Residency 2050: What Is the Future of Medical Training?

Ryan Syrek, MA

Disclosures

October 07, 2019

Grant Project Team Members from the University of North Carolina (UNC) School of Medicine

Looking to the future of residency training, we anticipate that predetermined time constraints for graduation will be removed; instead, resident training will be completed as a set of core competencies is attained. We also anticipate a more connected approach to training across the continuum, which includes an integration of future residency sites during medical school and improved practice management training to prepare residents for success once they join the workforce.

We also see an increased acknowledgement of the impact of burnout across the medical profession and anticipate a greater focus on wellness and programs that promote resilience and provide emotional support to residents during their training.

Our Reimagining Residency grant will support the expansion of the Fully Integrated Readiness for Service Training (FIRST) program. Established in 2015, the pilot phase of the FIRST program provides students with the opportunity to participate in an accelerated and advanced curriculum; this allows students to complete medical school in 3 years and enter the UNC Family Medicine Residency Program followed by 3 years of practice support after graduation.

Expanding this program to the additional specialties of general surgery, pediatrics, and psychiatry in the future will allow us to better serve the physician workforce needs of North Carolina. By offering a seamless transition between medical school, residency, and practice, we increase the likelihood that our students remain in North Carolina to practice and ensure they are best prepared to care for our state's diverse population. Additional programmatic elements of our grant include a focus on promoting an inclusive and positive clinical learning environment and increasing our focus on health systems science to produce physicians ready to achieve success in the ever-changing world of health care.

UNC School of Medicine was awarded an AMA grant for its project: Fully Integrated Readiness for Service Training (FIRST): Enhancing the Continuum from Medical School to Residency to Practice.

Grant Project Team Members from Oregon Health & Science University and University of California, Davis

The California Oregon Medical Partnership to Address Disparities in Rural Education and Health (COMPADRE) aims to develop a robust education collaborative to provide more and better-trained physicians for underserved communities in the region. COMPADRE will bring together dozens of residency programs, health systems, and community health centers to train more students and residents from rural, urban, and tribal communities and equip these individuals for practice in their communities.

  • By 2050, this bold initiative will result in development of a virtual regional campus to better locate medical education opportunities closer to vulnerable communities. Students will incur minimal educational debt and acquire their training closer to their home, using distance education technology and other modalities to remain connected with and learn from their communities.

  • By 2050, undergraduate medical education will be directly linked to residency training, allowing for greater continuity and enabling learners to put down roots where they study. Student and residents will be supported by their local communities and engaged in a vast COMPADRE learning and wellness network.

  • By 2050, the physician workforce will more closely reflect the diverse social, economic, and cultural identities of our nation. Most importantly, these physicians will have helped improve health in the region, serving as a model for other parts of the country affected by workforce shortages.

Oregon Health & Science University and University of California, Davis were awarded an AMA grant for their project: California Oregon Medical Partnership to Address Disparities in Rural Education and Health (COMPADRE).

Kalli Varaklis, MD, MSEd (Maine Medical Center)

We envision a future clinical learning environment where graduate medical education is fully integrated into the patient care environment to better prepare residents for team-based care and interprofessional, collaborative practice. This new clinical learning environment will ensure that graduates and clinicians in all of the health professions will have proficiencies essential to the evolving practice environment, including improving patient outcomes, demonstrating systems-level competencies, interpreting an ever-increasing amount of information and data, and participating in quality improvement and population health initiatives as an interprofessional team.

In the year 2050, we believe that residency and fellowship training will occur in an environment that values these principles:

  • Full team involvement in care planning with scheduled interprofessional rounds to communicate one message to patients and families

  • Patient and health care team cohorting

  • Rapid- cycle quality improvement on individual units with full team engagement

  • Team learning activities scheduled by and for the entire team

  • A shift to teaching back to the bedside

We envision this training model to be integrated into all inpatient and outpatient training settings as well as at rural training sites.

We believe that the Maine Medical Center pilot, Interprofessional Partnership to Advance Care and Education (iPACE) can help meet these aspirational goals. We anticipate that our Reimagining Residency project will implement the core principles of iPACE in inpatient and outpatient settings, in diverse specialties, and in rural training sites, achieving the goal of redesigning the clinical learning environment to ensure that all residents in our programs are ready for interprofessional practice.

Maine Medical Center was awarded an AMA grant for its project: Reimagining Residency: Ensuring Readiness for Practice Through Growing Interprofessional Partnerships to Advance Care and Education (iPACE).

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