Medical College of Wisconsin
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An Internal Medicine Resident Continuity Clinic at a Federally Qualified Health Center: Structure, Feasibility, and Early Outcomes. J Gen Intern Med 2025 May;40(6):1437-1440

Date

02/22/2025

Pubmed ID

39984802

Pubmed Central ID

PMC12045901

DOI

10.1007/s11606-025-09435-4

Scopus ID

2-s2.0-85219623307 (requires institutional sign-in at Scopus site)

Abstract

BACKGROUND: Educational opportunities in federally qualified health centers (FQHCs) are important to develop our physician workforce at FQHCs but are rare in internal medicine (IM) training programs.

AIM: To describe the process, feasibility, and early outcomes of an IM resident continuity clinic at a FQHC.

SETTING AND PARTICIPANTS: The IM residency is a large academic program. The FQHC serves over 40,000 patients per year, of which the vast majority are Hispanic/Latino(a) (88%), speak Spanish (69%), live below 100% of the federal poverty level (80%), and rely on Medicaid (60%) or lack insurance (22%).

PROGRAM DESCRIPTION: The continuity clinic was launched in July 2022 with six residents.

PROGRAM EVALUATION: After 18 months, patient panel grew to 680 patients. Patients are young (age 18-39 = 55%), uninsured (54%), below 100% federal poverty line (82%), and Spanish speaking (84%). Residents' continuity was 53.3% with a no-show and same day cancel rate of 26.6%. Residents saw an average of 15.76 patients per day while the attending's non-resident clinic saw 15.44 per day (P = 0.31). Average resident satisfaction was 96%.

DISCUSSION: A collaborative IM resident continuity clinic at a FQHC is feasible, highly satisfying for residents, and cost-neutral for the FQHC.

Author List

Hilgeman B, Lyons A, MacKinney T, Wilson P, Melster T, Markson M, Fletcher K

Authors

Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of Wisconsin
Brian Hilgeman MD Associate Professor in the Medicine department at Medical College of Wisconsin
Amalia J. Lyons MD Associate Professor in the Medicine department at Medical College of Wisconsin
Theodore MacKinney MD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Ambulatory Care Facilities
Continuity of Patient Care
Feasibility Studies
Female
Humans
Internal Medicine
Internship and Residency
Male
Middle Aged
Program Evaluation
United States
Young Adult