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A Better Way to Train Family Physicians

June 13, 2015

The Texas Academy of Family Physicians recently published a piece I wrote for them on the preliminary results of our P4 curricular innovations at my day job: the John Peter Smith Family Medicine residency.

Briefly, the P4 project (Preparing the Personal Physician for Practice) was a national experiment where 14 family medicine residencies across the U.S. were allowed to make major curricular changes. No two innovations were the same. Ours came in two layers, which we finally labelled as flexible longitudinal tracks.

First, we let residents stay for an extra year of training in anything reasonable, but it was totally optional. Second, we tried to take their educational passions and expose the residents to those patients and activities as soon as possible. Popular choices included rural care/global medicine/maternity care, sports medicine, geriatrics, HIV care, and others.

We had been waiting for the results of surveys of our graduates, and all the other P4 residency graduates. Read the TAFP article for more detail, but our maternal child health track resulted in graduates who were not only much more likely to deliver babies and perform C-sections, but who were also more likely to care for adults and children in the hospital, do hospital procedures, and do outpatient procedures such as vasectomies.

The extra training resulted in additive services, not a trade off of one kind of patient care service for another. This is important given the recent evidence that more comprehensive family physicians deliver care that is 10% less expensive than less comprehensive family physicians. JPS has created an even better way to prepare these young family physicians to be the solution America needs for its exorbitantly expensive healthcare system.

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