Douglass Alan B, Rosener Stephanie E, Stehney Michael A
Family Medicine Residency Program, Middlesex Hospital, Middletown, CT 06457, USA. adouglass@ midhosp.org
Fam Med. 2011 Jul-Aug;43(7):510-3.
Extending the residency curriculum to 4 years has been proposed as a logical innovation in response to the Future of Family Medicine Report given the increasing complexity of medical care and reduction in available training time due to duty hour restrictions. Middlesex Hospital, a participant in the P⁴ Initiative, is the first family medicine residency program to require a comprehensive 4-year curriculum for all residents.
Over a 4-year time frame, the program transitioned from 8-8-8 to 6-6-6-6 staffing. The existing 3-year educational core of the program was left intact, and six additional core rotations and 7-month tracks of curricular enhancement were added. The residency practice transformed to a Patient-centered Medical Home (PCMH).
Transition to a 4-year residency curriculum has proved smooth. Our funding model is sustainable, and practice income has increased. We have had no difficulty maintaining accreditation despite an innovative curriculum. A 4-year curriculum has resulted in substantially increased applicant interest and improved Match rates. The introduction of tracks has appealed to residents and has generated many positive spin-offs to the educational program as a whole. Transition to a PCMH has been of great value to both our patients and our learners.
Transition to a comprehensive 4-year curriculum has been successful and has provided many benefits to our learners, practice, and educational program. Our graduates are substantially better prepared for practice.
鉴于医疗护理日益复杂，且由于值班时间限制导致可用培训时间减少，作为对《家庭医学的未来报告》的合理创新举措，有人提议将住院医师培训课程延长至4年。米德尔塞克斯医院是P⁴倡议的参与者，是首个要求所有住院医师完成全面4年课程的家庭医学住院医师培训项目。
在4年时间内，该项目从8-8-8人员配置模式转变为6-6-6-6人员配置模式。该项目现有的3年教育核心内容保持不变，并增加了6个额外的核心轮转课程和7个月的课程强化环节。住院医师培训实践转变为以患者为中心的医疗之家（PCMH）。
向4年住院医师培训课程的过渡已证明顺利。我们的资助模式可持续，实践收入增加。尽管课程具有创新性，但我们在维持认证方面没有困难。4年课程极大地提高了申请人的兴趣并提升了匹配率。课程环节的引入吸引了住院医师，并为整个教育项目带来了许多积极的附带成果。向PCMH的转变对我们的患者和学习者都具有巨大价值。
向全面4年课程的过渡已取得成功，并为我们的学习者、实践和教育项目带来了诸多益处。我们的毕业生在实践准备方面有了显著提升。
