A study of closure of family practice residency programs

Between July 1, 2000, and July 1, 2002, the Residency Review Committee for Family Practice had received requests for voluntary withdrawal from 27 residency programs. This number represents a significant increase in the rate of program closure over previous years.

We compared descriptive data on these closing programs and explored factors contributing to the closure.

Descriptive program data were collected from the Accreditation Council for Graduate Medical Education, National Resident Matching Program, the American Academy of Family Physicians, and the American Board of Family Practice. Program directors from closing programs were invited to participate in a semi-structured interview to discuss factors contributing to the closure of their program.

Seventy-five percent of closing programs were community based, median program age was 11 years, board pass rate averaged 98%, and 69% cared for underserved communities. Financial, political, and institutional leadership changes were most frequently cited by program directors as primary reasons for program closure.

The rate of program closure is increasing, affecting programs that meet most measures of high quality. Quality programs are being lost, and the ultimate impact is yet to be seen. Program directors offer warning signs and advice that is generally applicable to other family practice residency programs.