ACGME Releases New Program Requirements for Family Medicine

AAFP News sat down with AAFP Vice President of Medical Education Karen Mitchell, MD to discuss how the new requirements will affect residents, programs and their communities.

AAFP News: What are some of the most significant changes in the new requirements supported by the AAFP?

Mitchell: This is the biggest change in the teaching of family medicine since the creation of the specialty. Two of the transformational changes relate to the delivery of patient care and resident assessment and learning.

We will have implemented panel measures instead of the 1,650 face-to-face visits that were required. Residents will manage a patient panel as part of a team approach to improving health equity and population health. Management of this patient panel will be done in a variety of ways, including telehealth and care in multiple settings. Continuity of care continues to be emphasized and will need to be measured, along with a minimum number of hours of caregiving in family practice. Patient advisory committees are needed for every family practice to meet the health needs of the community. Overall, the new program requirements continue to cover the holistic nature of family medicine.

Having fewer prescriptive requirements will allow programs to focus more on competency-based medical education. Resident assessment and coaching will be part of an individual learning plan required for each resident. There is more optional time — which should be based on the resident’s individual learning plan — so that the resident’s experience can be tailored to their future practice and learning goals.

Another change is that for the first time there is a two-tier pregnancy care requirement. Pregnancy care remains a cornerstone of family medicine training. The graduate level will have specific requirements for residents seeking independent practice in comprehensive pregnancy care after graduation so that they can obtain hospital privileges and accreditation.

AAFP News: Are there any changes that the AAFP has not supported?

Mitchell: We have not received our core faculty FTE request for protected non-clinical time. We have secured program leadership support that maximizes the amount authorized by the ACGME, with the time spent by the program director and associate program director dependent on the size of the program. But faculty teaching time is less than the minimum amount supported by the AAFP.

Faculty time is needed to meet program requirements, such as resident assessment and evaluation, resident mentoring, career planning and education, curriculum development and the creation and administration of learning opportunities. A letter from the ACGME Board of Directors recognized the Review Committee for family medicine diligent request for increased faculty time, but the ACGME Board of Directors did not grant this request.

They approved a change in the faculty-to-resident ratio for programs with 12 or more residents from a ratio of 1:6 to 1:4. That helps. However, programs must still meet all ACGME requirements, which means that many programs will need more dedicated faculty time and support. We will continue to monitor the situation.

AAFP News: How will the AAFP help programs implement these changes?

Mitchell: We have the Criteria of Excellence, published by our Residency Program Solutions Consultants. These experts in residence have made recommendations for programs to be carried out to improve the quality of their programs. These criteria can be used by residencies to show their institutions what it takes to deliver a high-quality residency program. We are continually updating this resource. The RPS program also provides consultation to individual programs to meet their unique needs.

Additionally, the Residency Leadership Summit in March will feature numerous workshops aimed at helping programs meet the new requirements. This will be an event not to be missed for residence managers. A pre-conference event will offer a small group format facilitated by RPS consultants for programs looking to find specific solutions to implementing the new requirements, as well as examples of best practices sponsored by the ABFM and the Association of Family Medicine Residency Directors.

To help programs meet the requirements, the AAFP is developing a collaborative learning opportunity around resident wellness, funded by the Health Resources and Services Administration. A pilot project using the videoconferencing format of the ECHO project (Extension for Community Healthcare Outcomes) is underway. More details to come. However, resident members can access wellness resources, including video coaching sessions, now on the Physician Health First webpage.

AAFP News: What else will programs need to meet these new demands?

Mitchell: Residences will need increased computer and data system capabilities to create simple ways to maintain records necessary for resident care in family medicine practice. We need EHR providers to integrate the data into their systems to contribute to population health and to be able to generate the necessary reports.

AAFP News: What do students and residents need to know? Will this impact current residents or only those from 2023?

Mitchell: For residents, this means that your program should help you understand population management, panel settings, and data that will help your future practice in a way that has not been required in the past. This means that you will take an active role in your own learning with faculty coaching to achieve your learning goals related to your future practice.

For students, you can be assured that residency training in family medicine will prepare you for future models of practice, including team-based care, value-based payment systems, and preparation to have skills for anyone. what a community in the United States. You will have the communication and relationship skills that embody the value of family medicine in our health care system. You will gain the full experience of a family physician, the basis for providing the best possible primary care services.

What excites me most is that with competency-based training and individual learning plans, our future family physicians will be able to take even more ownership of their own learning, with guidance from the body faculty, to prepare them for their careers and the communities they plan to serve.


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