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Innovating to Improve Individualized Training in Internal Medicine Residency: Inpatient Threads and Block 2.0.

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UCSF developed a customizable curriculum to individualize internal medicine (IM) residency training. This innovative program enhances mentorship and career development while meeting Accreditation Council for Graduate Medical Education (ACGME) requirements.

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Area of Science:

  • Medical Education
  • Internal Medicine Residency Training
  • Curriculum Development

Background:

  • Accreditation Council for Graduate Medical Education (ACGME) Internal Medicine (IM) requirements mandate specific durations for individualized and outpatient training.
  • Balancing these training requirements with clinical service demands presents a significant challenge for residency programs.
  • The University of California, San Francisco (UCSF) implemented a novel, multi-faceted strategy to personalize resident education across various clinical settings.

Purpose of the Study:

  • To design and implement a curriculum framework that fosters individualized education, provides longitudinal mentorship, and supports career progression.
  • To ensure the developed curriculum adheres to all ACGME program requirements for internal medicine residency.
  • To create a flexible educational structure that can be adapted to diverse resident needs and career aspirations.

Main Methods:

  • The study involved categorical Internal Medicine (IM) residents at Postgraduate Year 2 (PGY2) and PGY3 levels across three hospitals affiliated with UCSF.
  • Two key innovations were introduced: 'Inpatient Threads' for selecting career-aligned inpatient tracks and 'Block 2.0' for a revamped outpatient/elective curriculum.
  • Block 2.0 featured longitudinal subspecialty clinics (LSCs), skill-based pathways, dedicated scholarly time, and enrollment in a Graduate Medical Education (GME)-wide Academic Pathway.

Main Results:

  • Needs assessments and survey data from 2014-2023 informed the curriculum redesign.
  • Preliminary results indicate enhanced mentorship opportunities and increased participation in the resident research symposium.
  • Ongoing evaluations utilize ACGME surveys, internal surveys, and focus groups to assess program effectiveness.

Conclusions:

  • The developed customizable curriculum provides a replicable model for individualizing internal medicine residency training.
  • This approach successfully balances personalized educational experiences with the maintenance of a strong generalist foundation.
  • The program demonstrates a viable strategy for enhancing resident education and career development within the constraints of ACGME requirements.