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The Gift of Empanelment in a "Clinic First" Residency
Kumara Raja Sundar
Background In a traditional family medicine residency, residents often rotate monthly from one clinical service to another in block rotations to build skills in different disciplines, including outpatient clinical skills. Outside of an outpatient skills block, resident time in clinic is often limited to one half-day per week. In this essay, a family medicine resident makes a case for structuring primary care training around a "clinic first" curriculum where providing excellent outpatient clinical care and understanding the value of relationships "are the cornerstone of our learning."
What This Study Found The author describes a model in which residents are consistently present in clinic and empaneled with approximately 400 patients each that they care for from the beginning of their residency. Empanelment, the author states, has "allowed me to not only provide comprehensive care to my patients but also allowed me to develop competency and proficiency in managing their acute and chronic illnesses." Providing ongoing care has also helped him build relationships and understand the value of primary care. Residents need this type of experience, he states, in order "to build the primary care workforce of the future."
