The Impact of Length of Training on Clinical Preparedness Among New Graduates: A Report From the Length of Training Pilot Study in Family Medicine

Background and Objectives: Associations between training length and clinical preparedness are unknown. We compared assessments of clinical preparedness for family medicine graduates from 3-year and 4-year training programs. Methods: In this prospective case-control study, we compared responses from two surveys, which occurred 3 months after graduates started their first job. One survey was conducted by a supervising physician. The other was conducted by a clinic staff member who rated family medicine graduates from both 3-year and 4-year programs. Results: Our study included 403 graduates of 3-year programs, 185 who trained in 4-year programs with 36 months of training (4YR–36) and 274 who trained in 4-year programs with 48 months of training (4YR–48). Physician assessor ratings were similar across study groups on 18 of 21 Entrustable Professional Activities. The 4YR–48 graduates were rated higher for “practicing independently” on providing a usual source of comprehensive, longitudinal medical care for people of all ages (86.5% vs 77.9%); managing prenatal (63.1% vs 41.2%); and labor, delivery, and postpartum care (41.4% vs 25.7%). For five care process areas, physician assessors were more likely to rate 4YR–48 graduates as having “no challenges” with speed/timing related health care visits (91.9%) compared to 3YR graduates (82.4%). We noted no differences according to study group for staff member assessors. Conclusions: We found several differences in clinical preparedness according to length of training in this pilot study. Comprehensive longitudinal care, including prenatal and maternity care, were rated higher among graduates of 4YR–48 programs.