Four-year training in family medicine: Strength through versatility using the uniformed services as a model

BACKGROUND: There is concern regarding the number of US medical graduates choosing careers in primary care. To address this, the American Academy of Family Physicians (AAFP) Future of Family Medicine project has recommended increasing the length of family medicine residency from 3 to 4 years as one way to increase student interest in family medicine. Given increasing training requirements for family physicians, we investigated attitudes within the military regarding 4-year postgraduate training in family medicine. METHODS: A survey exploring attitudes toward extended training in family medicine was distributed electronically to all 1,659 members of the Uniformed Services Academy of Family Physicians. RESULTS: Most (68%) respondents felt that extending family medicine training to 4 years would not increase interest in family medicine. The mean suggested length for appropriate family medicine training, however, was 3.5 years. Respondent support for increased duration of training increased when coupled with certificates of added qualifications (CAQ). DISCUSSION: While military family physicians do not believe that extending family medicine residency to 4 years will increase interest in the discipline, they do acknowledge that extending training beyond the current 3-year model would be beneficial. Because of the central role of family physicians within the military health system, military family medicine residencies present an ideal environment for examining educational outcomes using 4-year training models.