Cultivating the Next Generation of Family Medicine Leaders

By Vivian Mason

Family Medicine attracts more medical student interest than any other specialty, according to recent survey data published by Medscape. And, according to the American Academy of Family Physicians, more medical students and graduates participating in the National Resident Matching Program in 2018 chose family medicine than ever before in the specialty’s history.

While Uniformed Services University (USU) consistently ranks in the top 10 for students matching to Family Medicine, USU’s commitment to cultivating top-notch family medicine leaders doesn’t stop with medical students. The University’s Family Medicine department continues its next-generation grooming through an innovative and immersive academic program – the Family Medicine Resident Development Program.

The program was rolled out in 2005 as the brainchild of Dr. Brian Reamy, professor, and former chair of Family Medicine in USU’s F. Edward Hebert School of Medicine and, now the school’s Senior Associate Dean for Academic and Faculty Affairs. In addition to Dr. Reamy, several faculty members have led the department program over the years, including Dr. Jessica Servey, and Dr. Christopher Bunt and until recently, Air Force Lt. Col. (Dr.) Christopher Jonas. Navy Cmdr. (Dr.) Mike Arnold now spearheads the effort.

Army officers speak with people at the American Academy of Family Physicians Family Medicine Experience 2017 or FMX 2017, Sept. 14 at the Henry B. Gonzales Convention Center in downtown San Antonio. (Photo by Derrick Crawford)

Since its inception, the Family Medicine Resident Development program has trained up to seven tri-service family medicine residents annually. According to Arnold, an assistant professor in USU’s Family Medicine department, e-mail notifications are sent to all military Family Medicine residency programs in the United States that applications are being accepted. Prior participants advertise the program through word of mouth and at the Uniformed Services Academy of Family Physicians annual meetings. Applicants submit a letter of recommendation from their program director, a personal statement, a research proposal, and a curriculum vitae. The applications are then reviewed and rated by the USU Family Medicine department faculty for competitive selection to the program.

Applicants are normally third-year active duty Army, Navy, or Air Force Family Medicine residents. The selection process typically yields two fellows from each service branch, who spend a month at USU. During that time, they are exposed to a variety of instructors from the Family Medicine department and learn leadership, teaching, and presentation skills through individual instruction and practice at both USU and Fort Belvoir.

Maj. (Dr.) William Bynum (right), 11th Medical Group, advises
Lt. \(Dr.) Mary Beth Ray, Family Medicine Residency Program,
n how to simulate placing a hormone implant into a patient’s
arm at the Fort Belvoir Community Hospital, Va. (U.S. Air
Force photo by Staff Sgt. Joe Yanik)

The curriculum is composed of several core elements that include small group teaching and instructional skills, clinical precepting, lecture skills, learner assessment and feedback, academic progression and career development, and scholarly activity and research. Particular emphasis is placed on building and mitigating shortages of effective junior faculty for the military Family Medicine residency programs. Participants also receive one-on-one instruction from faculty, extensive advice on their CVs, assistance with building their academic portfolios, instruction on academic promotion, research mentoring and direct experience in Reflective Practice, musculoskeletal courses, pre-clerkship courses, and teaching experiences. Residents are paired with USU faculty, closely observed, and given immediate and summative feedback. They practice what they have learned with students and residents. Over the course of the month, residents focus on an area of scholarly interest with the goal of publication or presentation.

The program goal is to ensure that graduates are equipped to become future leaders in Family Medicine.

This unique program has been studied and found to strongly enhance resident abilities in teaching, evaluation, feedback and research participation. Residents who have completed the program indicated high satisfaction with the curriculum and experience. These results were published in the 2012 edition of the journal Medical Teacher. A subsequent longer term study of graduates is in progress.

Family Medicine residents at the Naval Medical Center Camp Lejeune, North Carolina, participate in the annual Research Symposium. (Photo by Naval Medical Center Camp Lejeune)

The program has existed for 13 years, and 58 residents have graduated. Many have gone on to become nationally recognized teaching faculty, residency program directors, or associate program directors, and faculty at USU. Graduates have completed additional fellowships in faculty development or other disciplines, and some have become leaders in national family medicine organizations.

“It’s been an incredibly productive program,” remarked Jonas. “USU has a remarkable reputation, particularly the Family Medicine department. This is truly a special and unique place. There is simply nothing like it. I directed the program for two cycles, but with the involvement of such greats as Dr. Reamy, Dr. Servey, Dr. Bunt, and now Dr. Arnold, it is little wonder that results have been very favorable. We’re very fortunate to have a unified and collegial department that creates and collaborates on countless projects like this and we are really proud of its success. The results are truly inspirational.”