ABSTRACT
BACKGROUND AND OBJECTIVES: Maternity care training in family medicine is a major component of our specialty. The Association of Family Medicine Residency Directors (AFMRD) issued a position paper calling for a two-tiered system of training for family physicians based on concern that some residency programs are unable to meet the current Residency Committee-Family Medicine (RC-FM) requirements for maternity care training. This two-tiered system was also endorsed by other family medicine organizations, including the AAFP, ADFM, NAPCRG, and STFM. Despite this support of the new system, there remains concern among some family medicine educators about this two-tiered approach. The Society of Teachers of Family Medicine Group on Hospital Medicine and Procedural Training met in 2009 and 2010 to develop an alternative tiered system for the training of family medicine residents in maternity care. METHODS: Working from previous requirements for maternity care training and the AFMRD document, the group used a multi-voting process to identify the tiers and their elements. RESULTS: The group generated a three-tier system for maternity care training in family medicine residencies. These included curriculum, patient volume, faculty expectations, and institutional requirements. CONCLUSIONS: The three tiers we propose address the importance of maternity care, the limitations that some residencies face in providing adequate patient volumes, and the need to teach more advanced skills to those family medicine residents who will work in rural and underserved areas upon graduation. We urge family medicine governing bodies to adopt this system and believe that it will help preserve the essential role that family physicians serve in the care of pregnant women starting with basic maternity care and extending to advanced roles including care of complicated pregnancies and cesarean delivery.
Subject(s)
Curriculum , Family Practice/education , Internship and Residency/organization & administration , Maternal Health Services/standards , Obstetrics/education , Clinical Competence , Female , Humans , Physicians, Family/education , Pregnancy , Surveys and Questionnaires , United StatesABSTRACT
BACKGROUND AND OBJECTIVES: Family medicine does not have a defined scope of procedures or universal standards for procedural training. This contributes to wide variation in family physician training and difficulties obtaining hospital privileges for advanced procedures. The Society of Teachers of Family Medicine (STFM) Group on Hospital Medicine and Procedural Training previously developed a list of core procedures to be taught in all family medicine residencies. The group reconvened to develop a consensus list of advanced procedures within the scope of family medicine. METHODS: Working from a master list of procedures, the group, which consisted of 21 family medicine educators, used a multi-voting process to identify advanced procedures within the scope of family medicine. RESULTS: The group generated a list of 36 advanced procedures and added nine procedures to the previously created list of core procedures. CONCLUSIONS: The STFM Group on Hospital Medicine and Procedural Training proposes a list of advanced procedures within the scope of family medicine and urges family medicine governing bodies to use this list to define and standardize the scope of procedural training and practice in family medicine.
Subject(s)
Clinical Competence , Family Practice/education , Family Practice/standards , Internship and Residency/standards , Female , Humans , Male , United StatesABSTRACT
BACKGROUND AND OBJECTIVES: Specific procedural training standards for US family medicine residencies do not exist. As a result, family physicians graduate with highly variable procedural skills, and the scope of procedural practice for family physicians remains poorly defined. Our objective was to develop a standard list of required procedures for family medicine residencies. METHODS: The Society of Teachers of Family Medicine Group on Hospital and Procedural Training convened a working group of 17 family physician educators. A multi-voting process was used to define categories and propose a list of required procedures for US family medicine residency programs. RESULTS: The group defined five categories of procedures within the scope of family medicine. Consensus was reached for a core list of procedures that all family medicine residents should be able to perform by the time of graduation. CONCLUSIONS: Defining standards for procedural training in family medicine will help clarify family medicine's scope of practice and should benefit both patients and family physicians. We propose that with input from national family medicine organizations, the procedure list presented in this report be used to develop a national standard for required procedural training.
