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Residency Redesign: Much to Do

Jones D, McGuinness GA
Journal of Graduate Medical Education
Pub Med #: 

The authors of “Financing Residency Training Redesign”1 are to be commended as leaders of the exceptional Preparing the Personal Physician for Practice (P4) project funded by the Association of Family Medicine Residency Directors and the American Board of Family Medicine Foundation.2 They have taken the study of residency redesign to an important next level by estimating costs and finding that the cost of innovation represented a small increase above the baseline cost of training.

At least 2 other specialties have evaluated the content and structure of resident education at the same time as the P4 project in family medicine. The American Board of Pediatrics Foundation funded an in-depth analysis of pediatric residency training, the Residency Review and Redesign in Pediatrics (R3P) project,3and the results contributed to changes in the Accreditation Council for Graduate Medical Education (ACGME) Program Requirements for Pediatrics.4 Somewhat earlier, the Educational Innovation Project (EIP) of the ACGME began its exploration of innovative change by inviting selected internal medicine residency programs to innovate and collect information on their experience.5 The EIP produced a collaborating network of participating programs that shared their innovations, enabled the elimination of prescriptive program requirements for all internal medicine programs, and heralded elements of the ACGME's Next Accreditation System.6 Neither the redesign effort in pediatrics nor that in internal medicine programs produced published data on program-level costs of these initiatives.