University- Versus Community-Based Residency Programs: Does the Distinction Matter?

Chen, J. Gene; Saïdi, A.; Rivkees, Scott A.; Black, Nicole Paradise

doi:10.4300/jgme-d-16-00579.1

Cited by 20 publications

(15 citation statements)

References 26 publications

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“…13 In contrast, graduates of medical school-based pediatric and general surgery residency programs had higher first-time board pass rates compared to graduates of community-based programs. 8,14 While not a main outcome of this study, we noted the respondents' scope of practice was narrowed due to forces beyond the adequacy of their preparation (TABLES 2 and 3). For instance, while a majority of graduates reported feeling adequately prepared to practice newborn hospital care, pediatric hospital care, maternity care, and ICU, less than half of them reported providing these services currently.…”

Section: Discussionmentioning

confidence: 83%

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

Carek

Mims

Kirkpatrick

et al. 2020

Journal of Graduate Medical Education

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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.

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Section: Discussionmentioning

confidence: 83%

“…At present, this information is often unavailable. [4][5][6][7][8] The aim of this study was to examine self-reported preparation for practice, practice patterns, and American Board of Family Medicine (ABFM) board examination pass rate of family physicians based on the type and setting of the residency program in which they trained.…”

Section: Introductionmentioning

confidence: 99%

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

Carek

Mims

Kirkpatrick

et al. 2020

Journal of Graduate Medical Education

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“…However, recent literature also questions whether the distinction may not matter as much in the future with the frequent consolidation and mergers of large hospital systems; these chasms may cease in this day and age. 18 This exploratory analysis is no in any way meant to definitively establish a definition of county programs, but rather to identify common themes, offer some direction to residency applicants, and most importantly, begin a discussion among the EM community.…”

Section: Implic Ations For Educ Ation and Tr Aining In Emmentioning

confidence: 99%

Defining “county”: A mixed‐methods inquiry of county emergency medicine residency programs

Buchanan

Moreira

Taira

et al. 2021

AEM Education and Training

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IntroductionThere is no clear unified definition of “county programs” in emergency medicine (EM). Key residency directories are varied in designation, despite it being one of the most important match factors for applicants. The Council of Residency Directors EM County Program Community of Practice consists of residency program leadership from a unified collective of programs that identify as “county.” This paper's framework was spurred from numerous group discussions to better understand unifying themes that define county programs.MethodologyThis institutional review board–exempt work provides qualitative descriptive results via a mixed‐methods inquiry utilizing survey data and quantitative data from programs that self‐designate as county.Unique treatment, analysis and critiqueMost respondents work, identify, and trained at a county program. The majority defined county programs by commitment to care for the underserved, funding from the city or state, low‐resourced, and urban setting. Major qualitative themes included mission, clinical environment, research, training, and applicant recommendations. Comparing the attributes of programs by self‐described type of training environment, county programs are typically larger, older, in central metro areas, and more likely to be 4 years in duration and have higher patient volumes when compared to community or university programs. When comparing hospital‐level attributes of primary training sites county programs are more likely to be owned and operated by local governments or governmental hospital districts and authorities and see more disproportionate‐share hospital patients.Implications for education and training in EMTo be considered a county program we recommend some or most of the following attributes be present: a shared mission to medically underserved and vulnerable patients, an urban location with city or county funding, an ED with high patient volumes, supportive of resident autonomy, and research expertise focusing on underserved populations.

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“…Resource allocation and program structures can vary between residency program types of various specialties, underscoring the importance of focusing on a single specialty field. Such as, community based programs are smaller than university based program (Chen, Saidi, Rivkees, & Black, 2017), allowing residents to learn in variable clinical environments (Chen. et al, 2017;Howe A., & Ives G., 2001).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Training and Performance Differences in US Internal Medicine Residents Trained in Community- and University-Based Programs – a Systematic Review

Rehman

2018

JCT

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Introduction:Residents’ learning and performance depends on program structures, clinical setting and faculty mentors; however,performance differences between and community based vs. university based residents have not been exploredsystematically.Objectives:To systematically review the performance differences between internal medicine residents trained in community-basedprograms [CBPs] versus university-based programs [UBPs] in the US.Methods:Eligible studies were identified in Medline and Embase databases from 1990- June 2018. Eligible studies comparedlearning and performance differences between UBP and CBP internal medicine residency programs aligned withACGME recommendations.Results:Out of 4916 titles, 14 cross-sectional studies were included in the analysis. Diverse reporting among the includedstudies precluded meta-analysis. Significant differences were found in specific practice areas, such as knowledge aboutHIV, nutrition training, and program accreditation cycle. Residents in UBPs participated more often in hypothesisdriven research and had higher publication rates than residents in CBPs. Residents trained in CBPs experienced moreburnt out than those in UBPs and had higher prevalence of residents with problematic behaviors and deficiencies.Nonsignificant differences were found among residents regarding ABIM pass rate, medical procedures, and publichealth training.Conclusion:Our review reports inconsistent trends in residents’ learning and performances following RRC- IM and ACGMErecommendations. Significant differences were noted in areas that required more practice and system based learning,non-procedural skills and patient care. Future studies with larger sample sizes and adjusted analyses are needed toevaluate the difference between residents’ performance and learning in UBPs versus CBPs.

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University- Versus Community-Based Residency Programs: Does the Distinction Matter?

Cited by 20 publications

References 26 publications

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

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

Defining “county”: A mixed‐methods inquiry of county emergency medicine residency programs

Training and Performance Differences in US Internal Medicine Residents Trained in Community- and University-Based Programs – a Systematic Review

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