Family Medicine最新文献

{"title":"Assessment of Emergency and Trauma Stabilization Training in Family Medicine Residency Programs: A CERA Study.","authors":"Joel Klas, Cole Puffer, Paul Klas, Joyce C Hollander-Rodriguez, Patricia A Carney","doi":"10.22454/FamMed.2025.459247","DOIUrl":"https://doi.org/10.22454/FamMed.2025.459247","url":null,"abstract":"<p><strong>Background and objectives: </strong>Family physicians are central to the national emergency department workforce, especially in rural communities. However, the number of family physicians working in emergency departments is decreasing, perhaps due to lack of training.</p><p><strong>Methods: </strong>We assessed emergency medicine and trauma stabilization curricula in US family medicine residencies to identify barriers to training in these areas. Council on Academic Family Medicine Educational Research Alliance (CERA) program directors' surveys were administered between September 26, 2023 and October 30, 2023. We stratified data according to community size (&lt;30,000; 30,000-74,999; 75,000-149,999; 150,000-499,999; 500,000-1,000,000; and &gt;1,000,000) to explore whether training differed based on training program rurality.</p><p><strong>Results: </strong>Of the 715 program directors, 271 responded (37.9%). Of the program directors who responded, nearly 76% reported that residents spend 100 to 299 hours training in emergency rooms, and more than 86% reported that residents lead 0 to 5 trauma stabilizations by the time their training is complete, which did not differ according to rurality. Only 3.0% reported that all their graduates were prepared to work independently in emergency rooms, and 3.4% reported that all their graduates were prepared to lead trauma stabilizations, which also did not differ according to rurality. Barriers to training included Accreditation Council for Graduate Medical Education (ACGME) emphasis on other practice requirements (58.3%) and a lack of emphasis on trauma stabilization (69.7%).</p><p><strong>Conclusions: </strong>Most program directors reported that few of their residents were prepared to independently work in emergency departments. If ACGME wishes to increase family medicine graduates' entry into the emergency medicine workforce, system changes may be required to increase emphasis on emergency training and its core component of trauma stabilization.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noticing.","authors":"Minda Liu","doi":"10.22454/FamMed.2025.168307","DOIUrl":"https://doi.org/10.22454/FamMed.2025.168307","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing the Heart.","authors":"Amy Odom","doi":"10.22454/FamMed.2025.524393","DOIUrl":"https://doi.org/10.22454/FamMed.2025.524393","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining and Addressing Gaps in Mentorship for Underrepresented Faculty.","authors":"Fareedat O Ajibade, Christopher L Smyre, Latasha S Perkins, Arianne Cordon-Duran, Kendall M Campbell","doi":"10.22454/FamMed.2025.224099","DOIUrl":"https://doi.org/10.22454/FamMed.2025.224099","url":null,"abstract":"<p><p>The current political and social climate is directly and indirectly impacting the work-life wellness of family medicine faculty who are underrepresented in medicine (URiM). Furthermore, issues of social justice are an intimate part of the lived experience of URiM faculty physicians and cannot be ignored. Institutional programs and offices that have traditionally served to support URiM faculty-namely diversity, equity, and inclusion (DEI) offices and programs-are actively being dismantled through anti-DEI legislation across the country. Where do such changes leave URiM faculty in terms of career advancement and support? Studies show that mentorship is necessary and effective in URiM faculty development. Despite the gains through mentorship, gaps in the support of URiM faculty are obstacles to their reaching their highest potential. Obstacles such as pseudoleadership, scholarship delay, minority taxation, and income inequality make succeeding at their institution more difficult for these faculty members. These hurdles confound the reality that URiM faculty physicians tend to have value systems surrounding their own self-actualization, family structure, and professional development that differ from institutional priorities. Lack of awareness of these differences in mentorship needs has negative consequences for the growth and advancement of both URiM faculty and their institutions. Prioritization of effective mentorship strategies is necessary to bridge the value differences and overcome the obstacles that will ultimately benefit both the institutions and their URiM faculty. This article defines the gaps in mentorship of URiM faculty, introduces strategies for closing the mentorship gaps, and summarizes how doing so produces gains on a systemic level.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invisible.","authors":"Iris Wagman Borowsky","doi":"10.22454/FamMed.2025.897785","DOIUrl":"https://doi.org/10.22454/FamMed.2025.897785","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of the Family Medicine Clerkship: A CERA Secondary Analysis.","authors":"Bryce A Ringwald, David Banas, Allison Macerollo, Ericka Bruce, Matthew Farrell","doi":"10.22454/FamMed.2025.306815","DOIUrl":"https://doi.org/10.22454/FamMed.2025.306815","url":null,"abstract":"<p><strong>Background and objectives: </strong>The family medicine clerkship has been found to influence medical students' decision-making regarding specialty choice. Understanding how the family medicine clerkship has changed over the past decade may assist in recruitment efforts. Our study explored trends in family medicine clerkship design, length, and format and correlated these characteristics with high proportions of medical school graduates choosing family medicine.</p><p><strong>Methods: </strong>We performed a secondary analysis of the Council of Academic Family Medicine Educational Research Alliance annual family medicine clerkship director surveys from 2012 to 2023. We analyzed standard family medicine clerkship structure questions that were asked in each survey. We analyzed trends using Pearson's correlation coefficient test and correlations with χ2 test for independence.</p><p><strong>Results: </strong>Over the past 10 years, a transition from traditional block-style clerkships toward longitudinal-style clerkships has been increasing. Both block-style and longitudinal-style clerkships have decreased in length, with most clerkships lasting 4 weeks or less. A change also has taken place in the composition of clinical experiences, with reduced use of community preceptors as the primary source of clinical experiences. In 2021, schools with a higher percentage of students working with community preceptors were associated with higher percentages of medical students choosing to pursue family medicine.</p><p><strong>Conclusions: </strong>Alterations in the family medicine clerkships have led to medical students getting decreased and intermittent exposure to family medicine. Most clerkship experiences are not with community preceptors, a major change following the COVID-19 pandemic. The repercussions of recent changes to the family medicine clerkship on the rate of matching medical students into family medicine remains unclear.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diagnostic Blind Spot in Early Medical Education.","authors":"Waseem Jerjes","doi":"10.22454/FamMed.2025.135278","DOIUrl":"https://doi.org/10.22454/FamMed.2025.135278","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Population Health Management Practices Among Family Medicine Residency Programs.","authors":"Stephen M Carek, Carina Brown, Dana Neutze, John Emerson, Mark Shaffer, Alex Ewing, Peter J Carek","doi":"10.22454/FamMed.2025.484181","DOIUrl":"https://doi.org/10.22454/FamMed.2025.484181","url":null,"abstract":"<p><strong>Background and objectives: </strong>Population health management is a systematic approach to ensuring that all members of a given population receive appropriate preventative, chronic, and transitional care. It emphasizes addressing health inequities and the social determinants that influence health and related outcomes in communities served by family physicians. This study examines the current practices of family medicine residency programs in teaching population health management and the use of clinical data registries for their primary clinic sites.</p><p><strong>Methods: </strong>Data were collected through a survey conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA) from September 26 to October 30, 2023. The survey targeted program directors of Accreditation Council for Graduate Medical Education accredited family medicine residency programs, with a final response rate of 37.90% (271/715).</p><p><strong>Results: </strong>We found significant variability in the clinical data registries and population-based reports provided to residents. Of the residency programs, 29.52% provided both resident-specific and practice-level panel data, while 12.92% did not provide regular data reports. Clinical quality and patient satisfaction were the most common elements in reports. Programs varied in the frequency and dedicated time for population health management, with many programs citing resource constraints.</p><p><strong>Conclusions: </strong>The findings highlight the need for standardized education and clinical systems to integrate population health into resident training. Ensuring consistent, accurate, and actionable data can enhance the quality and value of care and prepare residents for future practice in value-based care environments.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Medicine Diploma Program in Jordan: Components for Success and Sustainability.","authors":"Benjamin Colton, Therese Zink","doi":"10.22454/FamMed.2025.442203","DOIUrl":"https://doi.org/10.22454/FamMed.2025.442203","url":null,"abstract":"<p><strong>Background and objectives: </strong>Jordan has residency positions available for approximately 20% of graduates from Jordanian medical schools, with approximately 30 in family medicine. Most graduates never complete a residency program and instead work as outpatient general practitioners (GPs). The need for more well-trained GPs is overwhelming. To address this gap, ERASMUS+ funding provided the money and technical expertise of European family medicine faculty to create a diploma program that enhanced prior efforts. In this paper, we share the evaluation data gathered for three levels of Kirkpatrick's four-level model and discuss the additional steps taken to ensure sustainability of the diploma program.</p><p><strong>Methods: </strong>A needs analysis consisting of a series of surveys, site visits, personal interviews, and bilateral meetings was conducted by the project consortium to identify the items most necessary in developing a sustainable project. The four levels of the Kirkpatrick evaluation model were used to evaluate the project.</p><p><strong>Results: </strong>Trainees improved in areas of understanding primary care, ethics and values, communication skills, and patient management. Six months after diploma completion, Level 3 data showed decreases in both antibiotic prescriptions and referral rates. To increase sustainability, our program involved local stakeholders from the beginning of the project, provided training for family medicine mentors, offered incentives for program trainees, and developed a sustainable financial model.</p><p><strong>Conclusions: </strong>Diploma programs fill an important void in the expertise of GPs. Building on prior diploma program efforts, our program added critical elements to create a successful and sustainable program.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five Years of Family Medicine Education in Zambia: Challenges, Milestones, and Lessons Learned.","authors":"Matthew S Haldeman, Evaristo Kunka, Bassim Birkland, Mpundu Makasa","doi":"10.22454/FamMed.2025.569547","DOIUrl":"https://doi.org/10.22454/FamMed.2025.569547","url":null,"abstract":"<p><p>Over the past 2 decades, the growing need to strengthen primary care in southern Africa has fueled a rising interest in the specialty of family medicine. Given the region's heavy burden of both communicable and noncommunicable diseases, along with restricted health care resources and limited access to care, family physicians may play a key role in improving health care access and quality in these settings. The development of family medicine in Zambia began in 2013 as a working group of committed clinical and public health academics, and progressed to the launch of that country's first family medicine residency in 2019. Despite enormous challenges, the program has flourished since that time, growing rapidly from the inaugural two residents in 2019 to 45 residents and recent graduates by 2025. While this growth has allowed the residency to become a leader in family medicine education in the region, it also has brought a new set of challenges. In this narrative, we describe the health care context of Zambia, the introduction of family medicine as a specialty to a new health care landscape, and the launch of that country's first ever and rapidly growing family medicine residency, as well as unique challenges, strategies employed, and lessons learned along the way. We conclude the article by looking ahead at new challenges and recommendations for the program's continued growth. The experiences and lessons learned may be used by future family medicine residency start-ups throughout sub-Saharan Africa.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}