Fellowship Integration into Residency Education
Fellowship Integration into Residency Education Consortium
A Four Year Family Medicine Residency Training Innovation
Problem Statement:
Can we train residents with the depth to meet their future practices utilizing embedded fellowship experiences while training in the breadth of family medicine within a 4 year residency?
Proposed Solution
Required 4 year residency for all residents
Program with strong generalist clinical core training through all 4 years
Residency with flexibility to customize training to supplement resident interests to achieve mastery of skills to meet community needs
Hypotheses or Questions
We are still in development, but we have spent time asking:
- What’s our north star? Full spectrum care is our value.
- How do we train people to articulate and advocate for that north star?
- What’s our consortium’s identity?
- What do we care about?
- How will AIRE change the perception of residents and their ability to do
things? - What is a family doctor? What should it be?
- How do we define the discipline and teach residents to be the thing we
want them to be? - How do we remake our role in the world?
- How do we make communities healthier?
Our Key Measures
Work in progress, but we are exploring:
- Distribution and success of graduates with fellowship skills and advanced skills
- Scope of practice of graduates
- Graduate practice/work setting (size and type of work)
- Quality of clinical care and continuity in residency practices
- Effects on residency practices
- Wellbeing of residents
- Graduate satisfaction
- Programmatic outcomes
- Resident Skills
- Effects on community needs
- Process of residency transitions (from 3 to 4 years)
- Validation of Family Medicine EPAs as a competency-based assessment tool
Expected Impediments
- Faculty Development and Faculty Buy-In
- Lack of understanding from non-core faculty about AIRE
- Chaos that comes with storming/group formation
- Lack of clarity regarding Board certification for AIRE fellowships
- Funding to explore our questions
- How to fully incorporate CBME into the AIRE program
Expected Enablers
- Experience from P4 and LOT
- Applicant Interest
- History of our programs
- Commitment from our program leadership
- Partnership between the ABFM and ACGME and a willingness for
ongoing support
Competency Based Medical Education
We have proposed 7 EPA Descriptions to evaluate/validate:
- Inpatient Family Centered Care of the Pregnant and Postpartum
Patient; - Outpatient Family Centered Care of the Pregnant and Postpartum
Patient; - Inpatient Family Centered Care of the Adult Patient;
- Outpatient Family Centered Care of the Adult Patient;
- Inpatient Family Centered Care of the Pediatric Patient;
- Outpatient Family Centered Care of the Pediatric Patient; and
- In-depth skills that meet the needs of the resident’s future
community.
Issues Needing Assistance
- Access to data about family medicine graduates from the ABFM (our program
vs all programs) - An ability to influence questions that are asked by the ABFM
- A forum to disseminate our findings—via existing publications and conference
settings - Identification of an external review committee
- Ongoing support to meet—regionally and nationally
- Help with various certifying boards that accredit fellowships
Our Inspiration
