Challenges of transitioning from resident to staff family physician: Rapid review

To determine which non-clinical elements should be included in the transition-to-practice curriculum of a residency training program.

A rapid review was conducted following Cochrane methods guidance using a predefined registered protocol. MEDLINE was searched and studies reporting on transition-to-practice curricula published in English were included. Manifest content analysis was used to identify and report the frequency with which various transition-to-practice curricular elements appeared in the literature. Grey literature, non-English studies, and those reporting on nonphysician health professionals were excluded.

A total of 40 articles met inclusion criteria. Most (92.5%) were from North America.

The most common study design was a survey (42.5%), followed by focus groups (12.5%) and semistructured interviews (12.5%). The most common non-clinical themes of transition to practice were financial and administrative aspects (37.0%), followed by personal well-being and work-life balance (21.0%), career planning and professional development (16.0%), and interpersonal skills and professional behaviour (16.0%). Other topics included legal knowledge related to medical practice (6.9%) and scholarly aspects of independent practice (3.8%).

Medical residents face a steep learning curve as they transition to independent practice. This study identified the most frequently discussed areas of training in non-clinical transition to practice discussed in the literature. Inclusion of these ideas into a dedicated transition-to-practice curriculum could support family residents as they move into independent practice. Further research should seek to evaluate the most effective ways to teach these elements, to identify elements specific to family medicine residency, and to explore learning opportunities for early-career physicians.