Project: Family Medicine Residency Curriculum Renewal
Introduction:
The College of Family Physicians of Canada (CFPC) has recently undertaken the enormous task of renewing the training program for medical residents specializing in Family Medicine. Years of research have built the foundation for a pan-Canadian shift in residency training that is better aligned with changing societal needs and the realities of modern medicine. Family Medicine Residency training has existed in Canada since 1966 in various forms. The current training program in Canada was established in 1986 and has undergone little change since then. The CFPC has engaged with medical schools across Canada to redesign Family Medicine training to meet the current and future needs of our population. At McGill, we have taken a collaborative approach, working with the Postgraduate Medical Education division along with the Family Medicine Education Research Group to undertake an in-depth evaluation of our curricular needs and objectives. Our goal is to engage with international experts, national leaders, and local stakeholders to develop a world-class, forward-looking curriculum in Family Medicine.
Reforming the Family Residency Program in Quebec
Joint Undertaking
Introduction
Primary care is evolving, society is changing, health concerns are growing more complex, knowledge is exploding, there is a huge influx of technology, new healthcare challenges are emerging among certain populations, and the family doctor’s role in interprofessional teams is shifting. It is currently a key—and critical—moment to reform family medicine residency programs. We, the signatories of this joint undertaking, strongly believe that these reforms are necessary. We share a common vision focused on the growing needs of the population, provision of care in priority areas, and strong primary care interprofessional teams.
Vision and Joint Undertaking
In the coming decades, family doctors will have to offer comprehensive, holistic medical care while remaining adaptable generalists. They will need to provide care to underserved communities and be skilled in areas of greatest societal need, such as home care, long-term care, mental health and addictions care, Indigenous health, health equity, emergency care and health technologies. Family doctors, as specialists in complexity, have a unique role to play in interprofessional teams.
We are convinced that reforming family medicine residency programs will train family doctors ready to tackle the challenges of tomorrow. We believe that this reform will require not only a change in the current two-year residency program, but also an overall increase in training time. In our opinion, it is simply not possible to bring about the necessary changes and additions to how we train our future family doctors without adding time to their education.
We believe that a residency extension focused on increasing autonomy in the transition to practice (lighter supervision, mentoring, practice management) would produce graduates who are better prepared for practice, more engaged with their communities, and well equipped for work in interprofessional teams. Developing and testing various models for lengthened residency programs (for example, 3-, 6- or 12-month extensions) would lead to an informed decision on the best model for Quebec. We are committed to rigorously evaluating such pilot projects.
Finally, this reform will help elevate the status of family medicine—in our faculties, in the public eye, and in the media. This, in turn, should help attract many high-calibre students and guarantee a frontline of healthcare enriched by the excellence of its dedicated and enthusiastic family doctors.
May 24, 2024
Joint Undertaking Letter
Please feel free to review the full letter (pdf) with all the signatories working on this initiative.
Curriculum Renewal Research Program Overview
Since 2018, the College of Family Physicians of Canada (CFPC) has been working towards renewing and strengthening primary healthcare in Canada. To do so, the CFPC created the Outcomes of Training Project (OTP), whose goals are to evaluate and renew the family medicine residency training program to enhance residents’ preparedness and transition to practice. The CFPC identified six main areas of societal need that need to be addressed in postgraduate medical education: home and long-term care, addictions and mental health, Indigenous health, virtual care and health informatics, health equity and anti-racism, and leadership, advocacy, and scholarship. As such, the McGill University OTP team, integrated into the Family Medicine Education Research (FMER) Group, has undertaken several research activities to respond to this call to action.
International perspectives on priority areas:
Dr. Keith Todd (Complex Systems Navigator, Principal Investigator),
Dr. Robson Rocha de Oliveira (Research Associate, Co-Investigator),
Dr. Charo Rodriguez (Director of the Family Medicine Educational Research Group (FMER), Co-Investigator)
Sima Zahedi (Research Assistant, Collaborator)
Amrita Sandhu (Research Assistant, Collaborator)
We are completing a Delphi study looking at what skills family medicine residents should have in the areas of societal need identified by the College of Family Physicians of Canada.
Investigating Local Priorities:
Dr. Keith Todd (Complex Systems Navigator, Principal Investigator),
Dr. Robson Rocha de Oliveira (Research Associate, Co-Investigator),
Dr. Charo Rodriguez (Director of the Family Medicine Educational Research Group (FMER), Co-Investigator),
Dr. Fanny Hersson-Edery (Program Director of Postgraduate Medical Education, Collaborator),
Dr. Marion Dove (Chair of the Department of Family Medicine, Collaborator),
Sandra Fournier (Research Coordinator, Co-Investigator),
Amrita Sandhu (Research Assistant, Collaborator),
Sima Zahedi (Research Assistant, Collaborator)
Using the nominal group technique, we engaged with 57 of McGill’s family medicine academics, clinical educators, and residents. They participated in six structured discussions to generate learning objectives for domains of care that directly impact our communities.
Understanding local training needs:
Dr. Keith Todd (Complex Systems Navigator, Principal Investigator),
Sandra Fournier (Research Coordinator, Co-Investigator),
Dr. Robson Rocha de Oliveira (Research Associate, Co-Investigator),
Dr. Fanny Hersson-Edery (Program Director of Postgraduate Medical Education, Co-Investigator),
Dr. Marion Dove (Chair of the Department of Family Medicine, Collaborator),
Amrita Sandhu (Collaborator)
The team sought to better understand how well our current curriculum is preparing residents to practice comprehensive care. This needs assessment provided us with a better picture of our learners’ needs and potential curricular gaps.
Outcomes of Training Project (OTP) Progress
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Project Team
Project Lead
Dr. Keith Todd is a practicing family physician at the Herzl Clinic and Jewish General Hospital in Montréal, Canada. Before completing medical school, Dr. Todd was engaged in research, completing a PhD at the Université de Montréal and a postdoctoral fellowship at McGill. He is currently actively involved in medical student and resident education in the areas of clinical teaching and quality improvement. Dr. Todd is also a member of the Canadian Task Force on Preventive Health Care working on guideline development for practicing primary care clinicians. His research interests focus on practice evaluation and medical education. In the fall of 2022, Dr. Todd was recruited to lead the Family Medicine residency curriculum renewal process for McGill University.
Research Associate
Dr. Robson Rocha de Oliveira, a Research Associate in the Department of Family Medicine, completed his Medicine studies (MDCM) at the State University of Londrina, Brazil (2003). He obtained a master’s (2010), a Ph.D. (2018), and completed a residency in Social and Preventive Medicine at the University of Sao Paulo, School of Medicine (2007). During his career, he supervised health indicator monitoring projects in the Department of Public Health, Sao Paulo (2007-2013). Dr. Rocha de Oliveira also joined Anhembi University, School of Medicine, as a professor in Public Health (2013-2018), and served as the Educational Program Director (2016-2018). Additionally, he pursued a Postdoctoral fellowship (2018-2020) and took a position as a Research Advisor (2021-2023) at the École de santé publique de l’Université de Montréal. He has an interest in medical education and Responsible Innovation in Health.
Program Administrator
Sandra Fournier is the Program Administrator for the Outcomes of Training Project in the Department of Family Medicine. Sandra graduated from McGill University with her Masters of Education and has an extensive background in research related to mental health and program/curriculum development. She is excited to be a part of this curriculum renewal project and hopes to continue contributing to the area of family medicine curricula.
Collaborators
Dr. Marion Dove – Chair, Department of Family Medicine
Dr. Fanny Hersson-Edery – Postgraduate Program Director.
Contact Info
We welcome inquiries, collaborations, and discussions about our family medicine education research project. If you have questions, are interested in learning more about our work, or would like to explore potential partnerships, please don’t hesitate to reach out to our dedicated research team. Your insights and contributions are invaluable to our mission, and we look forward to engaging in meaningful conversations with you. To connect with us, simply send us an email, and we will respond promptly. We are excited to connect with fellow researchers, educators, and healthcare professionals who share our passion for advancing family medicine education.
Contact Email: sandra.fournier@mcgill.ca
