An Internal Medicine Resident Continuity Clinic at a Federally Qualified Health Center: Structure, Feasibility, and Early Outcomes.

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.