The Outpatient Training Gap: A Pilot Study.

Area of Science:

• Medical Education
• Primary Care Training
• Family Medicine

Background:

• Family medicine residency training predominantly occurs in hospitals, not reflecting real-world outpatient primary care.
• A gap exists between hospital-based training and the outpatient settings where most primary care clinicians practice.

Purpose of the Study:

• To explore family medicine residency directors' perspectives on the balance of inpatient versus outpatient training.
• To identify factors influencing the allocation of resident time between hospital services and continuity clinics.

Main Methods:

• Pilot study involving a survey of 11 California family medicine residency program directors.
• Semi-structured interviews were conducted with 9 of the 11 surveyed directors.
• Qualitative thematic analysis of interview data to identify common themes.

Main Results:

• Program directors generally expressed satisfaction with the current inpatient/outpatient schedule balance for residents.
• Key factors influencing inpatient training included resident staffing needs, educational value of rotations, and limited continuity clinic capacity.
• Accreditation Council for Graduate Medical Education (ACGME) requirements for continuity clinic visits were perceived as hindering innovative outpatient training.

Conclusions:

• Family medicine residency program directors in this study did not perceive an overemphasis on inpatient training within their programs.
• The study highlights potential challenges in optimizing outpatient training experiences within current residency structures.