David J. Goldstein, M.D.*1;Patricia Lynn Seymour, MD MS2 and Judith Savageau, MPH2, (1)Natividad Medical Center Family Medicine Residency, Salinas, CA, (2)The University of Massachusetts Medical School, Worcester, MA

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 23

Categories: Education, Research Abstracts

Keywords: , , ,

Background: Accreditation Council for Graduate Medical Education (ACGME) program requirements for family medicine permit wide variability in adult inpatient medicine curricula. Family physicians compose a significant percentage of the hospitalist workforce, and the American Board of Family Medicine co-sponsors the Recognition of Focused Practice in Hospital Medicine. Previously published survey data describe certain residency characteristics (location, university affiliation, and program director attitudes regarding hospitalists) that correlate with graduates choosing hospital medicine as a career. Hypothesizing that there is an influence of residency curricular factors, we sought to describe the current state of adult inpatient medicine curricula in family medicine residencies and explore possible relationships with percentage of graduates choosing hospitalist work.

Methods: A 25-question, web-based survey was distributed by email invitation in March 2016 to all active U.S. family medicine residency directors, as identified by their listing in the American Medical Association’s Residency and Fellowship Database and participation in the 2016 National Residency Matching Program (n=475). The project was approved by the Natividad Medical Center Bioethics Committee.

Results: A total of 95 responses were received (20% response rate). Respondents represented community-based and university-based residencies and all regions of the country (Table 1). About half (54%) of the programs reported hospitalists in teaching roles. Half (54%) of programs structure more than 800 hours of training in adult inpatient medicine in their core curricula, and 39% reported their residents achieve more than 1000 adult inpatient encounters. Only 15% of programs offered a dedicated hospital medicine track, citing numerous barriers (Table 2). Over the last 3 years, 13% of family medicine residency graduates have become hospitalists. Programs in smaller communities were more likely to produce hospitalists, as were programs that reported higher numbers of adult inpatient encounters. No statistically significant associations were identified with geographic region, university affiliation, hours of adult inpatient medicine, critical care exposure, existence of hospital medicine track, or presence of hospitalist faculty.

Conclusions: While limited by low response rate, there was wide heterogeneity in the inpatient experiences offered at the responding family medicine residencies.  Most programs appeared to exceed the ACGME required minimums for inpatient and ICU encounters. More inpatient encounters in residency seem to correlate positively with graduates choosing hospital medicine careers, although this was not replicated when comparing hours of adult inpatient medicine training. Family medicine residencies in smaller communities are also more likely to produce hospitalists. From this data it appears that there is low availability and barriers to hospital medicine tracks within family medicine residencies.

To cite this abstract:

Goldstein, DJ; Seymour, PL; Savageau, J . TRAINING FAMILY MEDICINE RESIDENTS FOR HOSPITAL-BASED WORK: A SURVEY OF ADULT INPATIENT MEDICINE CURRICULA. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 23. Journal of Hospital Medicine. 2017; 12 (suppl 2). Accessed July 15, 2019.

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