Pandemic Disruption in Residency Did Not Alter Trends in Intended Scope of Practice

Context: The COVID-19 pandemic has disrupted both the healthcare system and medical education. In response to the pandemic, family medicine residency (FMR) programs had to adjust their training curriculum. This is the first national survey to explore the intended scope of practice of graduating family medicine residents in the pandemic.

Objective: We aimed to investigate whether the pandemic affected the intended scope of practice of graduating family medicine residents.

Study Design and Analysis: Cross-sectional study.

Setting or Dataset: We used 2017 through 2021 data from the American Board of Family Medicine (ABFM) Family Medicine Certification Examination Registration Questionnaire. The questionnaire is a required component of registration, which has a 100% response rate. The respondents are asked if they plan to provide a series of services and procedures after residency.

Population Studied: The examination is administered twice a year, spring and fall. The questionnaire is completed by graduating residents 3 to 4 months before the examination date. For example, 98% (3,983/4,066) of 2021 graduates completed the questionnaire prior to March 2021.

Intervention/Instrument: Nationwide survey for graduating family medicine residents.

Outcome Measures: Primary outcome was the intended scope of practice of graduating family medicine residents.

Results: 18,479 graduating residents were included in this study. Intended scope of practice in these services and procedures remained unchanged among 2021 graduating residents, compared with the pre-pandemic graduating residents from 2017 to 2020.

Conclusions: We did not detect a change in the intended scope of practice between pre-pandemic and pandemic period residency graduates despite the disruption of their medical education and higher burnout rates among family physicians. Our findings suggest that FMR flexibly adjusted their curriculum to ensure resident training on a variety of services and procedures in response to the pandemic. Our study includes the following limitations. Our survey did examine the intended scope of practice instead of actual provision of practice after residency, so it is still unknown how much the pandemic affects scope of practice after residency. It is possible that 2021 graduating residents already developed their competencies before the pandemic. To fully assess the pandemics’ impact on training, we need to track these trends with later cohorts, including 2022 and 2023 graduates.