The fourth-year chief resident position in family practice training, 1987-1992

The status of fourth-year chief resident (FYCR) positions in US family practice postgraduate training over the period 1987 to 1992 was assessed to better understand the role of the FYCR in family practice education.

Questionnaires were mailed to the residency directors of all US family practice residency training programs in 1987 and again in late 1991.

Response rates were 77% and 78% in 1987 and 1992, respectively. Nineteen programs had FYCR positions in 1987 and 15 had them in 1992. There was no statistically significant change in the number of FYCR positions during this time period. Family practice fellowships existed in 63% of programs. The major justifications for the position were administrative assistance, clinical instruction, and faculty development. Most FYCRs were funded through institutional salary lines or patient care revenue. Inpatient and outpatient clinical attending responsibilities were held by most FYCRs and increasingly, FYCRs are involved in faculty development training.

Between 1987 and 1992, FYCRs have taken on greater administrative and clinical instructor roles, and more programs are involving FYCRs in faculty development. The position offers a unique role for the transition between trainee and faculty.