The American College of Graduate Medical Education (ACGME) issued guidelines in 2019 lacking formerly required protected time for teaching and supervision by residency leadership and designated core faculty1. In contrast, 2018 STFM Member Surveys suggested that workload and administrative burden were the biggest challenges reported by faculty respondents 8. In response to the lack of protected time, the STFM Graduate Medical Education committee proposed the creation of a taskforce to develop joint guidelines for protected non- clinical time for Family Medicine Residency faculty, associate program directors and program directors. The objectives of the task force included providing review committees the autonomy to define the amount of time faculty need to meet their administrative responsibilities and accreditation requirements while also devoting adequate time to preparing residents for practice.
The significance of the task force may best be understood by the concurrent ACGME focus on faculty and resident wellness 2. Family medicine has been identified as having the third highest rates of reported burnout second only to intensivists and neurologists3. Family medicine faculty who are unable to take care of themselves cannot model and teach behaviors and strategies associated with well-being including personal resilience, a culture of wellness, and efficiency of practice 4. If as suggested, well-being habits may be “imprinted” during residency, targeting trainees has the potential for long-lasting effects. Faculty and program administrators who are satisfied and have achieved work life balance will have a positive impact on future practitioners. Protected non clinical time is essential to physician well-being and satisfaction which have also been associated with greater patient satisfaction and lower rates of professional work effort 5 Accrediting bodies, including the ACGME and the Clinical Learning Environment Review [CLER] support of protected non clinical time and wellness is essential to system wide changes needed to ensure provider and trainee well-being.
The task force objectives include (a) developing joint guidelines for protected non-clinical time for faculty in family medicine residency programs, (b) disseminating these guidelines at national conferences and peer reviewed journals and (c) appealing to the ACGME for changes in its requirements. All of these objectives are in alignment with the STFM proposed 2020 Strategic Plan including inspiring individuals to become exemplary, fulfilled and compassionate family medicine teachers and supporting family medicine education, workforce recruitment and retention. A timelines for the task force was created and has been followed to ensure satisfactory completion of the objectives included in table one:
Table one: STFM Protected Time Task Force Timeline
Objective
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Completion Date
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August 2019:
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Call for task force members
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Early 2020:
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2-day meeting of Task Force to review research and develop guidelines
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Early Summer 2020
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· One-day meeting of Task Force to work on papers and finalize plan for presentations
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Summer 2020
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Letter to ACGME
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Winter 2020
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Presentations begin
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ACGME is the Accreditation Council for Graduate Medical Education. - MT
ReplyDeleteFixed and sent to Mary. Thank you!
DeleteWe need to make sure this is written in a way that makes it relevant even if the ACGME comes out with acceptable guidelines. The task force was initially conceived due to increasing clinical productivity requirements for faculty. The ACGME issue came up after there was already momentum to address that. We should probably highlight in this section some of the reasons why there are expectations for increased clinical productivity (employed physicians, shrinking margins, administrative burden, EHRs). We should also note how all of those factors are affecting the education of residents and the care of patients. Those are really the key factors behind why the taskforce was created. - MT
ReplyDeleteAt the risk of sounding like an English professor, there should be a comma after CLER. GD
ReplyDeleteI agree with Mary, we should point out the struggles with maintaining appropriate time to teach surfaced before the ACGME changes went into effect and why--I think that goes to establishing purpose. Mary also talks about how the guidelines are to be used in the "intended audience" section--we will just want to make sure that this information ends up somewhere (either here or there).
ReplyDeleteI liked addition of some of the more focused detail of our work, and that may also fit well in the methodology section. That area may also be where we want to talk about the composition of our group (something like 'a diverse group representing a broad range of geographic location, program size, and practice scope' and including leadership from ADFM and AFMRD).
I also made notes that we wanted to incorporate something like this:
That there are a variety of family medicine programs ranging from small rural training tracks through large multisite programs with over 50 residents. There are also programs where core faculty supervise care in the hospital and others where core faculty work principally in outpatient care. As a result, guidelines may need to be adapted by the program director to fit the program’s needs. We do not want to stifle innovation. These guidelines will not be perfect." -SG