Continuity of Care as the Organizing Principle of Family Medicine Residency Training: A Narrative Review of the Evidence That Longitudinal Patient–Physician Relationships Improve Both Educational and Clinical Outcomes

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Background: Continuity of care is arguably the most critical part of family medicine. Through continuity of care physicians are able to further their connection to their patients which enhances patient trust. This improved communication helps them diagnose subtle changes in their condition early and ensure their patient is following the correct treatment plan. There are five different domains of continuity of care: informational continuity, managerial continuity, relational continuity, family continuity, and geographical continuity; this review focuses on relational continuity. Objective: To verify that the development of physician-patient relationships throughout continuity of care in family medicine would provide significant improvements to residents' educational outcomes and patient’s clinical outcomes. Aiming to prove that improved communication within continuity of care is the main contributor to better training and health results. Methods: We performed a search of studies and reviews that evaluated the extent to which continuity of care and enhanced resident training and patient outcomes. We looked into a variety of sources and significant journals published between 1993 and 2025, with an emphasis on clinical trials or other narrative reviews. Results: After removing irrelevant papers, duplicates, ones not in English, and any articles that were behind a paywall, 21 initial results remained. From those initial results, 14 full-text articles were screened, out of which 13 were used in the narrative review. These studies were then differentiated into multiple categories, Patient-physician interactions, family medicine residency, and relational continuity were used to categorize the studies, to then identify variations or consensuses. From the analysis conducted on the studies a consensus was formed that continuity of care was connected with better patient satisfaction, treatment of chronic conditions, preventive care provision, and lowered emergency room care utilization and hospitalization, while at the same time contributing to the educational experience and the interest to pursue family medicine within residents. Conclusion: This paper validates continuity of care as an important component of high-quality care. Enhanced health outcomes, including reduced mortality, improved patient satisfaction, and reduced healthcare costs, are linked to higher levels of continuity between patients and their primary care physicians. Better continuity can also be linked to fewer missed appointments, decreased duplicative or unnecessary care, and higher rates of appropriate follow-up, since it ensures patients are receiving the proper attention their condition needs, all of which reduces the time, effort, and money that goes into rescheduling. Moreover, continuity of care serves as one of the main principles for training residents, which has proven to help residents develop stronger clinical reasoning and professional responsibility. Overall continuity of care has been linked to better disease management, higher satisfaction, and resident training, making the healthcare system more personalized.