Lankenau Medical Associates (LMA) is the continuity practice for our internal medicine residency. It's a resident and faculty co-practice centrally located in Lankenau Medical Center, part of Main Line Health, which serves a medically complex, diverse mix of patients from West Philadelphia and surrounding suburbs. Each categorical resident builds a panel of primary care patients over a three-year period.
We prioritize the quality of our residents’ outpatient experience. Over the past few years, we have added an associate program director for ambulatory medicine, new ancillary staff members, a dedicated medical social worker, and a new practice management team run by Main Line HealthCare. During the COVID-19 pandemic, we created and streamlined a telemedicine workflow that prepares residents to practice in our post-pandemic world.
Other features of LMA include an on-site doctoral-level psychologist and a community garden at Lankenau Medical Center that grows fresh produce for our patients.
We transitioned to an "X+Y" scheduling model in 2021. This provides categorial residents uninterrupted time to focus on outpatient medicine during their "Y blocks," and a predicable "diastole" after intense inpatient rotations. This schedule has significantly improved continuity between patients and their resident primary care provider. Ambulatory residents are excused from clinical duties on Friday mornings for dedicated ambulatory education, which includes didactic lectures, point of care ultrasound (POCUS) training, and case-based discussions.
The ambulatory experience also includes dedicated subspecialty training. In the PGY-1 year, this takes the form of survey rotations in office-based dermatology, neurology, geriatrics, obesity medicine, diabetes education, sports medicine, and women’s health. In the PGY-2 and PGY-3 years, residents choose longitudinal ambulatory experiences among the core internal medicine subspecialties. Other offerings are available such as infection prevention and perioperative medicine. Upper year residents also have dedicated time for ambulatory quality improvement, panel management, and personal research projects during their ambulatory weeks.
Finally, we build “personal time” into ambulatory weeks, so our residents can keep up with essential life tasks like dentist appointments!