Department of Community Health and Family Medicine, University of Florida, Gainesville, FL.
Department of Family and Community Medicine, Pennsylvania State University College of Medicine, State College, PA.
Fam Med. 2022 May;54(5):369-375. doi: 10.22454/FamMed.2022.975755.
Musculoskeletal (MSK) concerns constitute up to 40% of primary care outpatient visits. Despite Accreditation Council for Graduate Medical Education (ACGME) family medicine program requirements for musculoskeletal medicine and sports medicine training, previous studies have shown that family medicine residency graduates do not have adequate training to manage common musculoskeletal conditions. Factors for this may include deficiencies in education at both the undergraduate and graduate medical education training levels.
A Council of Academic Family Medicine Educational Research Alliance survey of 287 family medicine program directors assessed the current state of the delivery of musculoskeletal medicine education. Opinions were gathered on the scope and delivery of training requirements as well as potential areas for further curricular attention.
Two hundred eighty-seven program directors responded to the survey (response rate 41.53%). Most (72.60%) were in university based or affiliated programs and had a fellowship-trained primary care sports medicine physician (59.85%) curricular lead. A majority (77.4%) did not feel that PGY-1 residents enter residency with the physical exam skills needed to evaluate common musculoskeletal (MSK) conditions , and most (81.15%) did not feel that there should be changes to the current ACGME requirements. An area highlighted for further investment is faculty development in point-of-care ultrasound (39.85%).
Although program directors believe that current ACGME MSK curricular requirements are likely appropriate, they do not feel residents arrive with the examination skills needed to evaluate common MSK conditions.Therefore, further attention can be given to medical student education in musculoskeletal exam skills prior to residency. Future research should develop objective measures using multiple assessors-students, residents, teaching faculty, and patients-to assess both the baseline and graduating competency in MSK medicine of our residents.
肌肉骨骼（MSK）问题占初级保健门诊就诊的 40%。尽管毕业后医学教育认证委员会（ACGME）家庭医学项目要求进行肌肉骨骼医学和运动医学培训，但先前的研究表明，家庭医学住院医师毕业后没有足够的培训来管理常见的肌肉骨骼疾病。造成这种情况的原因可能包括本科和研究生医学教育培训水平的教育不足。
学术家庭医学教育研究联盟理事会对 287 名家庭医学项目主任进行了调查，评估了肌肉骨骼医学教育的现状。收集了关于培训要求的范围和交付的意见，以及进一步课程关注的潜在领域。
287 名项目主任对调查做出了回应（回应率为 41.53%）。大多数（72.60%）是在大学附属或附属项目中，并且有一名经过 fellowship 培训的初级保健运动医学医师（59.85%）担任课程负责人。大多数（77.4%）认为住院医师在进入住院医师时没有进行评估常见肌肉骨骼（MSK）疾病所需的体检技能，大多数（81.15%）认为不需要改变当前的 ACGME 要求。进一步投资的重点领域是在即时护理超声方面发展师资力量（39.85%）。
尽管项目主任认为当前的 ACGME MSK 课程要求可能是合适的，但他们认为住院医师没有评估常见 MSK 疾病所需的检查技能。因此，可以在住院医师之前进一步关注医学生在肌肉骨骼检查技能方面的教育。未来的研究应使用多个评估者（学生、住院医师、教学教师和患者）来开发客观的衡量标准，以评估我们住院医师的 MSK 医学的基线和毕业能力。
