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

Abstract

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. To describe the process, feasibility, and early outcomes of an IM resident continuity clinic at a FQHC. 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%). The continuity clinic was launched in July 2022 with six residents. 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%. A collaborative IM resident continuity clinic at a FQHC is feasible, highly satisfying for residents, and cost-neutral for the FQHC.