Preparing family medicine physicians to meet the needs of their patients is a fundamental goal of residency training. These needs shift, and so training must also adapt. The revised Accreditation Council for Graduate Medical Education (ACGME) requirements for GME in family medicine call on residency programs to become increasingly sophisticated at measuring trainee outcomes with patient experience data, population health metrics, Milestones and/or ITE scores.1 Increasingly, stakeholders recognize that true outcome measures must also incorporate performance after residency to evaluate whether training goals are actually accomplished as graduates enter their practice. Further, in the absence of a formal knowledge-sharing system, a wealth of experiential wisdom is siloed rather than shared between program directors (PDs).2 A rising tide raises all ships! So, we might ask: in what novel ways can PDs measure and take pride in describing their program’s strengths and outcomes? Or: how can PDs whose alumni consistently perform well in one or more areas of family medicine practice share with other PDs how to prepare their residents for the same?
In 2023, the Strengthening Outcomes and Assessments in Residency (SOAR) project, a new community of practice established by the Association of Family Medicine Residency Directors (AFMRD) and the American Board of Family Medicine (ABFM), will aid residency programs in understanding their outcomes, sharing what works, and supporting self-study and improvement efforts. SOAR builds upon prior AFMRD efforts, such as the Residency Performance Index (RPI), and expands upon the ABFM National Graduate Survey (NGS).3-5 It will augment existing forums and events where program directors and faculty gather to reflect and swap bright spots by featuring outcomes data and information. It will provide opportunities for PDs to engage in educational scholarship and GME innovation that will shape the future of new program requirements and family medicine care delivery.
SOAR recognizes the importance of imprinting during residency as the foundation to post-graduate practice.6-8 To achieve socially accountable outcomes as a specialty, PDs must carefully consider the influence of their programs on their residents’ actual post-graduate practice. Examples might include whether graduates of rural residencies ultimately practice in rural areas or if programs that emphasize training in substance use disorder treatment produce alumni who continue to provide that care. SOAR aims to connect family medicine PDs with both the tools to identify programs whose alumni demonstrate certain qualities in post-graduate practice and with a forum in which to identify and discuss the replicable program characteristics that prepared those newly minted physicians to be successful.
SOAR seeks to help family medicine PDs adapt to recent revisions to the ACGME program requirements for family medicine, which call for the Program Evaluation Committee to include outcomes data—including graduate performance—in its programmatic assessment. SOAR can also assist PDs in composing Annual Program Evaluations, which should include a section on graduate attainment outcomes.
To facilitate a key principle of SOAR, the “For You by You” joint advisory committee was established in 2022. Members of the advisory committee include PDs, associate PDs, program coordinators, alumni PDs, and new-to-practice physicians. Over the past year, the advisory committee started to envision how the community of family medicine residencies can measure, highlight, and disseminate what family medicine GME does well. To align its work with AAFP and other health care organizations, the SOAR Advisory Committee, together with the AFMRD Board of Directors, proposed the project initially prioritize study and discussion of outcomes in 4 areas:
(1) Pregnancy care
(2) Care of infants and children
(3) Behavioral health
(4) Care of vulnerable populations
At the 2023 AAFP Residency Leadership Summit, the ABFM Foundation sponsored a SOAR kick-off event for residency leaders to introduce the community and discover some uncommon but successful behaviors and strategies of family medicine residency programs. To learn more about SOAR, visit the AFMRD and ABFM Foundation websites.
Acknowledgments
The authors express appreciation to the SOAR Advisory Committee and AFMRD Board of Directors for their ongoing insights into the conceptual work of SOAR.
- © 2023 Annals of Family Medicine, Inc.
