Primary Care Diabetes Fellowship Programs: Developing National Standards.

The rapid and constant increase in the number of people living with diabetes has outstripped the capacity of specialists to fully address this chronic disease alone. Furthermore, although most people with diabetes are treated in the primary care setting, most primary care providers feel under-prepared and under-resourced to fully address the needs of their patients with diabetes. Addressing this care gap will require a multifaceted approach centering on primary care training in diabetes and its complications. One-year diabetology fellowship programs are well situated to provide this training. Previous research has shown that the higher the diabetes-specific volume of patients seeing a primary care physician was, the better the quality outcomes were across six quality indicators (eye examinations, LDL cholesterol testing, A1C testing, prescriptions for ACE inhibitors or angiotensin receptor blockers, prescriptions for statins, and emergency department visits for hypoglycemia or hyperglycemia). Primary care diabetes fellowships have existed for many years, but the number of fellowships and fellowship positions has recently grown dramatically. This article proposes a standardized curriculum for such programs and makes the case for increasing their number in the United States.

Resident characteristics to evaluate during recruitment and interview: a Delphi study.

BACKGROUND AND OBJECTIVES: The recruitment and interview process for medical residency programmes is a time- and resource-intensive effort. There is very little research to guide programmes when evaluating residency candidates. This study represents one step in identifying candidate characteristics to assess during the recruitment and interview process. METHODS: Sixteen expert interviewers from 14 family medicine residency programmes in North Carolina participated in a three-round Delphi study to build consensus around a ranked list of successful resident candidate characteristics. An interrater reliability analysis produced average pair-wise agreement and Krippendorff's Alpha coefficients. RESULTS: Clinical skills, medical knowledge, interpersonal and communication skills, critical thinking, and professional and ethical behaviour were the highest ranked characteristics. Average pair-wise agreement for rounds two and three were 6.30 and 11.04%, respectively. CONCLUSIONS: Residency programmes may benefit from using an empirically studied list of characteristics to evaluate candidate applications and interviews. Future research should include national surveys of expert interviewers from a variety of residency programmes and a longitudinal study to correlate interview evaluations using the ranked list with measures of residency success.