Preparing our Future Family Physicians

Posted September 26, 2024: What is happening with the length of training?

Following the member motions at the 2023 AMM, we ceased plans for implementation of a mandated third year of family medicine residency training. Further analysis of past support for training extension is now unnecessary. Instead, the CFPC is working with educators, universities, and partners to develop an education action plan, and providing support university departments of family medicine in their approaches in adopting the Residency Training Profile (RTP).

About the Outcomes of Training Project

 

The status quo is no longer an option


Happy family with three kids on summertime More than five million people in Canada do not have a family doctor. At the same time, family physicians are managing the increasingly complex and evolving needs of communities. This is causing high rates of burnout.

To address the crisis in family medicine, the CFPC’s Outcomes of Training Project (OTP) aims to contribute to the transformation of health care systems through education reform.

Specifically, the OTP presents educational recommendations for delivering on the expectations defined in the Residency Training Profile and strengthening health care in changing times. These recommendations will prepare future family physicians to:
 
  • Work in comprehensive primary care teams
  • Work and meet the needs of communities anywhere in Canada
  • Respond to dynamic and ever-changing societal needs

A Board-supported initiative

This project was initiated by the CFPC Family Medicine Specialty Committee and supported by the Board, given the urgent need and landscape of family medicine. The Board remained continually apprised, engaged in consultations pertaining to the proposed changes, and ultimately granted its approval to the OTP recommendations. The Board continues to hold critical discussions with our Chapters, the academic community, regulatory bodies, and decision makers across Canada.
 

Key Learnings: The bottom line

 

Here’s what we learned about the current landscape of family medicine:

  • Family medicine is more than primary care.

  • Current data are inadequate to properly evaluate the impact of graduates on the health care system

  • Early career family physicians’ ability to serve all the needs of patients is decreasing

  • Early career practice choices are linked to training location, educational exposures, and the availability of supportive practices/models

  • Graduates are not prepared for the diverse societal needs of communities, resulting in the need for future training

  • Training gaps and areas for educational enhancement need priority attention

  • Family medicine training programs are under-resourced and the curriculum is full. This requires a longer training period.

The OTP aims to address these points and strengthen residency training.
 

 

Project Roadmap

 

Phase 1: Strategy – Discover and Define (2019 to 2022)

Through in-depth research and consultation, we were able to discover and define what is needed to strengthen family medicine education.

Download the OTP Report

Who are the family physicians that Canada needs now and into the future?
What are we aiming for in family medicine residency training?
How are we doing relative to this?
Where are we going?

Phase 2: Execution – Develop and Deliver (2022 to 2027)


Group of healthcare workers and patients of different ages in a huddle all with hands in smiling We are now in phase two, planning for implementation of the recommended changes. This phase is focused on curriculum renewal and change stewardship. By March 2024 we will have a national snapshot of what a renewed curriculum will look like, and what is possible in terms of implementation. This will inform the CFPC’s approach to implementing changes to educational standards between 2024 and 2027.

We recognize the complexity and challenge of implementing changes in the current environment. The CFPC is committed to a responsible, iterative, and collaborative systems approach, coupled with evaluation to guide ongoing efforts. The CFPC has convened an Education Reform Taskforce with broad stakeholder involvement. The task force meets regularly to help guide the curriculum and change processes and is governed by the CFPC’s Family Medicine Specialty Committee and Board of Directors.

The urgency to get started dovetails with the urgency of health system change. Additionally, the professional well-being of family physicians and the ability to optimize their role is vital to improving health workforce capacity.  The OTP recommendations outline educational changes that will support and enable broader system transformation.

The CFPC’s primary responsibility is to maintain and uphold an appropriately high and rigorous standard for training that keeps up with the times and prepares the next generation of family physicians.

Debunking OTP Myths: Spotlighting real solutions

To enhance your understanding of the OTP, we have gathered and addressed the most prevalent misconceptions making sure you have a clear perspective of how transformative the project will be for our profession.

 
     

    Myth 1: A three-year residency will undermine the profession and drive people away from becoming family doctors.

  • Fact: A three-year renewed residency will not create a gap year without graduates. Full stop.

    • The three-year renewed residency will be phased in gradually starting in 2027.
    • In a renewed three-year residency, our aim is to have residents in their transitional phase of training provide service in needed areas with a commitment to underserved communities and unattached patients.
    • The three-year renewed residency will better prepare graduates to practice anywhere, ideally in a team setting, and adjust to the changing role of family physicians. This will increase:
      • Health workforce capacity
      • Efficiency and care coordination that may reduce referrals
      • High-quality primary care and help managing complex, chronic illness

  • Fact: A three-year renewed residency will strengthen training.

    Family physicians are certified by the CFPC to practice. We know that there are competencies that many programs are not able to tackle or strengthen because of time constraints. With a three-year residency, curriculum enhancement will include the following topics, which are aligned with societal needs:
    • Home and long-term care
    • Addiction and mental health care
    • Emergency/acute care medicine
    • Indigenous health
    • Health equity and anti-racism
    • Virtual care and health informatics (digital health)

  • Fact: Being a family doctor is hard but one of the most rewarding medical careers.

    The role of family physicians is evolving as we provide more complex care. We hope to attract medical students who are interested in full-scope practice. We do not want to maintain a two-year residency simply to be the shortest available option. Family medicine is not for everyone, but it is a rewarding career for someone who:
    • Values relationships and whole person care
    • Offers versatility and adaptiveness
    • Enjoys diagnostic puzzles and possesses impeccable clinical acumen
    • Values community life, seeks to overcome inequities, and improve health conditions
    • Thrives as a collaborative leader in a health care team

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    Myth 2: There was no reason to implement a three-year renewed residency now. We should have waited.

  • Fact: There is a crisis in family medicine. The status quo is no longer an option.

    The CFPC’s Prescription for Primary Care identifies solutions to meet the needs of Canada’s health care systems and help solve the crisis in family medicine. One of the key solutions includes education reform. This is the current work of the OTP, which is funded by the Team Primary Care: Training for Transformation initiative (TPC). OTP is one of TPC’s 20 practitioner-specific training projects, which aims to change the practice environment and strengthen residency training, helping to achieve the Patient’s Medical Home vision.

  • Fact: Transformative change takes time. We cannot wait.

    The recommended changes to residency training are complex and will take multiple years to implement. See our project roadmap. Waiting would only prolong the current crisis in family medicine. The urgency to get started dovetails with the urgency of health system change and addressing physician well-being.

  • Fact: The needs of patients are changing and becoming more complex.

    Millions of people in Canada do not have a family doctor and managing the needs of communities is becoming increasingly complex. To better serve our communities and prioritize physicians’ well-being, we need comprehensive team-based care. With a three-year residency, future physicians will be able to work in a team-based model and offer care that meets the needs of today’s patients.


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    Myth 3: The CFPC is not basing these decisions on robust evidence and they did not consult broadly.

  • Fact: The CFPC spent four years researching and consulting with a range of interest holders.

    The CFPC has:
    • Consulted with more than 500 interest holders across more than 175 activities. This includes:
      • Field research with more than 300 practicing family physicians, including rural physicians. Analysis also included residents and medical students.
      • Multiple expert panels with members who are teachers and educational leaders.
      • Discussions with Chapters, the academic community, regulators and decision makers across Canada.
    • Consulted with the Board regarding the proposed changes on a regular basis.
    • Conducted multiple literature searches (resulting in more than 25,000 reviewed articles) and assessed 25 different data sets (national, provincial, electronic medical records).
    Our research findings can be found in these in our related resources and evidence summaries.

No results found.

No results found.

No results found.