Evaluating Changes in Family Medicine Applicant Characteristics Following the Onset of Virtual Interviewing.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic obliged the field of graduate medical education to pivot from in-person to virtual residency interviews in 2020. The decreased travel and financial barriers of this format could potentially lead to greater diversity and equity in the primary care workforce. We aimed to evaluate changes in applicant pools from in-person to virtual interviewing cycles. METHODS: We conducted a retrospective review of Electronic Residency Application Services (ERAS) from five US family medicine residencies across five interview cycles (three in-person and two virtual; 2017/2018 through 2021/2022). We compared geographic and demographic data about applicants as well as administrative program data. RESULTS: The study included 25,271 applicants. The average distance between applicants and programs was 768 miles during in-person interview years and 772 miles during virtual interview years (P=.27). Applicants who interviewed with programs were 446 and 459 miles away, respectively (P=.06). During in-person application years, applicants with backgrounds historically underrepresented in medicine (URM) submitted an average of 21% of applications; this increased approximately 1% during virtual interviewing years (OR, 1.08; P=.03). There were no other differences between in-person and virtual application years in rates of URM applicants. Residency programs received more applications from US medical schools (OR, 1.46; P<.0001) and were more likely to interview a US medical school applicant (OR, 2.26; P<.0001) in virtual years. Program fill rates appeared to be lower during virtual years. CONCLUSIONS: The virtual interviewing format did not appear to substantially increase the geographic, racial, or ethnic diversity of applicants, and was associated with increased applications from US medical schools.

Faculty development needs in residency redesign for practice in patient-centered medical homes: a P4 report.

OBJECTIVES: The study's objective was to describe faculty development skills needed for residency redesign in 14 family medicine residencies associated with the Preparing the Personal Physician for Practice (P4) project. METHODS: We used self-administered surveys to assess ratings of existing faculty development efforts and resident attitudes about faculty teaching between 2007 and 2011. Telephone interviews were conducted to assess faculty development activities and needs at baseline. Early project faculty development needs were addressed using tailored sessions delivered during site visits. We conducted a detailed content analysis of 14 site-specific comprehensive reports to characterize ongoing faculty development needs and faculty themes related to residency redesign. RESULTS: Early in the P4 project, faculty needs included skills in using the electronic health record (EHR) in teaching, change management, curriculum design, evaluation, learning portfolios and individualized learning plans, career coaching, qualitative research, competency-based assessment, and leadership. As the project progressed, the need for a "learning together" approach when training residents in transformed practices emerged. Using the EHR more effectively, evaluation and competency-based assessment skills, individualized curriculum design, better career coaching skills, shared leadership, and team-based care skills were consistent faculty development needs. Redesign strategies included having a committed core faculty group, faculty retreats, curricular change process management, intra-residency collaboration, and providing adequate support for key individuals. CONCLUSIONS: Faculty attempting to redesign residencies to train residents in patient-centered medical homes need new skills, and understanding these needs can inform faculty development programs nationally to achieve the crucial mission of training the workforce to accomplish this transformation.

Implementing radical curriculum change in a family medicine residency: the majors and masteries program.

BACKGROUND AND OBJECTIVES: There have been dramatic changes in the specialty of family medicine and the American health care system in the more than 40 years since the formation of the specialty. As a result, there is urgent need for experimentation and innovation in residency training to better prepare family physicians. METHODS: Waukesha Family Medicine Residency used a strategic planning process to identify four guiding concepts for a new model of residency education: intentional diversification; options for advanced training in a fourth year of residency; longitudinal, competency-based training; and strong fundamental background in family medicine skills. These concepts guided radical restructuring of the curriculum. RESULTS: The new Majors and Masteries curriculum begins with 19 months of training in core family medicine skills. Residents then elect to pursue a Major or Mastery in an area of interest. Majors are completed within 3 years, while Masteries are completed in 4 years and include advanced training (MPH, MBA, advanced obstetrics). Since implementation, residents have selected a broad range of Majors, three residents have elected advanced training in three different mastery areas, and resident recruitment has not been disrupted. CONCLUSIONS: The Majors and Masteries curriculum and the process used to implement it may benefit other residencies considering radical curriculum change.