The goals of the patient-centered medical home (PCMH) include the efficient and effective delivery of patient-centered care in the context of a continuity relationship. In residency training programs, competing demands on faculty, residents, and office staff create considerable challenge in demonstrating these vital attributes of the PCMH to residents. Given the emphasis on the PCMH, primary care residency programs need to strengthen the methods for teaching and modeling continuity, office efficiency, and team-based approaches to care.