Original Publication
Open Access

But Tommy Likes It Here: Moving to Adult Medicine

Published: July 3, 2012 | 10.15766/mep_2374-8265.9190

Included in this publication:

  • Instructor's Guide.doc
  • MedED Transition Case.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This 5-page case scenario walks through a typical transition process for a teenager growing into adult with a chronic illness. Barriers and resistance are highlighted on each page and the physician models one way of handling that issue on the next page. The case allows a rich discussion of transition issues including age appropriate care, handling of intrusive parents, feelings of the patient and provider, and problem solving skills.

An outline follows for the discussion leader that outlines which issues are presented on each page to ensure adequate pacing and balance.

Recognition of provider discomfort with transition issues became apparent in our division when we began discussing and studying the issue. The case was designed, based on many years of experience, to capture many key problems that arose.

It was used sucessfully at a Problem Based Learning Luncheon at the American Gastroenterology Association 2011 with excellent feedback from participants. It was also presented as GI Grand Rounds 2011 in our division. We have evidence that discussion of this topic, including this case, led to increased self-managment by patients with IBD (abstract accepted for NASPGHAN meeting in October)

Educational Objectives

  1. Learner can recognize barriers to age-appropriate care.
  2. Learner can develop new strategies to enhance patient self-management.
  3. Learner can reflect on emotions generated in the end of a long term provider-patient relationship.
  4. Learner can develop new strategies to improve provider to provider information during a transfer.

Author Information

  • Laurie Fishman, MD: Harvard Medical School

None to report.

None to report.


Fishman L. But Tommy likes it here: moving to adult medicine. MedEdPORTAL. 2012;8:9190. https://doi.org/10.15766/mep_2374-8265.9190