community dialogUE

Survey Results

These surveys were done in late October and November, and address curriculum, pedagogy, competency assessment, professionalism and the career trajectory. Questions were framed to target policy issues that will be discussed at the summit. Response rate so far is 57.3%. Results are preliminary.

Memorandum
Residents
Faculty
Fellow
Early Career Diplomates
Mid Career Diplomates
Later Career Diplomates

Family Medicine Organization(s)
(Click on the “+ Sign” Below to Expand)

Re-Envisioning Family Medicine Residency Education requires dialogue across the specialty. To meet this need, all of the clinical and academic organizations are engaging their communities. What follows summarizes each organizations’ strategy, including focus group topics and surveys, and will provides brief summaries and recommendations from each of the focus groups. Please also see the Background Briefs, which are intended to be “fire starters” for these discussions.

aafp

+ STRATEGIES

The AAFP made a commitment in early 2020 to help lead and support a family medicine organizational-wide process to provide input into the next set of ACGME family medicine residency program requirements. Major revisions are rare and important, and they offer an opportunity for major changes in the structure and function of residency training. There is increasing evidence that what happens during residency matters—quality and cost of care imprinted during residency lasts for up to 15–20 years, and the residents under these guidelines will practice until 2050 and beyond. This major revision, therefore, will frame the shape and promise of family medicine for the next generation.

The AAFP is uniquely positioned to provide insights around a series of core questions from students, residents, clinically active family physicians, and those involved in medical education including the Commission on Education and Residency Program Solutions (RPS) consultants. The AAFP is conducting a series of focus groups in September of each of these segments. Additionally, the AAFP has conducted resident and student leadership discussion forums with themes about the future program requirements to be added to the resources. The qualitative information gathered will be posted here to be utilized as resource material for those participating in the Residency Redesign Summit the AAFP will host in December.

+ TOPICS / SUMMARIES

Focus Group:

Future Training of Family Physicians Focus Group

Family Physicians: What does society need from the family physician of the future?

Should the 4 C's be updated to include a 5th C for Community Engagement to address unmet health and social needs in our communities?
How should telehealth and urgent care fit into continuity of care and coordination of care?
What should our approach be in training for comprehensiveness? How can residency education support graduates’ ability to shift practices and populations over time?
How do we prepare physicians to respond to their communities’ emerging needs as well as for changing locations, populations and scope of practice over their careers?
How should we shape residency to support the plasticity necessary for long term service to patients and communities?

COE: What does society need from the family physician of the future?

Should the 4 C's be updated to include a 5th C for Community Engagement to address unmet health and social needs of our communities?
What should our approach be in training for comprehensiveness?
What should our approach be in training family physicians to help address the “obstetrical deserts” that are rapidly expanding? What is the right balance between innovation and standardization? -How do we ensure that every graduating resident has the necessary knowledge and skills to function as a fully competent family physician while also encouraging innovation in residency education? -How much time in residency should be flexible to allow for individualized enhanced innovative experiences?

RPS Consultants: What is the right balance between innovation and standardization?

How do we ensure that every graduating resident has the necessary knowledge and skills to function as a fully competent family physician while also encouraging innovation in residency education?
How much time in residency should be flexible to allow for individualized enhanced innovative experiences?
How can we improve the social accountability of graduate medical education?
How can we improve the social accountability of graduate medical education?
How effective are current mechanisms of continuous quality improvement for residencies?

Residents: What should we teach?

Which clinical areas are so important in terms of function, morbidity and cost that all residents in the next 15-20 years must learn about them?
How much curricular flexibility should individual residencies and individual residents have to be responsive to local needs and individual residents’ interests?
What new curricula and new skills should be present in resident training?
How can residency education support graduates’ ability to shift practices and populations over time?
How do we prepare physicians to respond to their communities’ emerging needs as well as for changing locations, populations and scope of practice over their careers?
How should we shape residency to support the plasticity necessary for long term service to patients and communities?

Medical Students: How should we teach?

What new teaching technologies will improve outcomes in education?
How should competencies be best assessed?
What attracts you to family medicine?”

ABFM

+ STRATEGIES

The major focus of ABFM’s work are the requirements for Board Eligibility. We believe that the pace and amplitude of health care change are greater than any time in the last two generations, that the public has major and increasing unmet needs, and that the personal physicians of the future must play a key role in addressing these needs. Family Physicians are the most numerous and widespread of personal physicians. This makes the major revision particularly important, and we are very supportive of the community dialogue to inform our policy about Board Eligibility.

ABFM has been meeting regularly since December 2019 to identify key questions for residency redesign, and has been working closely with the leadership of the ACGME to coordinate the process of joint review and with Family of Family Medicine to develop this national dialogue and summit. In July, we published an editorial describing the core questions and their rationale (full article). In September, we will conduct a survey of all our active Diplomates and all Family Medicine residents. We will recruit those interested in contributing to the dialogue and survey them around key aspects of the major redesign. We will coordinate the content of the survey with the AFMRD survey and the focus groups developed by other organizations.

+ TOPIC / SUMMARIES:

acofp

+ STRATEGIES

ACOFP Plan for Input

+ TOPIC / SUMMARIES

Summary by Focus Group Leaders

Summary by Question

adfm

+ STRATEGIES

+ TOPIC / SUMMARIES

Focus Group:

ADFM’s Residency Redesign Focus Groups Plans

Chair Focus Group Summary

FQHC Leaders Focus Group Summary

Health sx Leaders Focus Group Summary

Patient Focus Group Summary

afmrd

+ STRATEGIES

In support of our mission to inspire and empower family medicine residency program directors to achieve excellence in family medicine training through a community of residency directors engaged in excellence, mutual assistance, and innovation to meet the health care needs of the public, AFMRD’s emphasis is on providing opportunities for program directors to participate in community dialogue. We have done this by offering two national Webinars designed to disseminate information and generate discussion related to the Core Questions. These Webinars were followed by an AFMRD member survey, which will lead to focus groups being conducted in the fall. An AFMRD Board of Directors member has served on the Starfield Summit Planning Committee since its inception.