Length and content of family practice residency training

Marguerite Duane, MD, MHA; Larry A. Green, MD; Susan Dovey, MPH, PhD; Sandy Lai, MD; Robert Graham, MD; and George E. Fryer, PhD

BACKGROUND: Family practice residency programs are based largely on a model implemented more than thirty years ago. Substantial changes in medical practice, technology, and knowledge necessitate reassessment of how family physicians are prepared for practice. METHOD: We simultaneously surveyed samples of family practice residency directors, first year residents, and family physicians due for their first board recertification to determine, using both quantitative and qualitative methods, their opinions about the length and content of family practice residencies in the United States. RESULTS: Twenty seven percent of residency directors, 32% of residents, and 28% of family physicians favored extending family practice residency to four years; very few favored 2 or 5 year programs. There was dispersion of opinions about possible changes within each group and among the three groups. A majority of all three groups would be willing to extend residency for more training in office based procedures and sports medicine, but many were unwilling to extend training for more training in surgery or hospital based care. Residents expressed more willingness to change training than program directors or family physicians. Barriers to change included disagreement about the need to change; program financing and opportunity costs, such as loss of income and delay in debt repayment; and potential negative impact on student recruitment. CONCLUSION: Most respondents support the current three year model of training. There is considerable interest in changing both the length and content of family practice training. Lack of consensus suggests a period of elective experimentation may be needed to assure that family physicians are prepared to meet the needs and expectations of their patients.

Duane M, Green LA, Dovey SM, Lai S, Graham R, Fryer GE. Length and content of family practice residency training. J Am Board Fam Pract 2002;15:201-8.