The OHSU Department of Family Medicine: Leading through educational innovation

More than 20 percent of School of Medicine graduates chose a family medicine residency during the three-year period analyzed by the AAFP. The achievement award was presented May 3 during the Society of Teachers of Family Medicine Annual Spring Conference. John Saultz, M.D., chair of the Department of Family Medicine, accepted the award at the Baltimore, Md., conference.

"The quality of our faculty in the Department of Family Medicine provide exceptional examples for our students about the role of family medicine in a comprehensive integrated health care system, which is at the root of this success," said Dean Mark Richardson. "The department contributes significantly to our educational accomplishments."

Recently, the department has undertaken additional innovations in its graduate-level curriculum for family medicine. In 2012, the Department of Family Medicine was selected for an innovative, four-year residency program aimed at expanding curriculum through the development of additional competencies, including change management, leadership, information management and population health management. The Accreditation Council for Graduate Medical Education is conducting the four-year Length of Training pilot.

"The evolving landscape of health care will require family physicians who have new and expanded skill sets," said Dr. Saultz. "We believe that a different model of residency program will better prepare physicians to lead in this rapidly changing practice environment."

The pilot-residency program adds one year to the traditional three-year program. Residents who complete the expanded training program will be expected to demonstrate proficiency in quality improvement skills, a 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.

"I knew I would need more than three years to be able to explore my areas of interest in-depth," said Emily Waterman, M.D., a resident in the first cohort of the expanded program. "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."

The four-year pilot program is not without skeptics; some people believe that adding time to training constrains the pipeline and reduces the pace at which new physicians enter the workforce. Dr. Saultz and educational leaders in the department have a different view.

"Access to primary care is essential to the success of health care reform. Simultaneously, the skill set needed for primary care physicians is also expanding. A goal of the four-year residency program is to prepare our family medicine physicians to be leaders in this evolving team-based, technology-heavy environment," said Dr. Saultz.

The competitiveness of the Department of Family Medicine's residency program is a testament to the recognition of the importance of educational innovation in this era of health care reform. In 2013, 1,241 applicants vied for 12 spots in family medicine, and there were 1,004 applicants for eight spots in Family Medicine Cascades East (in Klamath Falls). U.S. News & World Report named OHSU's family medicine education program fifth in the nation in its 2014 rankings.

OHSU also received recognition from the AAFP in 2012.


Innovation at work

OHSU Family Medicine at Richmond exemplifies new care models in an era of health care reform. Community outreach workers and family medicine physicians at Richmond are working with Health Share of Oregon – the coordinated care organization OHSU is participating in – to tackle longstanding health system challenges. One patient, who was featured on Oregon Public Broadcasting, was able to dramatically reduce the number of times he visited OHSU's emergency room as a result of care coordination with Lisa Pearlstein, community outreach worker, and Christina Milano, M.D., assistant professor of family medicine.


Pictured (l to r): Dr. Saultz accepts the AAFP award, presented by Jeffrey Cain, M.D., AAFP president.