Family medicine
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Maternity care training in family medicine is a major component of our specialty. The Association of Family Medicine Residency Directors (AFMRD) issued a position paper calling for a two-tiered system of training for family physicians based on concern that some residency programs are unable to meet the current Residency Committee-Family Medicine (RC-FM) requirements for maternity care training. This two-tiered system was also endorsed by other family medicine organizations, including the AAFP, ADFM, NAPCRG, and STFM. Despite this support of the new system, there remains concern among some family medicine educators about this two-tiered approach. The Society of Teachers of Family Medicine Group on Hospital Medicine and Procedural Training met in 2009 and 2010 to develop an alternative tiered system for the training of family medicine residents in maternity care. ⋯ The three tiers we propose address the importance of maternity care, the limitations that some residencies face in providing adequate patient volumes, and the need to teach more advanced skills to those family medicine residents who will work in rural and underserved areas upon graduation. We urge family medicine governing bodies to adopt this system and believe that it will help preserve the essential role that family physicians serve in the care of pregnant women starting with basic maternity care and extending to advanced roles including care of complicated pregnancies and cesarean delivery.
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Entry of US medical school graduates into family medicine residencies: 2010-2011 and 3-year summary.
This is the 30th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. This retrospective analysis based on data reported to the AAFP from medical schools and family medicine residency programs shows approximately 8.0% of the 17,081 graduates of US medical schools between July 2009 and June 2010 were first-year family medicine residents in 2010, compared to 7.5% in 2009 and 8.2% in 2008. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2010 than were residents from privately funded schools (9.6% versus 5.4%). ⋯ Approximately four in 10 of the medical school graduates (40.3%) entering a family medicine residency program as first-year residents entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the 3-year average percentage from each medical school of graduates entering family medicine residencies and the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs in 2010.
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Conflicting evidence exists about how patients would like their doctors to dress. This is complicated by new evidence showing elements of common physician attire (white coat or ties) can be contaminated with pathogens. ⋯ Patients in these three academic family medicine practices did not show any consistent preference for their physicians' attire. However, providing information about potential microbial contamination of clothing was associated with a shift in patient preferences for physicians not wearing a tie and a white coat.
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The introduction of a prescribed curriculum and a clinical rotation in the PGY-1 year of family medicine training can enhance learning in musculoskeletal and sports medicine. Combining learning experiences in sports medicine and musculoskeletal medicine in the early stages of training establishes a base to master the required competencies by the completion of the training program. ⋯ PGY-1 prescribed curriculum provides significant improvement in basic medical knowledge in musculoskeletal medicine, launches the learner toward the goal of competency, and fosters an appreciation for the role of musculoskeletal medicine in the practice of family medicine.
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The recent Affordable Care Act (ACA) includes physician training provisions to address the US primary care workforce shortage and maldistribution. Policymakers require current graduate medical education (GME) residency finance data to design and implement programs that increase primary care physicians. The University of Washington Family Medicine Network residencies have collaborated for 10 years in collecting and comparing data regarding the revenues and expenses of their training programs. Based on biennial survey results from 2000 to 2010, this study examines changes in the finances of residency training over a decade using a standardized methodology. ⋯ The mean cost per resident remained relatively stable over the 10-year period, with a 3.1% overall increase to $27,260 per resident per year. Programs that successfully obtained federally qualified health center (FQHC) status, increased their residency graduate medical education (GME) slots or received other new significant funding, such as state grants, were the most financially stable. Policy solutions would stabilize both federal GME and state Medicaid GME funding and increase reimbursement of primary care practice to maintain the viability of primary care training programs. Conclusions: The mean cost per resident remained relatively stable over the 10-year period, with a 3.1% overall increase to $27,260 per resident per year. Programs that successfully obtained federally qualified health center (FQHC) status, increased their residency graduate medical education (GME) slots or received other new significant funding, such as state grants, were the most financially stable. Policy solutions would stabilize both federal GME and state Medicaid GME funding and increase reimbursement of primary care practice to maintain the viability of primary care training programs.