National Family Medicine Residency Outcomes Project Methodology

Introduction: Multiple specialties including family medicine are engaging in a robust re-envisioning of residency training that culminates with new program requirements. No large-scale prospective studies linking curriculum to graduate outcomes have been available to guide the new standards. This report describes the methodology including representativeness and response rates of the Council of Academic Family Medicine Education Research Alliance (CERA) and American Board of Family Medicine (ABFM) National Family Medicine Residency Outcomes Project (FM-ROP). Methods: FM-ROP is a prospective cohort study that followed ABFM diplomates who graduated in 2018 into practice. A CERA survey conducted in 2018 measured residency exposures as reported by program directors. We measured graduate outcomes through the 2021 National Graduate Survey (NGS). We compared participant demographics to available demographics of the sample frame using bivariate analysis. Results: The response rate for the 2018 CERA program director survey was 43.3% (254/587). The response rate to the 2021 NGS was 45.1% (1,623/3,596). After merging the two data sets, our final analytic sample included 779 graduates from 211 residencies. Graduates from larger programs and those with an MD degree were more likely to be included in the matched data set. Conclusion: This study is the first national cohort study in any specialty that follows residency graduates by assessing program director perspectives on their training, including program structures and processes, and then linking this to graduate data on practice patterns and outcomes. The methodology of this project could be used in other specialties to help guide residency redesign.