This is the default program, but you can choose to switch to other tracks as your interests change.
Designed in direct response to resident feedback, this unique continuity clinic model pairs each resident with a single Virginia Mason general internal medicine attending for all three years of residency. Residents manage their panel of patients while being integrated into the larger clinic, allowing them a hands-on experience in a cutting edge, high-functioning primary care clinic. Working with the same preceptor throughout the residency allows for more personalized resident education, creates a strong, personal relationship with an experienced clinician, and offers insight into the long-term benefits of a continuity practice.
Virginia Mason has a long tradition of excellence in ambulatory internal medicine. Virginia Mason residents consistently score in the top 10th percentile in general internal medicine on national exams and frequently go on to enjoy careers in outpatient primary care. All categorical and primary care track residents have a single continuity clinic for their three years of training.
Residents establish a panel of patients and have initial and primary responsibility for evaluation, decision-making, care planning, record keeping, follow-up and ongoing management for all their continuity clinic patients. Attendings supervise residents with increasing autonomy as they demonstrate abilities to provide excellent patient care. Residents are part of a team of care providers in the ambulatory setting, including attending physicians, nurses and medical assistants.
The clinic experience consists of a full day each week on electives and every other week on wards. Residents do not have inpatient or elective duties on their clinic days. There is no clinic on night float and ICU rotations.
“The ability to request a clinic site gives you the ability to have a unique experience. Always having the same attending gives you the ability to form a mentorship and continue to work on your strengths and weaknesses. The benefit of this is that their teaching can continue to build off itself, week-by-week and year-by-year.” — Chad Rieck, MD, class of 2020
Residents can choose which facility to have their continuity care program. These sites include our Eastgate Public Health Center, or any of our GIM clinics in Seattle, Bellevue, Federal Way, Bainbridge Island, Issaquah, Kirkland and Lynnwood.
Eastgate Public Health Center
Residents can request to be assigned to the Eastgate clinic for their weekly, full-day continuity clinic. Eastgate is a King County public health clinic that has partnered with Virginia Mason since 2008 to serve the health care needs of the community and improve resident education. Residents at Eastgate quickly establish continuity with their panel of patients and are truly seen as the patients’ primary physicians. Residents learn to manage a stunning diversity of illness presentations in a resource-limited setting with the assistance of Virginia Mason teaching faculty. The partnership between Eastgate and Virginia Mason allows for expanded access to primary care for underserved patients, while providing a rich educational opportunity for our residents.
Eastgate is the largest of three King County public health clinics. Started in 2008, this public-private partnership has been very successful in its goals of educating residents and providing increased health care access in King County. Residents manage a diverse population of underserved, largely non-English speaking patients under the supervision of Public Health (mornings) and Virginia Mason educators (afternoons). Ancillary services at Eastgate are excellent — with onsite Spanish interpreters, as well as nurses and medical assistants, dedicated to the Virginia Mason program. By expanding the capacity of the clinic, residents play valuable roles in providing care to patients who might otherwise go without adequate health care.
Outpatient Elective Experiences
An advantage of choosing Virginia Mason is that you have the option to specialize your elective experiences. Electives can be customized to meet the educational goals of individual residents — to focus on inpatient or outpatient medicine, particular disease states or subspecialties, or patient populations of interest. Most of the rotations have an outpatient focus but you can request to adapt the rotation to your future career. Some of our residents who know they would like to be hospitalists request to do all inpatient consultations or even join the inpatient service for part of their rotation. Since there are few fellows at the hospital, residents are pushed to build the plans and treatment options for the patients. They can request to help perform procedures during their rotations too, including bronchoscopy.
In addition, residents can request to take numerous electives, including outpatient gynecology/women’s health, outpatient general surgery, hyperbaric medicine, orthopedics/sports medicine, ophthalmology, otolaryngology, physical medicine and rehabilitation and urology. These electives are open to all residents, but are preferentially assigned to residents in the primary care program.
Rotations are taken in two- or four-week blocks and residents work Monday through Friday, without weekends or call. Residents complete all MKSAP questions during their specialty electives and review topics missed on the In-Training Exam with faculty preceptors.
All residents participate in the Systems-Based Improvement elective during their R2 or R3 year, allowing them the unparalleled opportunity to learn about the internationally-renowned Virginia Mason Production System.
Inpatient Elective Experiences
As a senior resident, you can request a float service elective where you work with an attending to have your own service, without leading a team. The resident on the hospitalist elective works one-on-one with a Virginia Mason hospitalist faculty to care for 10 to 14 patients without a larger intern team. The resident rounds independently, checking in with the attending throughout the day. This rotation emphasizes autonomy, advanced clinical decision-making skills, and is a good option for those interested in a hospitalist career.
- The shift is from 7 a.m. to 7 p.m., or 9 a.m. to 9 p.m., Monday through Sunday, every other week.
- In the off weeks, the resident has about two days of continuity clinic and is otherwise free.
- Residents continue to attend conferences and didactic sessions when they are in the hospital.
In addition, there is a subset of two-week elective rotations tailored to residents interested in further refining their inpatient subspecialty knowledge including the inpatient psychiatry service, glycemic control team and neurology consult service.