Is family medicine residency too short and too urban?

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  1. Wayne Weston

    I agree with the 4 paths for improving rural family medicine. In addition, a program of structured CME for the first few years in practice, tailored to the needs of the community and supported by mentorship might be better than a 3rd year of residency. But, one challenge that is mentioned too infrequently is the need for better training for managing patients with mental illness. And we seem to be in the middle of an epidemic of mental illness. Learning good skills in therapy & counseling requires close supervision and feedback that is hard to get in CME programs.

  2. Dr Mayelin Figueroa

    In my opinion Family Medicine Residency should be at least 3 years . I graduated from a medical school in Cuba and our program there was 3 years .

  3. Nancy Fitch

    I am a rural physician doing ER and obs for 17 years. The CME I was funded to do by the Ontario gov’t helped me greatly for 15 years: I was supported to keep my ACLS, ALARM, ATLS, NRP, PALS all up to date. This financial support (for travel, accomodations, the course fees AND a daily stipend for being out of the office) helped me get out of Dodge, network, and keep my skills in my rural area top quality. I recommend re-instating CME funding for rural physicians.

  4. Hebs

    While I feel family medicine residency is too short, I’m astonished at how quickly a nurse practitioner can be trained (2 years of education after practicing as a registered nurse for 4 years) with relatively the same scope of practice.

    I worry about the unintended consequences of extending FamMed training. Post-education support is absolutely necessary though.

  5. Ken C

    If a 3rd year of residency reduces the amount of “taking your best guess and doing it,” then I’m all for it.

    Responsibilities of northern/rural GPs are greater, this is why the learner experience is superior. It’s a balance of access to care with quality of care.

  6. Franklin Warsh

    Even if the capacity was there to extend training by a year (and I seriously doubt there is), it would effectively remove more than 1000 family doctors from independent practice. This is what happened 25 years ago when licensure after a 1-year internship was phased out, and it created the family doctor shortage that made rural recruitment even harder. If you couple extension of training with the work patterns of the current generation of family docs (many more women taking mat leave, decrease in hours, reduced OB and hospital work), it would make a looming human resource problem – waning interest in family medicine – far worse and almost overnight.

    I learned more in my first year of independent practice than I did in most of residency. No amount of training is going to take clinical uncertainty away, and even the most experienced of us miss things and make mistakes. Residency’s purpose is to train doctors to competency, not mastery.

  7. Paul teman

    In Calgary, medical school is three years and then family residency is 2 years. Please, someone explain how 4 years of medical school and 3 years of family practice residency in that states is crammed into what Calgary trainees get? How can it be equivalent?

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