Starfield Summit Is First Step in Revising Residency

Starting next month, FPs will see a rollout of thought-provoking ideas about the future of training that sprang from Starfield Summit IV: Re-Envisioning Family Medicine Residency Education hosted in December by the AAFP and ABFM. That event, which also included contributions from and participation by the American College of Osteopathic Family Physicians, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group and the Society of Teachers of Family Medicine, gathered a diverse group of family physicians and other stakeholders from all sectors of the specialty, including practicing clinicians, educators, researchers, administrators, learners and public members/patient advocates. They were tasked with answering six key questions, including what and how family medicine residents should be taught.

The drafts of 31 papers related to those questions were discussed during the Dec. 6-7 meeting. At its conclusion, attendees were asked to ponder one final question: “If there is no change, will family medicine residencies as currently organized meet the needs of society over the next 25 years?”

Fifty-one of 54 participants said no.

Attendees, having read and discussed all the papers, also were asked to assess the level of change needed on a scale of one to 10 (with one being none and 10 representing aggressive change). The average response was 6.5.

“Summit participants felt overwhelmingly that we must change to meet the needs of society, and we need significant change,” said Karen Mitchell, M.D., director of the AAFP’s Division of Medical Education. “Now it’s up to the ACGME writing group to put it all together.”

The final versions of the aforementioned 31 papers will be published in a March supplement to Family Medicine, the official journal of STFM. Those papers also will be considered by the Accreditation Council for Graduate Medical Education program requirement writing group, whose members participated in the Starfield Summit as observers.

Summit participants reached consensus on a number of ideas, such as making room in the new program requirements for both substantial innovation and better standardization, but it will be up to the writing group to determine whether to incorporate recommendations from the summit in its work. Mitchell, however, said many of the themes developed during the event resulted in “compelling suggestions,” such as the need to focus on a resident’s continuity patient panel and population health, as well as “competency-based education” incorporating master adaptive learning.

The ACGME writing group is expected to publish a draft of updated principles for family medicine residency program requirements by early March, Mitchell said. A 45-day public comment period will follow.

Mitchell, who will give a presentation on the Starfield Summit with ABFM President and CEO Warren Newton, M.D., M.P.H., next month during the virtual Residency Leadership Summit, urged family physicians and trainees to learn more about the process and participate.

“Input from the family medicine community is so important to ensure we are addressing the family physician training needs of the future,” she said.

A commentary about the process written by Newton, Mitchell and ABFM Chair Michael Magill, M.D., is expected to be published in the March issue of the Annals of Family Medicine. Additionally, survey data regarding residency training collected by family medicine organizations last fall and background briefs are available on the Starfield Summit website.

Mitchell said another comment period is likely later in the rigorous process when specific requirements are proposed. Implementation of the new requirements is expected to take place by July 2022.