New Program Grooms Residents for the Future of Health Care
A novel program will allow some family medicine residents to gain leadership skills, develop competencies in comprehensive family medicine and earn a Masters degree at the same time.
The Integrated Three Year Family Medicine Residency Program, IP3 for short at the University of Toronto Department of Family and Community Medicine (DFCM), is a robust program with two main academic components. First, residents will develop core competencies in comprehensive family medicine leading to certification with the College of Family Physicians of Canada. Second, they will earn a University of Toronto Master of Science Degree in System Leadership and Innovation.
“Because it is integrated, the learnings from the clinical and leadership components support each other and the practicum activities in the Master's programs are intended to be relevant to the work our residents will do after graduation,” says Dr. David Tannenbaum, Deputy Chair, Partnerships at DFCM and IP3’s Program Director.
The leadership component is currently offered through the University of Toronto Institute of Health Policy, Management and Evaluation, and participating family medicine residents will further meet their academic requirements through electives and practicum opportunities.
The program has not received a formal indication that it will obtain government funding despite expressed interest, but that has not deterred Dr. Tannenbaum and colleagues from pursuing a pilot program in July 2018 with two residents from Barrie and Mount Sinai Hospital.
Two years ago, Dr. Tannenbaum approached DFCM faculty with interest in leadership training, including Vice-Chair for Family Doctor Leadership Dr. David White, and Vice Chair of Education, Dr. Risa Freeman. Typically, residents do two years of family medicine training and some elect to do a third year where they gain enhanced skills in various areas of practice. Dr. Tannenbaum felt it was time to try something new.
“The program was initially conceived as having two arms – one in which an enhanced skills PGY3 program would be integrated with the standard two-year residency designed to maintain skills in comprehensive care while developing an area of clinical interest – and another in which a leadership-based Masters would be completed in parallel with standard residency training.”
After considerable deliberation, a decision was made to launch a pilot version of the leadership arm to test the concept of an integrated program and to focus on leadership competencies. With models of regional coordination of primary care in the province and with changes in practice models, family physicians are often sought out for leadership roles in Local Health Integration Networks (LHINS), institutions and at the practice level. The IP3 would help new family physicians meet the challenges of these roles through formal leadership training.
The idea received full support from the six Chairs of Departments of Family Medicine in Ontario, who viewed the program as an important first step in meeting leadership needs in primary care across the province. A written proposal on behalf of the chairs was sent to the Ontario Ministry of Health and Long-term Care in early March seeking funding for the program and residency positions.
“We presented the program to first-year residents at a city-wide core day. Six residents were willing to extend their training and commit to delaying their certification examination in family medicine until the third year. Four of them submitted applications and we were able to accept two,” says Dr. Tannenbaum.
DFCM is running the pilot program with an internally-funded proof of concept model: IP3’s leadership curriculum will be continuously updated as the residents move through the curriculum.
Administrators will be looking at how integration is truly working with the IP3’s major components. In a parallel process, DFCM’s Office of Education Scholarship is conducting a literature review and interviews with stakeholders and experts that will inform the program’s ongoing development.
“In time, it is our hope that we can return to the original idea of also integrating training of certain enhanced clinical skills into a three-year horizontal program that will permit graduates to help meet advanced clinical needs of patients in many communities. In the meantime, we are excited about the launch of the leadership arm of IP3 and look forward to working closely with the first cohort of residents.”