Family Medicine Advances Transition to Competency-Based Education

By July 2023, family medicine residency programs will need to make major changes to their programs to meet new ACGME requirements. The 2023 requirements reflect the first major update for family medicine residencies in about 10 years.¹ The new requirements include several components that necessitate changes in how education is delivered and assessed, with an emphasis on ensuring that residents demonstrate competence.²

In August 2022, the American Board of Family Medicine Foundation awarded the Society of Teachers of Family Medicine (STFM) a 17-month grant to support the development phase of a multi-year project to equip residency programs to deliver competency-based medical education (CBME) and assessment. This work is being chaired by Linda Montgomery, MD, Vice Chair of Education at the University of Colorado Department of Family Medicine.

To set the groundwork for the project, 41 individuals met at a Summit in January 2023 to discuss the future of CMBE in family medicine. Participants included family medicine leaders, faculty, coordinators, and residents, plus representatives from pediatrics, surgery, and Canadian family medicine. Topics of discussion included:

• Needs of family medicine residency programs

• The difference between CBME and traditional medical education

• Competency frameworks and outcomes

• Assessment methods

• Assessment technologies

• Individualized learning plans

• Expectations for standardization of CBME across programs

• Next steps for a task force

Broad takeaways from the Summit:

• This change/reform in education is in service to what family medicine needs.

• Don’t assume CBME is time variable.

• A transition will require extensive faculty development.

• It’s important to ensure we’re not creating one more thing for programs to do/measure. This is “the thing,” not “an additional thing.”

• With CBME, we don’t necessarily need to assess competence in everything a family physician might do. We can test some and assume others.

• This transition will take time; we need to make incremental changes.

Summit participants also discussed strategies for ensuring that CBME is equitable, accurate, and not too burdensome for faculty, coordinators, and residents.

STFM has now formed a task force, which will meet through January 2024 to:

• Identify and aggregate available training and resources

• Develop new assessments and assessment approaches

• Aggregate and develop templates and strategies for individualized learning plans

• Identify strategies for including residents in the assessment process

• Create a plan for faculty development

• Create a plan for piloting new assessments and assessment approaches

Task force members include:

• R. Aaron Lambert, MD, Program Director, Cabarrus Family Medicine Residency Program

• Pamela MacMillan, GME Coordinator, University of Wyoming

• Stephenie Matosich, DO, Associate Program Director, Family Medicine Residency Spokane

• Linda Montgomery, MD, Vice Chair of Education, University of Colorado Department of Family Medicine

• W. Fred Miser, MD, MA, Professor Emeritus, The Ohio State University Wexner Medical Center

• Randolph Pearson, MD, Assistant Dean for GME, MSU Family Medicine Residency

• Michelle Roett, MD, MPH, Professor and Chair, Department of Family Medicine, Georgetown University Medical Center

• Mary Theobald, MBA, Chief of Strategy and Innovation, Society of Teachers of Family Medicine

• Priyanka Tulshian, MD, MPH, Residency Faculty, Contra Costa Family Medicine Residency

• Olivia Rae Wright, MD, Program Director - PeaceHealth Southwest Family Medicine/Addiction Medicine Fellowship

• Velyn Wu, MD, MACM, Core Faculty, University of Florida Family Medicine Residency Program

• Bright Zhou, MD, MS, Resident, Stanford O’Connor Family Medicine Residency

Future phases of CBME work will focus on faculty development, plus implementation, piloting, and dissemination of CBME resources and assessment tools developed and aggregated by the task force.

• © 2023 Annals of Family Medicine, Inc.