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This is something that's been getting a little more steam in the past couple of years; what are your thoughts about increasing the current GME to four years? (Personally, I think it's way overdue.)
hidradenitis said:This is something that's been getting a little more steam in the past couple of years; what are your thoughts about increasing the current GME to four years? (Personally, I think it's way overdue.)
eddieberetta said:It is an absolutely atrocious idea. We as physicians are pricing (and educating) ourselves out of the market. It makes absolutely no sense that the POST graduate component of a PHYSICIAN training program in family medicine should be YEARS longer than that of mid-level providers who can do exactly the same thing. Also what does it say about med school -- it is such a waste of time that no one who attends can practice any sort of medicine without 4 years of additional training??
It is ludicous that a nurse or PA can train into general practice faster than a surgeon. This would make it even harder?!? This sort of thing will be the nail in the coffin for physician participation in primary care.
Terrible idea. We should be doing the opposite. We have to recognize what the allied providers have already figured out: on the job training and learning is not such a bad thing...
THREE-YEAR FAMILY MEDICINE RESIDENCY CURRICULUM
Goal: Design a curriculum that emphasizes family medicine knowledge, skills, and attitudes in office-based care and coordination of care, and that allows flexibility to develop moderate focused ambulatory expertise in some areas.
Family Medicine Expertise
Physician-patient relationships
Chronic disease management
Urgent/emergent care
Community medicine
Coordinated care
Biopsychosocial model of care
Proactive management of the practice
Focused Expertise (Examples)
Geriatrics
Sports medicine
Behavioral medicine
Adolescent medicine
Office-based procedures
Principles for Curriculum Design
Learning begins in the Family Practice Center/ambulatory area and continues throughout the 3 years
Occur in an open-access practice that is accessible, available, and efficient
Emphasize the development of physician-patient relationships over time
Emphasize continuous quality improvement, both in the process of care and in the outcomes of care
Teach management of the practice and its population utilizing:
Practice rounds
Active precepting
Proactive patient interventions
Utilize electronic information systems to monitor physician activity, patient care quality and practice outcomes
Become the primary site for much of the ambulatory subspecialty teaching: procedures, orthopedics, otolaryngology, dermatology, etc
Hospital rotations deemphasized as part of the educational experience
The doctor-patient relationship is a fundamental part of the practice, learning and evaluation
This relationship is maintained throughout a variety of health care settings.
Competency measures of knowledge, skills, and attitudes are both periodic and ongoing and form the basis for advancement
Management of the practice from an individual to a population perspective is emphasized
FOUR-YEAR FAMILY MEDICINE CURRICULUM
Goal: Design a curriculum that generates additional knowledge, skills, and attitudes in family medicine and facilitates attainment of in-depth expertise in 1 or 2 domains of family medicine.
Family Medicine Expertise
Physician-patient relationships
Chronic disease management
Urgent/emergent care
Community medicine
Coordinated care
Biopsychosocial model of care
Proactive management of the practice
Focused Expertise (Examples)
Geriatrics
Obstetrics/women?s care
Sports medicine
Adolescent medicine
Behavioral medicine
Research/teaching
In-patient care
Rural care
Advanced procedural abilities
Principles for Curriculum Design First 3 years build toward the fourth year
Ambulatory focus, from start to finish
An individual program may be able to offer only 1 or, at most, a choice of 2 focused areas for the year
Competency measurements would run through the program
Flankstripe said:Four year Family Medicine residency? Bad idea. In Canada, FM is a two year residency and still consistently can't attract residency applicants. A four year residency would just about completely kill off FM as a specialty; it can only make it even more unpopular than it already is.
sdude said:FP's do fine with three--if they want additional training in some area of interest--that's what fellowships are for. I would much rather have a three year residency with a "Family Practice Surgery" CAQ or Sports Medicine CAQ ... As I mentioned, that's what CME and fellowships are for.
hidradenitis said:I have to admit this is probably the most realistic option out there. Even so, the fellowship opportunities available to FP's could stand some improvements. The Sports Med and Geriatric CAQs are well and good; why not standardize the OB and EM/Urgent Care fellowships? Or a 'FP Surgery' or Rural Care CAQ? What about a two year EM fellowship that gives you ABEM certification? Seems there's a lot that could be done to increase options.