the ability to adeptly handle primary care issues while providing subspeciality care.