The Future of Family Medicine Residency Training

Submitted on Mon, 08/03/2020 - 13:48

For the first time in over 10 years, the Accreditation Council for Graduate Medical Education (ACGME) plans to develop a major revision of the Family Medicine Residency Guidelines. The ACGME Family Medicine writing group, led by Stacy Potts, MD, will convene in the late fall of 2020, with the formal process beginning in early 2021. A major revision provides a rare and important opportunity for the specialty of family medicine–convening conversations across the specialty and bringing forward substantial evidence to bear, while coordinating with the ACGME through the process.

A major revision is significant in that habits related to quality and cost imprinted in residency endure for many years. In December 2019, based on its strategic plan, the American Board of Family Medicine (ABFM) began discussing priorities for the new residency guidelines, seeking input from family medicine partner organizations, including the Family Medicine Leadership Council, the American Academy of Family Physicians (AAFP) Commission on Education, and the Boards of Association of Departments of Family Medicine (ADFM), Society of Teachers of Family Medicine (STFM), and Association of Family Medicine Residency Directors (AFMRD). Along with these partner organizations, the North American Primary Care Research Group (NAPCRG), and the American College of Osteopathic Family Physicians (ACOFP), ABFM urges the larger community of the family medicine specialty, including front line clinicians, resident directors and faculty, residents and the patients, communities, employers, and health systems to become a part of the conversation. In a recent article published in the Journal of the American Board of Family Medicine, ABFM proposed 6 key questions to begin the dialogue:

What does society need from the personal physicians of the future? The outcomes of American health care are poor. A recent report in JAMA argued that American life expectancy has declined since 2014; Americans are sicker and die earlier across most diseases and all ages despite a much higher investment in health care than European countries.

What should we teach? Residency involves both education and training. ABFM emphasizes education, as graduates will play multiple roles over their careers, needing to adapt to changes in health care and society. What new competencies and curricula should all residencies require?

How should we teach? There is compelling evidence that active learning is dramatically superior to passive learning—do residency didactics need to change? Beyond mode of teaching, how will we implement competency-based education?

How will we prepare graduates for practice over their lifetimes? Residency graduates will practice for 30–40 years; the science as well as the basic organization and financing of health care will all change. How do we prepare them for those changes?

What is the right balance between innovation and standardization? Over the last generation, Family Medicine has embraced innovation in residency education—do we need to continue this, or should we emphasize standardization to keep our promise to the public?

How can we improve the accountability of residency education? Residencies must adapt their teaching practices and curricula to changing conditions. More broadly, given the nation’s massive investment in GME, how will we assure the public that they are getting what they need?

The “Family of Family Medicine”–the AAFP, the ACOFP, AFMRD, STFM and NAPCRG, in addition to ABFM–is organizing discussions across the specialty over the next several months, leading up to a national summit in December. Community dialog and the national summit will provide important context and key themes for ACGME’s writing committee; however, the ACGME is independent and will make its own decisions. A dedicated journal issue will focus on the evidence and discussions from the national summit. ABFM and its partner organizations welcome input from all those in the specialty.

The full article, The Future of Family Medicine Training is Our Future: A Call for Dialogue Across Our Community, can be found by clicking here.

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