Resident panels consist of a broad spectrum of patients and demographies (age, sex, ethnicity, educational levels, medical condition). Residents are listed as the primary care providers in our electronic medical record so that they receive all tests, consultations, and communication regarding ER visits and admissions to the hospital. Residents have primarily responsibile for providing care for their patients and are given planned opportunities to continuously improve their patients' quality of care. Our chart review program represents a critical cornerstone for our residents' participation in practice-based learning and improvement. Each year, residents review a subset of their patient panel, document their adherence to national preventive and chronic disease care recommendations, and critically reflect on their medical practices by identifying specific commitments to change. Residents then work with their faculty mentor and health care teams to improve processes of care and facilitate improvement in patient outcomes as evidenced by subsequent chart reviews.