scholarly journals A cross-sectional study of United States family medicine residency programme director burnout: implications for mitigation efforts and future research

2020 ◽  
Vol 37 (6) ◽  
pp. 772-778
Author(s):  
Tamatha M Psenka ◽  
John R Freedy ◽  
Lisa D Mims ◽  
Alec O DeCastro ◽  
Carole R Berini ◽  
...  
Keyword(s):  
Medical Education ◽  
Depressive Symptoms ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Emotional Exhaustion ◽  
Future Research ◽  
Programme Director ◽  
Family Medicine Residency ◽  
Graduate Medical ◽  
Residency Programme

Abstract Background Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority residency programme directors. Objective This study assessed symptoms of burnout (emotional exhaustion, depersonalization) and depression along with evidence-based individual and environmental risk factors in a U.S. sample of family medicine residency programme directors. Methods The omnibus 2018 Council of Academic Family Medicine Education Research Alliance survey was used to contact programme directors at all Accreditation Council for Graduate Medical Education accredited U.S. family medicine residency programmes via email. Descriptive data included programme director and programme characteristics, Areas of Worklife (workload, values and control), loneliness (lack companionship, feel left out and feel isolated), burnout (emotional exhaustion, depersonalization) and depressive symptoms. Chi-square tests contrasted descriptive variables with burnout and depressive symptoms. Logistic regression (LR) modelled associations between significant descriptive variables and burnout and depressive symptoms. Results The survey response rate was 45.2% (268/590). Programme directors reported: emotional exhaustion (25.0%), depersonalization (10.3%) and depressive symptoms (25.3%). LR models found significant associations with emotional exhaustion (Workload: lacking time and other work-related resources); lack of companionship, depersonalization (North West Central residency region; Workload and lack of companionship) and depressive symptoms (Black/African American ethnicity). Conclusions One-quarter of U.S. programme directors report burnout or depressive symptoms. Future research should consider associated variables as possible intervention targets to reduce programme director distress and turnover.

scholarly journals Addressing the Scholarly Activity Requirements for Residents: One Program's Solution

2011 ◽  
Vol 3 (3) ◽  
pp. 379-382 ◽  
Author(s):  
Peter J Carek ◽  
Lori M Dickerson ◽  
Vanessa A Diaz ◽  
Terrence E Steyer
Keyword(s):  
Medical Education ◽  
South Carolina ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Residency Program ◽  
Scholarly Activity ◽  
University Of South Carolina ◽  
Family Medicine Residency ◽  
Graduate Medical ◽  
Regional Medical

Abstract Background Scholarly activity as a component of residency education is becoming increasingly emphasized by the Accreditation Council for Graduate Medical Education. “Limited or no evidence of resident or faculty scholarly activity” is a common citation given to family medicine residency programs by the Review Committee for Family Medicine. Objective The objective was to provide a model scholarly activity curriculum that has been successful in improving the quality of graduate medical education in a family medicine residency program, as evidenced by a record of resident academic presentations and publications. Methods We provide a description of the Clinical Scholars Program that has been implemented into the curriculum of the Trident/Medical University of South Carolina Family Medicine Residency Program. Results During the most recent 10-year academic period (2000–2010), a total of 111 residents completed training and participated in the Clinical Scholars Program. This program has produced more than 24 presentations during national and international meetings of medical societies and 15 publications in peer-reviewed medical journals. In addition, many of the projects have been presented during meetings of state and regional medical organizations. Conclusions This paper presents a model curriculum for teaching about scholarship to family medicine residents. The success of this program is evidenced by the numerous presentations and publications by participating residents.

scholarly journals The Cost of Family Medicine Residency Training:

2018 ◽  
Vol 50 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Judith Pauwels ◽  
Amanda Weidner
Keyword(s):  
Medical Education ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Health Resources ◽  
State Funding ◽  
Financial Resources ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Graduate Medical ◽  
State Expenditures

Background and Objectives: Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. Methods: A group of family medicine residency programs have shared their financial data since 2002 through a biennial survey of program revenues, expenses, and staffing. Data sets over 12 years were collected and analyzed, and results compared to analyze trends. Results: Overall expenses increased 70.4% during this period. Centers for Medicare and Medicaid Services (CMS) GME revenue per resident increased by 15.7% for those programs receiving these monies. Overall, total revenue per resident, including clinical revenues, state funding, and any other revenue stream, increased 44.5% from 2006 to 2016. The median cost per resident among these programs, excluding federal GME funds, is currently $179,353; this amount has increased over the 12 years by 93.7%. Conclusions: For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.

scholarly journals International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends

2018 ◽  
Vol 10 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Awad A. Ahmed ◽  
Wei-Ting Hwang ◽  
Charles R. Thomas ◽  
Curtiland Deville
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
International Medical ◽  
Physician Workforce ◽  
International Medical Graduates ◽  
Graduate Medical ◽  
Medical Graduates ◽  
The Us

ABSTRACT Background  Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective  We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods  We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990–2015, the slope was estimated using simple linear regression. Results  IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. Conclusions  IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

Mapping the Balint groups to the Accreditation Council for Graduate Medical Education family medicine competencies

2017 ◽  
Vol 53 (1-2) ◽  
pp. 47-58 ◽  
Author(s):  
Albert Lichtenstein ◽  
Jumana Antoun ◽  
Chris Rule ◽  
Katherine Knowlton ◽  
Jeffrey Sternlieb
Keyword(s):  
Medical Education ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Communication Skills ◽  
Learning Opportunities ◽  
Group Discussions ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Balint Groups ◽  
Balint Group

Introduction Balint group discussions provide learning opportunities for many of the competencies and milestones put forward by the Accreditation Council for Graduate Medical Education. The current literature is mixed concerning the effect of Balint groups on communication skills and professionalism. Aim To map the content of the Balint discussion to the competencies and milestones put forward by the Accreditation Council for Graduate Medical Education. Methodology: A group who were both experts in Balint and members of the clinical competency committee of residency programs rated narratives that summarized Balint group discussions. Credentialed Leaders of the American Balint Society were invited via email to submit narratives (250 words) about Balint groups that they have led, or were leading, with residents. Results Only four narratives were submitted. Additional cases were recruited through literature review of published Balint discussion cases. A total of 25 cases were rated by the committee. There was agreement between three out of four raters on at least one core milestone in every case. The most frequent milestones were C1 (develops meaningful therapeutic relationships with patients and families), C2 (communicated effectively with patients, families, and public), Prof1 (completes a process of professionalization), and Prof3 (demonstrates humanism and cultural proficiency). Balint groups provided a learning opportunity for a subset of milestones in at least 36% of the cases. Conclusion This pilot research suggests that Balint groups and the discussions of complex and challenging cases provide learning opportunities for multiple family medicine milestones, mainly communication skills and professionalism. Further research is needed to refine the methodology and the rating system.

scholarly journals Outcomes of a Scholarly Activity Curriculum for Family Medicine Residents

2021 ◽  
Vol 53 (4) ◽  
pp. 285-288
Author(s):  
Tharani Ravi ◽  
Inez Cruz ◽  
Fozia Ali ◽  
Sandra K. Burge ◽  
Robert Wood ◽  
...  
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Scholarly Activity ◽  
Review Committee ◽  
Graduate Medical ◽  
The Impact ◽  
Education Review ◽  
Family Medicine Residents

Background and Objectives: Scholarship is essential to growth and innovation in family medicine. Moreover, the Accreditation Council for Graduate Medical Education Review Committee-Family Medicine requires family medicine residents to complete scholarly activities. However, many residents lack the training and confidence to successfully conduct such activities. In the year 2014, our residency implemented a scholarly activity curriculum to train our residents to plan, complete, and disseminate research and quality improvement projects. We sought to evaluate the impact of one institution’s scholarly activity curriculum for family medicine residents on resident scholarly activity productivity. Methods: We reviewed the scholarly activities conducted by our family medicine residents in the 5 years after initiation of the scholarly activity curriculum and compared them to those conducted in the 5 years prior to initiation of the curriculum. Results: Since 2014, the percentage of residents who coauthored at least one poster increased significantly, from 55.2% in 2009-2014, to 82.5% in 2014-2019 (P<.001). In the academic years 2014 to 2019, residents also coauthored significantly more book chapters compared to the 5 years prior to the curriculum. Conclusions: Our curriculum has been successful in improving resident scholarly activity productivity as evidenced by a significant increase in the percentage of residents coauthoring posters and the total number of book chapters written by residents.

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