Expectations of the Competencies of Entering Family Medicine Residents: Do Members of the Family Agree? A CERA Study

摘要

Background and Objectives: Little information is available on what competencies family medicine program directors expect of incoming residents and whether those incoming residents can deliver on such expectations. Our aim was to determine whether there is a common set of skills that both family medicine clerkship directors and program directors agree are important for entering residents to possess and how often these are being demonstrated.Methods: This study is an analysis of data obtained in the 2014 CERA Family Medicine Clerkship Director and Program Director surveys. Clerkship directors and program directors were provided with a list of skill areas and professional characteristics and asked to rate how important it is for medical school graduates to demonstrate them as well as how many medical school graduates consistently demonstrate each skill or characteristic.Results: Both groups placed highest importance on honesty, professionalism, and communication skills among incoming residents. Clerkship directors placed higher importance on several skill areas, with program directors emphasizing professional characteristics. This division was also seen in the opinions of the two groups for how well entering residents demonstrated each area.Conclusions: Clerkship directors identify several skill sets as being more important for graduating medical students to possess compared with program directors. Program directors seem to value more personal characteristics as important for entering residents to possess rather than skills. Future implications may include a focus from family medicine clerkships on skills that are valued by program directors but not rated as commonly seen among incoming residents.(Fam Med 2016;48(8):613-17.)Family medicine clerkship directors have a broad set of curriculum goals and objectives for their clerkships whose lengths can vary from 4–8 week blocks to longitudinal scheduling across an entire year. Many different groups within medical education and the specialty have defined goals and objectives for medical student education. Medical educators are responsible for producing graduates with basic competencies in a wide range of areas with the national Family Medicine Clerkship Curriculum,1 focusing on patient care; knowledge and skills for acute, chronic, and preventive care; office visits; and the principles and roles of family medicine in our health care systems.Competencies defined by the Accreditation Council for Graduate Medical Education (ACGME) have been incorporated into residency training since 2007, and medical schools are now examining these six competency areas to determine which are most relevant to undergraduate medical education.2 Within medical schools, family medicine clerkship directors and faculty regularly examine their curricula to make sure they meet the goals and objectives of medical schools, the Liaison Committee for Medical Education, and specialty standards. However, anecdotally, there has been increasing concern expressed at national meetings by some family medicine residency program directors that entering residents are less well-prepared than past medical school graduates. Often the implication is that medical schools are failing in their responsibilities to provide a well-rounded, general education to their students. There is also concern expressed over the wide variability in the apparent preparedness of US graduates entering family medicine residency programs. These concerns mirror those reported across specialties for a number of years.3,4A number of family medicine researchers have described predictors of residency success, as well as attempted to characterize program director expectations for incoming residents. For example, Paolo et al demonstrated that higher medical student third-year GPAs and USMLE step 1 and step 2 scores correlate with more favorable residency program director ratings.5 In terms of new family medicine resident performance, Langdale et al examined wha