Participating FM AIRE Programs

Cahaba + UAB Family Medicine Residency Program

Location: Birmingham, Alabama

Program Director: John B Waits, MD, CPE, FAAFP

The Cahaba+UAB Family Medicine Residency offers an optional 4-year curriculum that integrates fellowship training into the core residency program. Key innovations include:

1. Offering residents the choice in PGY-2 year to opt into a 4-year track with focused training in areas like obstetrics, sports medicine, emergency medicine, or global health.
2. Using a longitudinal integrated curriculum that interleaves advanced training throughout PGY-3 and PGY-4 years, rather than separating residency and fellowship.
3. Developing new areas of concentration beyond existing fellowships, such as ultrasound/echo, endoscopy, rural medicine, and leadership development.
4. Implementing competency-based assessments using Entrustable Professional Activities (EPAs) to guide progression.
5. Aiming to produce graduates with clinical mastery in chosen areas while maintaining broad family medicine skills, to better serve rural and underserved communities.

This model allows for more comprehensive training tailored to family medicine residents’ career goals and community needs.

Greater Lawrence Family Medicine Residency

Location: Lawrence, Massachusetts

Program Director: Nicholas Weida, MD

The Lawrence Family Medicine Residency program has a fully integrated, mandatory 4-year residency curriculum in Family Medicine. Key features include:

1. Extending training to 4 years for all residents, with 6 additional months of required core rotations in areas of societal need (e.g., care of women and children, practice and health system management, population health) and 6 months in an Area of Concentration (AOC).
2. Providing up to 50% additional clinical encounters and continuity experiences.
3. Using competency-based assessment to accelerate development of clinical mastery, with particular focus on high-level (Level 5) Family Medicine Milestones.
4. Tailoring curricula to individual resident needs and community health priorities.
5. Aiming to produce graduates with broader scope of practice and advanced skills to better serve in rural, underserved, and academic settings.

This model builds on the program’s extensive experience (minimum 8 years) operating a fully integrated 4-year residency curriculum as a participant in the ACGME Length of Training Pilot.

The goal is to study how extended, tailored training can enhance physician development, improve patient outcomes, and better meet workforce and community health needs.

John Peter Smith Family Medicine Residency Program

Location: Fort Worth, Texas

Program Director: Daniel Casey, MD

The JPS Family Medicine Residency has implemented and expanded its optional, integrated 4-year curriculum in family medicine. Key features include:

1. Offering residents the choice to opt into a 4-year track with focused training in areas like maternal child health, advanced rural medicine and surgery, behavioral medicine, and others.
2. Integrating fellowship training longitudinally across years 3-4 for sports medicine, geriatrics, and hospice/palliative care, rather than the traditional “3+1” model.
3. Developing more specific Entrustable Professional Activities (EPAs) to guide competency assessment in each track.
4. Using principles of Rawlsian justice to address maldistribution of medical care in underserved areas and offering advanced training opportunities to resident who plan to practice in underserved areas.
5. Aiming to produce graduates with broader scope of practice and advanced skills to serve in rural, underserved, and academic settings.

This model builds on JPS’s 17 years of experience offering optional 4-year tracks and participation in the P4 Initiative and ACGME Length of Training Pilot. The goal is to study how extended, tailored training can enhance physician development, improve patient outcomes, and better meet workforce and community health needs, particularly in medically underserved areas.

Mercy Family Medicine Residency

Location: St. Louis, Missouri

Program Director: Sarah Cole, DO

The Mercy Family Medicine Residency has implemented an optional, integrated 4-year curriculum with a focus on community-based primary care-led obesity management. Key features include:

1. Offering residents the choice to extend residency to 48 months by completing an additional area of concentration (AOC) in obesity management.
2. Integrating obesity medicine training longitudinally across years 3-4 for those who opt in, rather than as a separate fellowship.
3. Developing curriculum and assessments based on Obesity Medicine Education Collaborative (OMEC) competencies, mapped to Family Medicine Entrustable Professional Activities (EPAs).
4. Aim to produce graduates with advanced skills in obesity management who can incorporate this expertise into community-based family medicine practice.
5. Focusing on addressing health disparities and improving access to obesity care in underserved areas.

This model builds on Mercy’s existing family medicine program and partnerships with obesity medicine experts. The goal is to study how extended, tailored training can enhance physician development in obesity management, improve patient outcomes, and better meet workforce and community health needs, particularly in medically underserved areas.

Middlesex Family Medicine Residency

Location: Middletown, Connecticut

Program Director: Kimberly Legere-Sharples, MD, MS, MEd.

The Fully Integrated 4-year residency in Family Medicine at Middlesex FMR is an innovative approach to family medicine residency training that extends the standard 3-year program to 4 years. This model aims to enhance the breadth and depth of resident training to better meet societal needs and prepare graduates for the evolving healthcare landscape. Key features of this innovation include:

1. Enhanced core curriculum: An additional 6 months of required experiences for all residents in areas of societal need, such as care of women and children, practice and health system management, and population health.
2. Area of Concentration (AOC): 6 months of immersion and advanced skill development in a specific area of passion or anticipated practice need, such as surgical obstetrics, academics, or advanced behavioral health.
3. Increased continuity experience: Up to 50% additional clinical encounters in all areas of Family Medicine.

The goals of this innovation are to:

1. Support the development of advanced expertise and clinical mastery
2. Spur educational and clinical innovation
3. Improve patient outcomes
4. Enhance social accountability and community responsiveness of Family Medicine residency programs
5. Increase the workforce of broadly trained residency graduates with advanced skills

This innovation builds on 15 years of experience with 4-year residency programs and aims to provide a model for other residency programs seeking to increase both breadth and depth of resident training.

Oregon Health and Science University Family Medicine Residency

Location: Portland, Oregon

Program Director: Joe Skariah, DO

OHSU has implemented a required 4-year curriculum called Fellowship Integration into Residency Education (FIRE). Key features include:

1. Extending residency to 48 months for all residents, with the first two years focused on broad family medicine training and years 3-4 allowing for advanced GME experiences.
2. Integrating fellowship training longitudinally across years 3-4 in areas like sports medicine, hospice/palliative care, clinical leadership, and others. This allows residents to potentially earn fellowship certifications within the 4-year program.
3. Developing more specific Entrustable Professional Activities (EPAs) to guide competency assessment throughout the 4 years.
4. Maintaining continuity clinic and family medicine experiences throughout all 4 years, even during fellowship tracks.
5. Offering a comprehensive family medicine track for residents not pursuing fellowship certification.
6. Aiming to produce graduates with broader scope of practice and advanced skills to serve in rural, underserved, and academic settings.

This model builds on OHSU’s 15 years of experience offering an optional 4-year curriculum during the ACGME Length of Training Pilot. The goal is to study how extended, integrated training can enhance physician development, improve patient outcomes, and better meet workforce and community health needs. The proposal includes a partnership with Ventura County Medical Center to implement a similar model.

Riverside Methodist Family Medicine Residency

Location: Columbus, Ohio

Program Director: Stephen Auciello, MD

OhioHealth Riverside has implemented an optional, integrated 4-year (PGY2-PGY4) Leadership Area of Concentration (AOC) in healthcare leadership and medical education within their family medicine residency. Key features include:

1. Offering up to 2 residents per class the option to extend residency from 3 to 4 years, with focused training in advance healthcare leadership and medical education.
2. Integrating leadership training longitudinally across years 2-4, including experiences in health systems science, team leadership, and practice management.
3. Maintaining continuity clinic throughout all 4 years, with PGY4 residents providing at least three half-days per week of patient care.
4. Having PGY4 residents take on teaching and mentoring roles for PGY1-3 residents, including co-teaching quality improvement curriculum and supporting office QI initiatives.
5. Developing specific Entrustable Professional Activities (EPAs) for leadership and teaching skills, mapped to relevant Healthcare Administration, Leadership, and Management principles and Clinician Educator milestones.
6. Using a variety of assessment methods including direct observation, educator portfolios, multi-source feedback, and reflective journaling to evaluate AOC residents’ progress.
7. Aiming to produce graduates with enhanced clinical, teaching, and leadership skills who are prepared for roles in academic family medicine and healthcare leadership.

This model builds on Riverside’s existing family medicine program and aims to create a pipeline of skilled healthcare leaders and educators. The goal is to study how integrated leadership training can enhance physician development, improve healthcare delivery systems, and potentially help address faculty shortages in family medicine residencies.

Ventura County Medical Center Family Medicine Residency

Location: Ventura, California

Program Director: Jacob David, MD

VCMC has implemented a required 4-year curriculum as part of the Fellowship Integration into Residency Education (FIRE) consortium. Key features include:

1. Extending residency to 48 months for all residents, with a common PGY-1 and PGY-2 curriculum focused on broad family medicine training.
2. Offering advanced GME experiences in years 3-4, including tracks in Addiction Medicine, High Risk Obstetrics, Global Health, Advanced Hospital Medicine, and Comprehensive Family Medicine.
3. Integrating existing fellowship programs (e.g., Addiction Medicine) into the 4-year model, potentially allowing residents to earn board eligibility for Certificates of Added Qualification.
4. Maintaining continuity care practices throughout all 4 years of training.
5. Using Entrustable Professional Activities (EPAs) and Family Medicine Milestones to guide skill development and assessment.
6. Focusing on training “generalist specialists” prepared to practice in under-resourced settings, including rural and international locations.

This model aligns with VCMC’s long-standing mission of training full-spectrum family physicians for underserved areas. The program aims to preserve core components of broad training while providing advanced skills to meet community needs. VCMC will collaborate closely with OHSU to implement and study this innovative approach to family medicine residency education.