Continuity Clinic Requirements

AY2022-2023 Forms and Instructions 

1. Clinic Milestones Patient Survey

continuity clinic 4005 surveys should be entered in MedHub Self Evaluations Clinic Milestones Patient Survey by Third Trimester Due Date (see Roadmap). To start, you need two items: (1) Patient surveys (see the form like this) that your clinic collects from your patients, then your clinic director reviews and gives the surveys to you. (2) The MedHub evaluation notification for " Self Evaluation-Continuity Clinic Milestones-Patient Survey for Residents" that will be sent on your 2nd clinic month. Please complete entering 5 of them when you are at clinic. For questions please contact

IMPORTANT NOTE: If you did not complete them by Third Trimester Due Date (see Roadmap), they will trigger a missed deadline.

2. Clinic Performance Data and QI

Data format varies up to the clinic.

     Upload QI/Panel Management Summary UCH/DH/VA

AY2022-2023 Clinic QI Participation for HTT residents:

  • Spend on clinic QI (mostly practice management) at most 45-60 minutes during clinic week
  • No formal QI deliverables at clinic required by HTT residents
  • For HTT residents at VA: they won’t be required to attend CMR QI didactics during clinic weeks

3. Clinic Observation (CO) 

All residents are required to have a Clinic Observation (CO). Interns will need to trigger the CO form from MedHub (*select the CO form) and request it from their clinic attending. If you have any questions, please contact your clinic director.


    For Clinic Directors Use:

    1. 360° Multisource Milestones (PDF) -- Once a year, a notification will be sent on 3/15.

    2. Patient Survey Blank Form (PDF) -- Collect 5 of them and give them to your interns/residents.

    3. Clinic Observation MedHub Form (PDF) -- Please remind your interns to trigger the form and complete it in MedHub.

    4. Roadmap AY 22-23 

    5. Peer Teaching (not required) - Example evaluation Form (PDF)