In Response to “Reenvisioning Family Medicine Residency Education”

The July-August 2021 Family Medicine special issue, “Reenvisioning Family Medicine Residency Education” focused on several important elements of the philosophy, content, and delivery of resident education.”1 In addition to the elements presented by the authors, residents’ careers and well-being are affected by their financial literacy education, or lack thereof.

Residents have a relatively poor state of financial health and literacy and have identified financial health as an important source of stress and burnout.^2,3 This is particularly important for family medicine residents; a recent study demonstrated that the indebtedness of family medicine residents is increasing even faster than the average of all US allopathic graduates.4 Crucially, more than 90% of respondents want financial literacy education (eg, debt, insurance, purchasing a home).5

Notably, high debt burden may influence whether family medicine residents choose to enter academic medicine.6 A financial literacy program can provide residents with the confidence to manage their existing obligations and avoid further debt so that finances do not become a deterrent to pursuing an academic career. Adding required financial literacy education is in service of our goal to improve the well-being of our residents and potentially increase the number of academic family physicians.

This is a contributor to burnout that we can address through the existing infrastructure of the required Health Systems Management curriculum. Family medicine is uniquely positioned to integrate this into our curriculum standards. The specialty was the first to implement a practice management curriculum requirement where 100 hours (or 1 month) is required by the Accreditation Council for Graduate Medical Education for Family Medicine.^7,8 Personal finance would only strengthen topics such as an understanding of contracts and utilizing resources to enhance physician well-being, both of which are included in the recommended Health Systems Management Guidelines by the American Academy of Family Physicians.⁹ Moreover, short curricular interventions in resident populations have been studied with positive results. There are multiple ways to incorporate this into the curriculum, including guest lectures, assigned reading, faculty/advisor discussions, and didactic sessions.¹⁰

The evidence is clear regarding financial literacy education: (1) the literature has identified an educational gap, (2) there is strong resident desire for this education that is congruent with our mission as family medicine educators, and (3) it is feasible. If the intention of the Health Systems Management Guidelines is to prepare our resident physicians for the real world, we must include personal finance in that discussion.