The Task Force on Medical Education of the Future of Family Medicine project calls for residency programs to be individualized to learners’ needs and to offer expanded educational opportunities in areas needed by graduates. (1)
The Residency Assistance Program’s guidelines for excellence also encourage that “an individualized educational plan should be developed for residents as they matriculate into the residency program.” (2)
Traditional approaches to meeting individual residents’ needs include elective rotations and post-residency fellowships. Unfortunately, the number of residents who desire fellowship training greatly exceeds the number of available positions. Individual electives are generally available and effective in meeting residents’ needs for brief clinical experiences. However, many residents desire a more structured and focused curriculum with greater depth, breadth and evaluation methodology, as well as some form of recognition for their advanced training in a particular area within the traditional structure of the Family Medicine Residency.
The Association of Family Medicine Residency Directors Board of Directors has recommended that the Area of Concentration concept be offered as a tool for individual programs to use as an aid in designing individual education plans for residents.
Guidelines for Individual Areas of Concentration
A. Written program of study including competency-based goals and objectives. Evaluation measures should be included.
B. Faculty mentor is to be identified and the resident will review their progress periodically with their faculty mentor.
C. Suggested time frame is 4 to 8 months duration. Focused blocks of time (4 week block electives) and/or longitudinal components are possible formats. Specific time frames will vary based on goals and objectives as chosen by the resident.
D. Scholarly Project – must be presented at least locally, although presentation at the state or national level is encouraged. (Resident is responsible for funding travel and other related expenses. Use of discretionary funds is allowed.)
E. Resident will attend a CME meeting in the AOC. (Resident is responsible for funding travel and other related expenses. Use of discretionary funds is allowed.)
F. Resident will present a critical appraisal of a current journal article in their AOC.
G. Quality outcomes should be demonstrated and documented in the AOC with case logs, patient outcome data and faculty reviews of resident competency, as appropriate to the AOC goals and objectives.
H. A letter summarizing the training completed will be written by the Program Director for placement in the resident’s portfolio and attached to the final residency completion letter.
Interested residents are encouraged to develop (in consultation with their Faculty Advisor and/or selected AOC mentor) and complete an Area of Concentration during their training.
Some potential topic areas include, but are not limited to:
Advanced Obstetrics*
CAM / Integrative Medicine*
International Health*
Sports Medicine
Academic Family Medicine / Research
Behavioral Medicine
Urgent Care / Emergency Medicine
Geriatrics*
Adolescent Medicine
Sleep Medicine
*draft available
References:
Bucholtz JR, et. al. Task Force Report 2: Report of the Task Force on Medical Education. Ann Fam Med. 2:S51-S64(2004).
RAP Criteria for Excellence, 6th edition p. 21
Frank SH, Smith CK. Areas of Concentration Programs in University-based Family Practice Residency Training. Family Medicine. Vol. 25, April 1993, pp. 242-4.
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