Authors’ Response to “Integrating Accelerated Medical School Programs With Extended Family Medicine Residency Programs: Innovations in Length of Training”

Patricia Carney; Lars Peterson; Alan Douglass; Stephanie Rosener; W. Perry Dickinson; Mark Nadeau; Karen Mitchell; Colleen Conry; James Martin; M. Patrice Eiff

doi:10.22454/FamMed.2025.483616

LETTERS TO THE EDITOR

Authors’ Response to “Integrating Accelerated Medical School Programs With Extended Family Medicine Residency Programs: Innovations in Length of Training”

Patricia A. Carney, PhD | Lars E. Peterson, MD, PhD | Alan B. Douglass, MD | Stephanie E. Rosener, MD | W. Perry Dickinson, MD | Mark T. Nadeau, MD, MBA | Karen B. Mitchell, MD | Colleen Conry, MD | James C. Martin, MD | M. Patrice Eiff, MD

Fam Med. 2025;57(10):762-762.

DOI: 10.22454/FamMed.2025.483616

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TO THE EDITOR:

We appreciate the many points these authors raise regarding the benefits and challenges associated with choosing a career path during medical training,^¹ in response to our original article about length of training.^² Some students enter medical school with clear preferences in mind. While some continue to pursue their initial preferences, others change their selection based on the clinical training experiences they undertake during training. Yet another group of students prefers to understand the full array of options before they decide on their career specialty.

We believe an important feature of the AIRE (Advancing Innovation in Residency Education) programs in family medicine (and in other specialties) is the Accreditation Council for Graduate Medical Education’s recognition that waivers should be offered from select requirements to enable further educational innovations in training.^³ That would enable programs to explore novel approaches to graduate medical education training and enhance both educational and clinical outcomes. While our study has no data regarding possible 3 + 4 programs, that would be a potential innovation that could build on the experiences of both the existing 3 + 3 experiments and this length of training pilot.

Importantly, AIRE encourages the adoption of key principles of competency-based medical education (CBME), educational outcomes, and improving health and health care. What is ironic here is that CBME is theoretically designed to avoid time-based training by focusing on competency attainment. We agree with these authors that allowing for training length and configuration options is desired by trainees, is not detrimental to their training, and can ultimately result in well-trained family physicians who are happy with their career and who, as a result, provide optimal care to their patients and their communities.

References

Ringwald BA, Middleton JL, Auciello SE. Integrating accelerated medical school programs with extended family medicine residency programs: innovations in length of training. Fam Med. 2025;57(9):682–683.
Carney PA, Valenzuela S, Dinh DH, et al. Impact of training length on scope of practice among residency graduates: a report from the Length of Training Pilot Study in Family Medicine. Fam Med. 2025;57(8):550–563.
Accreditation Council for Graduate Medical Education. Advancing innovation in residency education (AIRE). Accessed October 15, 2025. https://www.acgme.org/initiatives/advancing-innovationin-residency-education-aire

Lead Author

Patricia A. Carney, PhD

Affiliations: Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, OR

Co-Authors

Lars E. Peterson, MD, PhD - American Board of Family Medicine, Lexington, KY | Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY

Alan B. Douglass, MD - University of Colorado School of Medicine, CU Anschutz Medical Campus, Denver, CO

Stephanie E. Rosener, MD - Department of Family Medicine, Mountain Area Health Education Center, Asheville, NC | Family Medicine, University of North Carolina School of Medicine, NC

W. Perry Dickinson, MD - University of Colorado School of Medicine, CU Anschutz Medical Campus, Denver, CO

Mark T. Nadeau, MD, MBA - Family Medicine Residency Program, University of Texas Health Science Center, San Antonio, TX

Karen B. Mitchell, MD - Student and Resident Initiatives, American Academy of Family Physicians, Leawood, KS

Colleen Conry, MD - University of Colorado School of Medicine, CU Anschutz Medical Campus, Denver, CO

James C. Martin, MD - Long School of Medicine, University of Texas Health Science Center, San Antonio, TX

M. Patrice Eiff, MD - Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, OR

LETTERS TO THE EDITOR

Authors’ Response to “Integrating Accelerated Medical School Programs With Extended Family Medicine Residency Programs: Innovations in Length of Training”

Patricia A. Carney, PhD | Lars E. Peterson, MD, PhD | Alan B. Douglass, MD | Stephanie E. Rosener, MD | W. Perry Dickinson, MD | Mark T. Nadeau, MD, MBA | Karen B. Mitchell, MD | Colleen Conry, MD | James C. Martin, MD | M. Patrice Eiff, MD

TO THE EDITOR:

References

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Co-Authors

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