STFM ADVOCATES FOR PROTECTED NONCLINICAL TIME FOR RESIDENCY FACULTY

Action Based on STFM Member Survey

In 2018, STFM conducted a member survey in preparation for development of a new strategic plan. In an open-ended question, members in all work settings identified workload/administrative burden/competing priorities as their biggest challenge. Many noted that expanding clinical demands were impinging on academic and education time. Following are sample responses to a question asking them to identify their biggest work-related challenge right now:

• Screws are tightening on medical educators everywhere to see more patients, publish more, teach more students, do more online training

• Too many demands, balancing patient care with teaching

• Find(ing) time to do research and teaching while asked to see more patients in the clinic

• Need for more teaching time

• I would like to have more time for academic pursuits (eg writing and research), but find myself being pulled into more and more clinical work. I would like more tools to advocate for balance

• Trying to meet various demands regarding measuring and documenting milestones and administering the program evaluation committee and other administrative work, versus actually doing real teaching and maintaining my own knowledge, taking care of my own clinical practice, and still trying to maintain joy in my work

• Promoting scholarship in a context where many faculty are pressed to increase clinical productivity and in general, are feeling rather burned out

• Underfunded faculty time for nonclinical residency work…navigating leadership in private institution with different mission than learning

In response to the member survey, the STFM Graduate Medical Education Committee, chaired by David Lick, MD, began to formulate strategies to help members—who are feeling that they no longer have time to meet their obligations to their academic programs— advocate for protected time for teaching and meeting academic and accreditation requirements.

The Committee conducted a national survey of program directors to quantify the amount of time allocated for faculty nonclinical work and how much time it actually takes to do required nonclinical work. The results of the survey will be used by a new task force, chaired by Simon Griesbach, MD, to develop Joint Guidelines for Protected Nonclinical Time for Faculty in Family Medicine Residency Programs. The guidelines will be disseminated to health system administrators, who rely on national guidelines and requirements when allocating teaching time, as well as to designated institutional officials, program directors, department chairs, and core faculty.

Response to ACGME Family Medicine Program Requirements

On July 1, 2019, new Accreditation Council for Graduate Medical Education (ACGME) Family Program Requirements went into effect. These requirements changed the program director requirements from 70% supported time for “program administration, evaluation, teaching, resident precepting, and scholarship” to a scaled amount of supported time—based on number of residents—for “administration of the program.” The new requirements also require supported time for associate program director(s) who must devote the “majority” of “professional experiences to administration of and clinical education in the program.”

Protected time for core faculty is not quantified in the new requirements.

When the draft of the Family Medicine Requirements was released for review and comment last spring, STFM joined with the other family medicine organizations to voice concerns about the requirements around program director and faculty time.

Upon release of the final requirements, STFM and other family medicine organizations again raised opposition. STFM sent a letter to the ACGME asking them to give review committees the autonomy to define the amount of time their faculty needs to meet administrative responsibilities and accreditation requirements, while devoting sufficient time and attention to preparing residents for future independent practice. As of the writing of this article, STFM is awaiting communication about next steps by the ACGME, as well as the release of FAQs from the ACGME Family Medicine Review Committee.