@article{10.22454/FamMed.2022.677868,
author = {Lefevre, Nicholas M. and Young, Richard A. and Li, David M. and Casey, Dan},
title = {Scope of Practice and Location of 3- Versus 4-Year Family Medicine Residency Graduates},
journal = {Family Medicine},
volume = {54},
number = {9},
year = {2022},
month = {10},
pages = {700-707},
doi = {10.22454/FamMed.2022.677868},
abstract = {Background and Objectives: The John Peter Smith (JPS) Family Medicine Residency Program participated in two national experiments: Preparing the Personal Physician for Practice (P4, 2007-2012) and the Length of Training Pilot, which began in 2013. In these experiments, JPS created optional integrated 4-year areas of emphasis (AOE). The objective of this study was to examine the career outcomes of JPS graduates differentiated by those who completed a 4-year AOE, versus traditional fourth-year fellowship, vs 3-year only.
Methods: We surveyed each graduate who started residency from 2007-2016 on their scope of practice. We also searched each graduate via Google to identify each of their practice sites and ascertain their status as a Health Professional Shortage Area (HPSA) or Medically Underserved Area for primary care (MUA-P).
Results: Of the 220 residents who entered the program as interns, 70 completed an integrated AOE (31.8%), 54 completed 3 years of training with a traditional fourth-year fellowship (24.5%, 40 at JPS, 14 at another location), and 93 completed only 3 years of training (42.3%). The overall percentage of JPS graduates who work in the United States (n=201) in HPSAs or MUA-Ps is similar to national numbers (45.3% vs 43.5% for HPSAs, 35.3% vs 33.3% for MUA-Ps). Graduates of a JPS integrated AOE track were more likely to work in a HPSA or MUA-P than other graduates (81.4% vs 38.5% traditional fellowship vs 45.6% 3-year only, P<.001; US practice sites only). Graduates of sports medicine fellowships were particularly less likely to work in HPSAs/MUA-Ps than other graduates (26.1%). Graduates of integrated AOEs provided much broader scopes of cognitive and procedural services than fellowship or 3-year graduates.
Conclusions: In JPS graduates, 4 years of training with an integrated AOE had a large association with serving vulnerable populations, and providing broader cognitive and procedural services.},
URL = {https://journals.stfm.org//familymedicine/2022/october/young-2021-0607/},
eprint = {https://journals.stfm.org//media/5183/young-2021-0607.pdf},
}