Creating the Future of Family Medicine with 4-year Residency at OHSU

4yearThe OHSU Department of Family Medicine has launched a four-year residency program aimed at expanding curriculum through the development of additional competencies.

In July, the Accreditation Council for Graduate Medical Education notified the department that it was one of 12 residency programs selected to participate in the organization's 4-year Length of Training pilot.

"Residency education in family medicine has been fairly static since the establishment of our specialty," said Roger Garvin, MD, Residency Director. "We're re-envisioning what our curriculum should look like and, as a part of that, extending our curriculum into a fourth year.

The Affordable Care Act, and the increase in the emphasis on primary care, calls for new residency graduates who can lead and adapt to change.That adaptability is just one area the four-year curriculum is focused on.

"The health-reform process in our country will require family physicians who have new and expanded skill sets," said John Saultz, MD, Department Chair."This is particularly true in Oregon where the reform process is ahead of much of the rest of the country.To prepare family physicians to practice in this environment, a new model of residency program is required.We are trying to create that model here in Family Medicine, and we are partnering with other programs around the country to study which changes are associated with better educational outcomes."

Implementation of the 4-year Family Medicine Residency Program included the development of additional competencies:

·Change management


·Information Management

·Population Health Management

Residents will be expected to complete a minimum of 3000 patient visits during their four-year residency.Goals/outcomes of the program include residents' demonstration of proficiency in Quality Improvement Skills, capacity to use leadership skills and styles, assessment of the quality of evidence used in family medicine and efficiency of practice to the level of a junior faculty in first year practice.

This fall's interns, the Class of 2016, will be the first to complete the four-year residency.Interns said the extra year of training will give them a broader perspective and more time to pursue interests.

"I knew I would need more than three years to be able to explore my areas of interest in-depth," said Emily Waterman, MD. "I am also excited that this expanded program includes an emphasis in relevant areas such as leadership and the Patient-centered Primary Care Home, since these will be very pertinent to my career once I leave residency."

Lindsay Braun, MD, also said the additional year would provide opportunities to explore specific interests.

"Family medicine is a broad field and the prospect of being in the first group to undergo and shape changes in the curriculum is an exciting one," she added.

Family medicine physicians of the future will be expected to take on a leadership role in both patient management and health care public policy, said Jason Kroening-Roché, MD, MPH.

"At a time when health policy and primary care have never been more exciting, an extra year of training will give us the broad perspective and skills to be leaders in family medicine going forward," he said.

Kira Paisley, MD, also cited leadership training as an important component of the four-year curriculum.

"Family medicine has a very broad scope of practice and an extra year of training will hopefully make me more comfortable in my skill set," Paisley agreed. "I'm excited about the ability to tailor my training to my interests and get elective time for concentrated experiences."