Continuity Clinics

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 primary care. All categorical and primary care track residents have a single continuity clinic for their three years of training.

Throughout the three years, residents spend on average one full day per week at continuity clinic (some rotations more, and some less due to inpatient demands).

• Residents do not have inpatient or elective duties on clinic days
• On electives, residents have one to two full days of clinic each week
• On wards, two clinic days per month
• On ICU, progressive care and Night float, there is no clinic

Residents establish a panel of patients and have 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 ability to request a clinic site gives you the ability to have a unique experience. Having consistent attendings 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

We have two options for continuity clinics:

• The Eastgate Public Health Clinic
  • Diverse underserved patient population and complex medical disease
  • Traditional residency clinic format (2-3 residents per day, working with one attending)
• The Virginia Mason Continuity Clinic
  • Showcasing the Virginia Mason Production System in a primary care model
  • One-on-one preceptorship. Residents work with two attendings and 2-3 co-residents through their three-year residency, facilitating mentorship and coverage.

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 and Virginia Mason educators. 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.

“Eastgate is an amazing experience. Every clinic day, I leave feeling I’ve made a difference in my patients' lives; providing care they otherwise would not have access to, helping empower them with knowledge and understanding of their health conditions, and learning from them in return both about complex medical conditions and culturally competent care.” — Cheyenne Enevold, MD, class of 2021

Designed in direct response to resident feedback, this unique continuity clinic model pairs two residents with two Virginia Mason general internal medicine attendings for all three years of residency. Residents manage their panel of patients while being integrated into the larger clinic, providing hands-on experience in a cutting edge, high-functioning primary care clinic. Working with the same preceptors throughout residency allows for more personalized resident education, creates a strong, personal relationship with experienced clinicians, and offers insight into the long-term benefits of primary care. Senior residents mentor junior residents to the benefit of both.

Three main locations: Downtown Seattle, Federal Way and Lynnwood. Possibility of other Virginia Mason regional clinics, if strong resident preference — Kirkland, Bellevue, Issaquah and Bainbridge Island.

The best part about the VM Federal Way clinic is that there is no shortage of medical and psychosocial complexity, and a wide variety of bread and butter internal medicine chief complaints. For instance, on a typical day, I see patients with chronic opioid use, diabetes follow up, hypertension follow up, new depression, and leg cellulitis.” — Quincy Pham, class of 2023

“The VM Federal Way clinic patient population reflects the complexity of patients you will encounter once done with training. The continuity clinic experience here gave me the confidence to manage multiple chronic, complex multiorgan conditions. If interested in primary care, I highly recommend establishing a patient panel here throughout your residency career.” — Chris Choi, class of 2024