Does Community- or University-Based Residency Sponsorship Affect Graduate Perceived Preparation or Performance?

Abstract

Background Residency training occurs in varied settings. Whether there are differences in the training received by graduates of community- or medical school–based programs has been the subject of debate. Objective This study examined the perceived preparation for practice, scope of practice, and American Board of Family Medicine (ABFM) board examination pass rates of family physicians in relation to the type of residency program (community, medical school, or partnership) in which they trained. Methods Predetermined survey responses were abstracted from the 2016 and 2017 National Family Medicine Graduate Survey of ABFM and linked to data about residency programs obtained from the websites of national organizations. Descriptive statistics were used to summarize the data and logistic regression to examine differences between survey results based on type of residency training: community, medical school, or partnership. Results Differences in the perception of preparation as well as current scope of practice were noted for the 3 residency types. The differences in perception were mainly noted in hospital-based skills, such as intubation and ventilator management, and in women's health and family planning services, with different program types increasing preparedness perception in different domains. Conclusions In general, graduates of family medicine community-based, non-affiliated, and partnership programs perceived they were prepared for and were providing more of the services queried in the survey than graduates of medical school–based programs.

Using the Family Medicine National Graduate Survey to Improve Residency Education by Monitoring Training Outcomes

“…Research studies using data from the Graduate Survey have shown a large gap between practice and preparation 4 with further variation between academic-and community-based programs. 5 Other studies using the data have shown lower odds of burnout with broader scope of practice, 6 state-level variation in burnout, 7 associations between residency training and buprenorphine prescribing, 8 barriers to practicing obstetrics, 9 provision of contraceptive services and abortion care, 10,11 and participation in loan repayment programs. 12 Possible Uses and the Future With multiple years of data, residencies have the capability to identify persistent gaps in their curricula and make changes.…”

The Practice Is the Curriculum

“…31 Conversely, a recent graduate survey indicated that graduates' actual practice scope was narrower compared with the scope they felt prepared to provide. 32 Thus, ensuring residents continue to provide a comprehensive scope of care will mean balancing training opportunities with what is needed and should be provided in the community setting. Part of comprehensiveness is focusing on quality of care for both prevention and chronic disease.…”

Ongoing Self-review and Continuous Quality Improvement Among Family Medicine Residencies

“…This information was used in a QI project that lead to a significant decrease in the readmission rate to an inpatient family medicine team. 10 For overall program improvement to truly occur, the patient care, scholarship, and community activities of graduates need to be assessed and used in program improvement activities. Currently programs are only required to monitor board pass and certification rates of graduates.…”

“…12 This tool has been used in the literature to further assess family medicine residency training. 10 The discipline needs to go beyond this graduate survey and include patient quality of care measures, patient satisfaction surveys, and community activities of graduates.…”