Rationale

1. THE FOUR-YEAR RESIDENCY: An Emerging Model for Excellence in Family Medicine EducationStephanie E. Rosener, M.D. & Alan B. Douglass, M.D. Rationale Future Directions • Colorado • Missouri-Columbia • WVU • Medical students considering Family Medicine are seeking innovative new approaches to residency training. The four-year residency is emerging as a model providing superior preparation for practice • Four year residencies offer: • Specialized training required to flourish in the PCMH • Added content that preserves the breadth of Family Medicine • Solutions for the “gridlock” in a 3-yr model, allowing more flexibility and elective time • Additions to curriculum without sacrificing core content • Restoration of training time lost (20%) to work hour restrictions • An attractive option to outstanding medical students Loma Linda • There are many questions yet to be answered… • Future evaluation through the P4 Project will: • Measure improvement in mastery of ACGME competencies • Evaluate depth and breadth of training • Observe graduate practice patterns and career satisfaction • Examine long-term resident satisfaction with training • Evaluate 4th year residents as leaders and educational catalysts • Measure chronic disease management outcomes and quality of care indicators • Evaluate long-term financial feasibility of the 4-yr residency • MPH • CHOICE OF TRACKS • Global Health • Preventive Med • EARLY COMMITMENT to Family Medicine • Integrated FELLOWSHIP • “MAJOR vs. MASTER” • Optional ADDED DEGREE • Added CORE CONTENT • TRACKS OF EXCELLENCE • Optional ADDED DEGREE Early Findings Conclusion Baylor John Peter Smith Waukesha • 4-year Family Medicine residency models allows: • Expanded depth and breadth of training • Added preparation for practice in the PCMH • Individualized training • Initial data indicates that the 4-year residency: • Is not a barrier to student recruitment • May attract more highly qualified applicants • May increase residents’ satisfaction with training • We expect 4-year residency graduates to: • Confidently enter practice in the PCMH • Achieve mastery of chronic disease management • Be innovative in their approach to patient care • Maintain a broad scope of practice • Be prepared for a variety of practice settings • Be more satisfied with both training and future practice • Good News… • Initial evaluation of the seven P4 4-yr residencies reveals: • Increased numbers of applicants • Improved match results – filling with higher ranking applicants • Higher average USMLE scores for 2008 applicant class • - USMLE Step 2 (Middlesex) • - USMLE Step 3 (WVU) • Higher In-training exam scores (Missouri-Columbia) • Higher patient satisfaction scores vs. 3-yr residents (WVU) • Higher resident satisfaction with training (Missouri-Columbia) Middlesex Common Themes • Emphasis on the Patient-Centered Medical Home • Broad-spectrum training including procedures • Areas of concentration • Flexibility and customizable training experience • Expanded use of technology • Enhanced Family Medicine identity

2. Measure improvement in mastery of ACGME competencies • Evaluate long-term resident satisfaction with training • Observe graduate practice patterns and career satisfaction • Measure chronic disease management outcomes/Quality of • Care Indicators • Evaluate PGY-4 residents as leaders and educational Catalysts • Evaluate depth and breadth of training • Evaluate long-term financial feasibility of 4-yr residency