A revolution in family medicine residency training is in the works.
Within six years, some family medicine residency training may begin during the fourth year of medical school. Or residency training may lengthen to four years. Residents may routinely care for patients in their homes or see them in street-side clinics that serve the homeless. Programs could increase the use of simulated clinical encounter tools, or they may reinforce the value of learning procedures in outpatient clinics.
Revolution on the Horizon
Residency Training Demo Launches This Fall
By News Staff
8/25/2006
And many of the innovations will arise from a nationwide demonstration project, dubbed Preparing the Personal Physician for Practice, or P4, that gets under way this fall with a call for proposals. As many as 20 residency programs to be selected for the program will test teaching innovations that are designed to prepare family physicians for the new model of care described in the Future of Family Medicine report.
Residency programs can submit a letter of intent to participate in P4 by going to the Web site of TransforMED, the Academy's practice redesign initiative. The Web site contains a link to the P4 project, including the online call for proposals and applications. Residencies will be asked to describe the innovations that would be implemented and tested and to address the difference a proposed innovation would make for the program's graduates. Proposals will be accepted from Sept. 1 through midnight Sept. 29.
Programs that submit successful proposals during stage one of the application process will be asked to submit a full proposal that provides more details. At this stage, the residencies will describe the problems to be addressed by the innovation, the essential features of their experiment and how those features relate to the new model of care, the components of the residency program that would change during the experiment, the hypotheses or researchable questions to be addressed, and the determining factors that would be used to decide whether the experiment required alteration and whether the innovation had succeeded.
Selected P4 programs are expected to be chosen in late January 2007 and may begin launching their experiments as soon as June 2007.
TransforMED, which recently launched a national demonstration project to test a new model of care in 36 family medicine practices, will provide oversight to participating programs with guidance from a 12-member P4 steering committee.
The P4 nationwide demonstration project was initiated this spring with $1.7 million in pledges from the Association of Family Medicine Residency Directors, or AFMRD, and the American Board of Family Medicine Foundation.
Described as "a pragmatic, comparative case study of 10-20 experimenting residencies," P4 is expected to unleash "a barrage" of new ideas for teaching residents, according to Samuel Jones, M.D., co-chair of the P4 steering committee, president-elect of AFMRD and a director of the Virginia Commonwealth University/Fairfax Family Medicine Residency Program in Fairfax.
Larry Green, M.D., co-chair of the P4 steering committee and a member of the ABFM board of directors, agreed. Creativity will be key to proposals' success, he said, adding, "This is not a prescriptive project where we tell the residency what to do. We're asking them what they will do."
Selected categories for innovation are
Residency programs can submit a letter of intent to participate in P4 by going to the Web site of TransforMED, the Academy's practice redesign initiative. The Web site contains a link to the P4 project, including the online call for proposals and applications. Residencies will be asked to describe the innovations that would be implemented and tested and to address the difference a proposed innovation would make for the program's graduates. Proposals will be accepted from Sept. 1 through midnight Sept. 29.
Programs that submit successful proposals during stage one of the application process will be asked to submit a full proposal that provides more details. At this stage, the residencies will describe the problems to be addressed by the innovation, the essential features of their experiment and how those features relate to the new model of care, the components of the residency program that would change during the experiment, the hypotheses or researchable questions to be addressed, and the determining factors that would be used to decide whether the experiment required alteration and whether the innovation had succeeded.
Selected P4 programs are expected to be chosen in late January 2007 and may begin launching their experiments as soon as June 2007.
TransforMED, which recently launched a national demonstration project to test a new model of care in 36 family medicine practices, will provide oversight to participating programs with guidance from a 12-member P4 steering committee.
The P4 nationwide demonstration project was initiated this spring with $1.7 million in pledges from the Association of Family Medicine Residency Directors, or AFMRD, and the American Board of Family Medicine Foundation.
Described as "a pragmatic, comparative case study of 10-20 experimenting residencies," P4 is expected to unleash "a barrage" of new ideas for teaching residents, according to Samuel Jones, M.D., co-chair of the P4 steering committee, president-elect of AFMRD and a director of the Virginia Commonwealth University/Fairfax Family Medicine Residency Program in Fairfax.
Larry Green, M.D., co-chair of the P4 steering committee and a member of the ABFM board of directors, agreed. Creativity will be key to proposals' success, he said, adding, "This is not a prescriptive project where we tell the residency what to do. We're asking them what they will do."
Selected categories for innovation are
- source and content of training, such as a change in approach to maternity care, enhancements in chronic disease management or differentiation for a particular patient population;
- length of training, such as incorporating first-year residency content into the fourth-year medical school curriculum or expanding residency training to four years to enhance the breadth or depth of competency;
- place of training, such as increased emphasis on in-home care or other nontraditional sites;
- structure of training, such as changes in the order and timing of training components; and
- measurement of competency, such as less reliance on length of time spent in a competency area or more use of clinical simulators.
The innovations tested by P4 programs are expected to initiate significant change in the content, structure and location of family physician training, according to Green.
"The value of this is that residencies have the opportunity to develop innovations in teaching family medicine that will change the future of residency training," he said. And because the application process includes approval by the residency review committee that oversees family medicine training, participating residencies will "have the opportunity to develop those changes without the traditional restrictions" set out by the residency review committee, said Green.
For more information on the project, contact Jay Fetter, P4 project manager, at jtfetter@transformed.com
"The value of this is that residencies have the opportunity to develop innovations in teaching family medicine that will change the future of residency training," he said. And because the application process includes approval by the residency review committee that oversees family medicine training, participating residencies will "have the opportunity to develop those changes without the traditional restrictions" set out by the residency review committee, said Green.
For more information on the project, contact Jay Fetter, P4 project manager, at jtfetter@transformed.com
