scholarly journals Disability Policies and Practices in Family Medicine Residencies: A CERA Study

2021 ◽  
Vol 53 (3) ◽  
pp. 211-214
Author(s):  
Lisa M. Meeks ◽  
Ben Case ◽  
Heidi Joshi ◽  
Diane M. Harper ◽  
Lisa Graves
Keyword(s):  
Medical Education ◽  
Family Medicine ◽  
Students With Disabilities ◽  
Primary Source ◽  
Disability Policy ◽  
Hospital System ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Disability Disclosure ◽  
Policies And Practices

Background and Objectives: Increasing the diversity of family medicine residency programs includes matriculating residents with disabilities. Accrediting agencies and associations provide mandates and recommendations to assist programs with building inclusive policies and practices. The purpose of this study was (1) to assess programs’ compliance with Accreditation Council for Graduate Medical Education (ACGME) mandates and alignment with Association of American Medical Colleges (AAMC) best practices; (2) to understand perceptions of sources of accommodation funding; and (3) to document family medicine chairs’ primary source of disability-related information. Methods: Data were collected as part of the 2019 Council of Academic Family Medicine Educational Research Alliance Chairs’ Survey. Respondents answered questions about disability policy, disability disclosure structure, source of accommodation funding, and source of information regarding disability. Results: Half (56%) of responding chairs reported maintaining a disability policy in alignment with ACGME mandates, while half (52%) maintain a disability disclosure structure in opposition to AAMC recommendations. Funding sources for accommodation were reported as unknown (32.9%), the hospital system (27.1%), or the departmental budget (24.3%). Chairs listed human resources (50.7%) or diversity, equity, and inclusion offices (23.9%) as the main sources of disability guidance. Conclusions: The number of students with disabilities in medical education is growing, increasing the likelihood that family medicine residency programs will select and train residents with disabilities. Results from this study suggest an urgent need to review disability policy and processes within departments to ensure alignment with current guidance on disability inclusion. Department chairs, as institutional leaders, are well positioned to lead this change.

Combating LGBTQ+ health disparities by instituting a family medicine curriculum

2021 ◽  
pp. 009121742110352
Author(s):  
Nina Grace Ruedas ◽  
Terri Wall ◽  
Christopher Wainwright
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Health Disparities ◽  
Family Medicine ◽  
The United States ◽  
Residency Programs ◽  
Health Curriculum ◽  
Family Medicine Residency ◽  
Lgbtq Health ◽  
Growing Population

Research shows that a growing number of people in the United States are identifying as LGBTQ+. Therefore, it is more important than ever that clinicians are trained to be knowledgeable, inclusive, and culturally aware. Unfortunately, there is a lack of LGBTQ+ health education requirements in graduate medical education. As a result, fewer clinicians are prepared to care for this growing population. The shortage of knowledgeable clinicians contributes to LGBTQ+ health disparities and barriers to care. One strategy to combat these deficiencies in health care is for Family Medicine residency programs to create and carry out an LGBTQ+ health curriculum. This article will review LGBTQ+ health topics, identify efforts that Family Medicine residency programs can make, and summarize curriculum developments made by the St. Vincent's Family Medicine Residency Program.

scholarly journals The relationship between regional medical campus enrollment and rates of matching to family medicine residency

2020 ◽  
Vol 11 (3) ◽  
pp. e73-e81
Author(s):  
Dorothy Bakker ◽  
Christopher Russell ◽  
Mary Lou Schmuck ◽  
Amanda Bell ◽  
Margo Mountjoy ◽  
...  
Keyword(s):  
Medical Education ◽  
Family Medicine ◽  
Role Models ◽  
Leadership Role ◽  
Medical Council ◽  
Pass Rates ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Regional Medical ◽  
Regional Campus

Background: The Michael G. DeGroote School of Medicine expanded its medical education across three campus sites (Hamilton, Niagara Regional and Waterloo Regional) in 2007. Ensuring the efficacy and equivalency of the quality of training are important accreditation considerations in distributed medical education.  In addition, given the social accountability mission implicit to distributed medical education, the proportion of learners at each campus that match to family medicine residency programs upon graduation is of particular interest. Methods: By way of between campus comparisons of Canadian Residency Matching Service (CaRMS) match rates, this study investigates the family medicine match proportion of medical students from McMaster’s three medical education campuses. These analyses are further supported by between campus comparisons of Personal Progress Index (PPI), Objective Structured Clinical Examination (OSCE), Medical Council of Canada Qualifying Examination-Part 1 (MCCQE1) performances that offer insight into the equivalency and efficacy of the educational outcomes at each campus. Results: The Niagara Regional Campus (NRC) demonstrated a significantly greater proportion of students matched to family medicine. With respect to education equivalency, the proportion of students’ PPI scores that were more than two SD below the mean was comparable across campuses.  OSCE analysis yielded less than 2% differences across campuses with no differences in the last year of training.  The MCCQE1 pass rates were not statistically significant between campuses and there were no differences in CaRMS match rates. With respect to education efficacy, there were no differences among the three campuses’ pass rates on the MCCQE1 and CaRMS match rates with the national rates. Conclusions: Students in all campuses received equivalent educational experiences and were efficacious when compared to national metrics, while residency matches to family medicine were greater in the NRC. The reasons for this difference may be a factor of resident and leadership role-models as well as the local hospital and community environment.

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 Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

2021 ◽  
Vol 8 ◽  
pp. 238212052110186
Author(s):  
Lisa M Meeks ◽  
Ben Case ◽  
Erene Stergiopoulos ◽  
Brianna K Evans ◽  
Kristina H Petersen
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Students With Disabilities ◽  
Class Size ◽  
Medical Schools ◽  
Organizational Characteristics ◽  
School Level ◽  
Student Diversity ◽  
Structural Barriers ◽  
Disability Disclosure

Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied. Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size. Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size. Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.

scholarly journals Maternity Care Tracks at US Family Medicine Residency Programs

2021 ◽  
Vol 53 (10) ◽  
pp. 857-863
Author(s):  
Steven E. Roskos ◽  
Tyler W. Barreto ◽  
Julie P. Phillips ◽  
Valerie J. King ◽  
W. Suzanne Eidson-Ton ◽  
...  
Keyword(s):  
Family Medicine ◽  
Maternity Care ◽  
Underserved Populations ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Response Rate ◽  
Care Training ◽  
Practice Methods ◽  
Residency Program Directors ◽  
The Relationship

Background and Objectives: The number of family physicians providing maternity care continues to decline, jeopardizing access to needed care for underserved populations. Accreditation changes in 2014 provided an opportunity to create family medicine residency maternity care tracks, providing comprehensive maternity care training only for interested residents. We examined the relationship between maternity care tracks and residents’ educational experiences and postgraduate practice. Methods: We included questions on maternity care tracks in an omnibus survey of family medicine residency program directors (PDs). We divided respondent programs into three categories: “Track,” “No Track Needed,” and “No Track.” We compared these program types by their characteristics, number of resident deliveries, and number of graduates practicing maternity care. Results: The survey response rate was 40%. Of the responding PDs, 79 (32%) represented Track programs, 55 (22%) No Track Needed programs, and 94 (38%) No Track programs. Residents in a track attended more deliveries than those not in a track (at Track programs) and those at No Track Needed and No Track programs. No Track Needed programs reported the highest proportion of graduates accepting positions providing inpatient maternity care in 2019 (21%), followed by Track programs (17%) and No Track programs (5%; P<.001). Conclusions: Where universal robust maternity care education is not feasible, maternity care tracks are an excellent alternative to provide maternity care training and produce graduates who will practice maternity care. Programs that cannot offer adequate experience to achieve competence in inpatient maternity care may consider instituting a maternity care track.

scholarly journals Residency Setting Association With Resident Substance Use Disorder Training: A CERA Secondary Data Analysis

2020 ◽  
Vol 52 (3) ◽  
pp. 198-201
Author(s):  
Joshua St. Louis ◽  
Emma Worringer ◽  
Wendy B. Barr
Keyword(s):  
Substance Use ◽  
Family Medicine ◽  
Residency Program ◽  
Secondary Analysis ◽  
Secondary Data ◽  
The United States ◽  
Resident Training ◽  
Addiction Medicine ◽  
Residency Programs ◽  
Family Medicine Residency

Background and Objectives: As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula. The objective of our study was to identify factors that correlate with increased residency training in addiction medicine across a broad sample of family medicine residencies. Methods: We performed secondary analysis of a national family medicine residency program director survey conducted in 2015-2016 (CERA Survey PD-8). We obtained data from the Council of Academic Family Medicine Educational Research Alliance (CERA) Data Clearinghouse. We analyzed residency clinic site designation as a patient-centered medical home (PCMH), federally-qualified health center (FQHC), or both, for their correlation with faculty member possession of DEA-X buprenorphine waiver license, as well as required residency curriculum in addiction medicine. Results: Residency programs situated in an FQHC were more likely to have faculty members who possessed DEA-X buprenorphine waiver licenses (P=.025). Residency clinics that were both a PCMH as well as an FQHC also correlated strongly (P=.001). Furthermore, residencies with faculty who possessed a DEA-X license were significantly more likely to have a required curriculum in addiction medicine (P=.002). Conclusions: Our quantitative secondary analysis of CERA survey data of family medicine residency program directors revealed that resident training in addiction medicine is strongly correlated with both residency clinic setting (FQHC or FQHC/PCMH) as well as residency faculty possession of DEA-X licenses.

Annual block scheduling for family medicine residency programs with continuity clinic considerations

2016 ◽  
Vol 48 (9) ◽  
pp. 797-811 ◽  
Author(s):  
Jonathan F. Bard ◽  
Zhichao Shu ◽  
Douglas J. Morrice ◽  
Luci K. Leykum ◽  
Ramin Poursani
Keyword(s):  
Family Medicine ◽  
Block Scheduling ◽  
Continuity Clinic ◽  
Residency Programs ◽  
Family Medicine Residency
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