Ambulatory and Outpatient Training

Continuity Clinics

Ambulatory education is an integral part of the training program at Harvard BWH/CHB Med-Peds.  Weekly resident clinics take place at one of our two affiliated health centers where residents see adults and children in the same session.  Outpatient training begins during internship and accelerates through junior and senior residency.  All residents manage their own outpatient panel of patients under the supervision of faculty preceptors.  The clinic patient populations offer ethnic and socioeconomic diversity, with both sites serving a largely Spanish-speaking population.  Residents work with the same preceptors for four years and all preceptors are available throughout the week to help with concerns and questions about patients.  Teaching conferences at the beginning or end of each clinic session provide a time for group discussion of cases and common ambulatory problems.

Martha Eliot Health Center

 The Martha Eliot Health Center (MEHC) is Children’s Hospital Boston’s community health center in the Jamaica Plain neighborhood of Boston.  Established in 1966, it is one of the nation’s oldest community health centers and embodies more than 40 years of commitment to the children and families of Boston.  Since its humble beginnings as a makeshift "well-baby" clinic in a woodworking room serving families of its neighboring low-income housing development, MEHC has become a stand-alone comprehensive health center.  It currently provides pediatric and adult primary care, adolescent, OB/GYN, mental health, nutrition, optometry, HIV, and early intervention services to families in Jamaica Plain, Mission Hill, and other Boston neighborhoods. The patient population is diverse and the center's staff prides itself on caring for the vibrant population of African-Americans, Latinos, Somalis, Cape Verdeans, and other ethnicities of Jamaica Plain and the surrounding community.  Residents have a combined session of adult and pediatric patients during their weekly continuity clinic and also have the opportunity to add extra sessions during ambulatory blocks in the Adolescent or Women’s Health department. Martha Eliot Health Center.

 

 

Upham’s Corner Health Center

The Upham’s Corner Health Center is organized to provide comprehensive, personalized, and continuous health services for the whole family in a comfortable and convenient setting.  The Upham’s Corner Health Committee was established in 1971 as the outgrowth of community action to develop a primary health care facility in the Upham’s Corner community. This action was undertaken in response to the exodus of physicians from Upham’s Corner moving their practices to the suburbs or closing them due to retirement. Located in temporary quarters on the second floor of the Municipal Building at 500 Columbia Road, the health center was ready for its first patients on January 1, 1973. Filling a void in health care services, the health center experienced rapid growth in all service areas and now offers comprehensive services including: Family Medicine, Pediatrics, Adult Medicine, Family Planning, OB/GYN & Midwifery, Prenatal Care, Laboratory Services, Podiatry, Dermatology, Eye Care, Adult Day Health, Women Infants and Children (WIC) Program, Nutrition Counseling and Education, Childbirth Classes, Smoking Cessation, Asthma Management, Teen Services, Community Outreach, Social Services, Behavioral Health, Domestic Violence Counseling, Boston Healthy Start Initiative, Group Treatment, Home Health Care Services, and Adult and Children’s Dentistry.  Uphams Corner Health Center.

Outpatient Training

During medicine time, outpatient subspecialty clinics are integrated into ambulatory medicine block rotations so that all residents are exposed to a broad spectrum of disease processes.  Concentrated outpatient block time offers extensive didactic curricula encompassing the principal topics in general internal medicine as well as special seminars focusing on the patient-doctor relationship, clinical epidemiology, ethics, health policy, and teaching skills.  During outpatient block rotations residents’ schedules are devoted to primary care clinics and electives. The electives include subspecialty clinics, home visits, and opportunities for community service.  Residents interested in community service can work with homeless adults and adolescents, provide health education to middle school students and the elderly, provide care at a school-based clinic, and work with community activists to improve the health of their community.  PGY-2-4 residents plan the curriculum for their ambulatory blocks in order to fulfill their personal learning goals.

The pediatric component of training offers a broad array of ambulatory experiences ranging from the outpatient portion of subspecialty rotations (e.g. allergy/immunology, endocrinology, neurology, gastroenterology, rheumatology, and pulmonary) to rotations with an primary ambulatory focus such as the child development and adolescent medicine blocks.  In addition, there are ambulatory general pediatric experiences through continuity clinic and international rotations.  This rich array of ambulatory rotations includes a focus on advocacy training.  In the past, residents have worked with the Massachusetts state legislature, Boston Public School system, and neighborhood health centers.  Ambulatory exposure occurs throughout all 4 years of the program at sites at Children's Hospital Boston, Boston Medical Center, and community and school sites.  Those with a particular interest in primary care and practice management are able to concentrate on ambulatory experiences during their 2-month research/ elective block in their 4th year of training.
Our residents often take advantage of international ambulatory experiences during elective time.  Financial support for travel is available to the majority of residents wishing to pursue experiences abroad.  For more information about international opportunities through Children’s Hospital, please visit BCRP-International.