Should Family Medicine Residents Train for Three Years or Four?

In April 2012, the Accreditation Council for Graduate Medical Education (ACGME) issued a call for proposals for a pilot program aimed at reviewing the length of training for family medicine residency programs; the first group of programs have been chosen to participate (see list below).

But recently, the ACGME's Review Committee for Family Medicine (RC-FM) announced a second application period that is open through Dec. 15. The review committee also is seeking additional residency programs to serve as control groups for the pilot. Programs will be notified as to the status of their applications by Feb. 15, 2013.

Ultimately, the RC-FM would like to see 20-25 residency programs participating in the four-year, length-of-training pilot with an equal number of residencies serving as the control group.

The program -- officially titled the Family Medicine Length of Training Pilot -- will begin in July 2013 and conclude by June 2019. The pilot's steering committee has approved residency programs in five U.S. Naval hospitals for participation in the pilot. Those programs are located in

In addition, the following programs have been chosen to participate:

Peter Carek, M.D., chair of the RC-FM, stressed the importance of the pilot project. He told AAFP News Now that the results "would be used to shape the future of graduate medical education in family medicine."

Carek, a professor and vice chair in the Department of Family Medicine at the Medical University of South Carolina in Columbia, said that even though the length-of-training pilot's primary goal is to examine the length of residents' training, the endeavor will fill another important need.

"We expect that the project will serve as a wealth of data and information regarding the optimal methods, curriculum and patient care activities needed in a training program," said Carek. "These are the kinds of things that will improve the performance of graduates as they serve as physicians in a modernized, frontline medical practice."

Carek noted that one of the recommendations of the leaders of the Future of Family Medicine Project -- a collaborative project of the family medicine community that culminated in a report published as a supplement to the March 1, 2004, Annals of Family Medicine -- touched on the length of training of family medicine residents.

Authors of that 2004 report encouraged "active experimentation" in family medicine education and called for the relative merits of three-year versus four-year training programs to be tested and evaluated through experimentation based in pilot programs.

Nearly a decade later, that's exactly the path being taken.