An important aspect of the pediatric residency program is the continuity clinic experience. This required experience provides residents with an understanding of and an appreciation for the longitudinal nature of general pediatric practice. By following their own panels of patients, residents experience firsthand the physical and emotional growth and development of children; preventive care and the management of acute and chronic medical conditions; and the interaction of child, family and physician.

Through the continuity clinic experience residents have the opportunity to provide ongoing care to their own panel of patients. All residents have continuity clinic at least one afternoon per week; on some rotations residents will have continuity twice a week.

For an individual resident this experience may be either hospital-based or office-based in a practice outside the medical center. In both the hospital-based and practice-based continuity clinic experiences residents:

• See the diversity of demographics and disease in the community;
• Learn how physicians develop and nurture long-term relationships with their patients and how parents and children become attached to their pediatricians;
• Observe how physicians educate their patients about health-related issues and (sometimes) broader issues related to the quality of their lives;
• Gain an understanding of how clinical decision-making is affected by the relationship between the physician and the family;

Hospital-Based Clinic

The hospital-based continuity experience provides residents with the opportunity to learn how primary care can be delivered to children within the context of a large hospital-based practice that serves a wide community near the hospital. Residents will develop a continuity panel of patients with a wide variety of acute and chronic disorders. They will serve as the primary care providers for these children. The clinic also provides a number of supportive care services for the residents and their patients including social services, chronic disease programs and access to community-based services.

Office Practice

The office-based continuity experience provides pediatric residents with the opportunity to learn about the “private practice” of pediatrics. Residents assigned to the office-based continuity clinic program will see how office-based pediatric practice really works. Participants in this program learn how to schedule patients; the roles of the various office staff and how the staff can help or hurt a practice; how practices deal with health care financing issues; and how busy physicians manage their time and arrange coverage with other physicians. Residents also see how physicians practice without immediate availability of laboratory facilities, social workers and other consultants; how the physician and office staff become the coordinators of patient care; how physicians interact with patients who seek out medical information and frequently challenge the physician; and how physicians can serve as resources to their communities and can become involved in local medical professional activities.

Ambulatory Care Didactics

There is a strong didactic experience in continuity clinic, directed at providing a solid knowledge base related to ambulatory general pediatrics. We have developed a curriculum of topics that are addressed over the three-year continuity clinic experience. The curriculum contains “core topics” that are discussed each year, and “additional topics,” many of which should be discussed during the three-year continuity clinic experience. To guide the resident's learning, each topic has clearly stated educational goals and objectives.