Expectations of Family Medicine Residency Graduates

Family medicine residency graduates will be able to independently and competently practice the specialty of family medicine. They will have been trained to meet the six Accreditation Council for Graduate Medical Education (ACGME) competencies, and will be prepared to provide continuing, comprehensive and personal care within the context of family and the needs of the community. This document has been written for consideration by family medicine residency training programs as they prepare family physicians for future practice.

All family medicine residency graduates should:

  1. Demonstrate continuous commitment to professionalism in the practice of family medicine.
  2. Demonstrate current medical knowledge utilizing a bio-psychosocial model to provide evidence-based comprehensive patient care.
  3. Be able to lead and practice within an interdisciplinary care team to provide comprehensive patient care.
  4. Be able to provide care with a systems-based approach, while serving as a patient advocate.
  5. Become board certified and successfully maintain board certification in family medicine through information mastery and life-long practice-based learning.
  6. Be able to effectively communicate with the patient, family and healthcare team about the diagnosis, evaluation and management of a particular condition in a collaborative fashion.
  7. Facilitate continuous learning and quality improvement for all members of the healthcare team.
  8. Be competent in the care of patients throughout the continuum of life, managing their care in multiple environments including but not limited to home, office, acute care hospital and long-term care facilities. The graduate’s role in each setting is defined by the relationship with the patient, the patient’s need for services and needs of their respective communities, including providing maternity care that reflects the competency of the family physician.
  9. Have the technical skill, knowledge and experience to perform clinical procedures within the scope of family medicine reflecting the graduate’s training, experience and the needs of the community.
  10. Demonstrate the ability to join or build a fiscally sound practice that meets the identified needs of the community served utilizing the principles of the patient-centered medical home.
  11. Demonstrate competency in the following skills necessary for the successful practice of family medicine:
    1. Providing health care addressing specific social, cultural and community needs.
    2. Appropriately recognizing the need for consultation, and comanaging the patient when applicable or appropriate.
    3. Practicing cost-effective medicine and care coordination when ordering diagnostic tests, prescribing and utilizing other therapeutics.
    4. Recognizing and coordinating gaps in health of the individual patient and entire patient panel.
    5. Integrating appropriate available technologies (EHR, secure messaging, video visit, point of service references) to improve patient care and its documentation in practice.
    6. Providing evidence-based comprehensive, acute, chronic and preventive services to patients and their communities.
    7. Providing guidance to patients and families regarding advanced directives, end-of-life issues and unexpected diagnoses/outcomes.

12. Demonstrate knowledge and experience with understanding the public health issues in their    
      communities, and coordinate care with community health agencies to improve the health of their
      patients and community.

Family medicine organizations developed Entrustable Professional Activities (EPAs) for Family Medicine End of Residency Training in 2015. (http://fmahealth.org/sites/default/files/EPAs_for_FM_End_of_Residency_Training.pdf(fmahealth.org))

This list of 20 EPAs collectively define the type of care that the residency graduate can be trusted to deliver to the public. EPAs are an educational tool that allows faculty to make competency-based decisions on the level of supervision required by trainees. The list of expectations itemized in this policy extends beyond clinical knowledge and skills, and thus complement EPAs for Family Medicine End-of-Residency Training.

(April Board 2009) (July 2016 BOD)