Volume 3 • Issue 1 • 1000197
J Community Med Health Educ
ISSN: 2161-0711 JCMHE, an open access journal
Community Medicine & Health Education
Gimpel et al., J Community Med Health Educ 2013, 3:1
http://dx.doi.org/10.4172/2161-0711.1000197
Research Article Open Access
Family Medicine Resident Education: An Innovative Model of Community
Medicine Training
Nora Gimpel
1
, Patti Pagels
1
, Vibin Roy
1
, Zoe Tullius
2
and Tiffany Billmeier Kindratt
1
*
1
Department of Family and Community Medicine, UT Southwestern Medical Center, USA
2
Department of Pediatrics, Northwestern University, Hospital of Chicago, USA
Abstract
Introduction: Family Medicine residents benefit from comprehensive training models which incorporate community
medicine and population health principles into patient care. This paper describes an innovative Community Medicine
(CM) rotation and reports its effectiveness. Objectives of the rotation are to train residents to 1) identify and intervene
in community health problems, 2) respond to particular health issues and care for local cultural groups, 3) coordinate
local community health resources in the care of patients, 4) focus on underserved population and 5) assimilate into
the community and its organizations.
Method: Residents (N=21) participated in a longitudinal CM rotation that included 8 weeks (2 blocks) in the first
year and 4 weeks (1 block each) in second and third years. Resident activities included several community agency
site visits, health education, journal clubs, didactics, community-based participatory research (CBPR) and direct
patient care. Selected residents (2 per year) participated in a targeted community action research experience (CARE).
Residents completed a pre-test evaluating their knowledge and attitudes of CM (1=strongly disagree; 5=strongly
agree). After the rotation, residents completed a post-test and rated their perceptions of whether the curriculum goals
were accomplished (1=not accomplished; 5=accomplished).
Results: Residents’ knowledge and attitudes improved significantly on most areas of Community Medicine (CM)
(p<0.05). All residents reported that the CM rotation increased their knowledge of health promotion activities (5.00).
Residents also felt strongly about their ability to locate community resources of benefit to their patients (4.87), care for
patients in non-traditional sites (4.86) and assimilate into the community after graduation (4.81).
Conclusion: Residents evaluated the CM rotation favorably. Our rotation is a comprehensive model that can be
used by other residencies to train community responsive physicians and meet ACGME guidelines. Rotation activities
can be tailored to the specific needs of other residencies and their communities.
*Corresponding author: Tiffany Billmeier Kindratt, MPH, Research Study
Coordinator, Department of Family and Community Medicine, UT Southwestern
Medical Center, 5920 Forest Park Rd, Dallas, TX 75390-9165, Tel: 214-648-7096;
Fax: 214-353-0604; E-mail: tiffany.kindratt@utsouthwestern.edu
Received January 30, 2013; Accepted February 20, 2013; Published February
22, 2013
Citation: Gimpel N, Pagels P, Roy V, Tullius Z, Kindratt TB (2013) Family Medicine
Resident Education: An Innovative Model of Community Medicine Training. J
Community Med Health Educ 3: 197. doi:10.4172/2161-0711.1000197
Copyright: © 2013 Gimpel N, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Keywords: Community medicine; Family medicine; Training;
Residency
Introduction
Family Medicine (FM) resident education needs innovative
training models to demonstrate the importance of Community
Medicine (CM) and population health training in residency education.
At all levels of training and practice, population- and community-
based approaches allow clinicians to examine their quality of care for a
specific patient population, make changes in their own system of care
and study how these changes affect their practice [1]. e Accreditation
Council for Graduate Medical Education (ACGME) requires that
FM residents receive a structured curriculum in CM which includes
didactic and experiential activities in topics such as abuse, school
health, communicable disease reporting, epidemiology, disaster
responsiveness and the development and use of community resources
to address social determinants of health [2]. ese competencies in CM
can be met by mastering the following four domains: 1) participation
in health activities in the community; 2) sociocultural awareness in care
of patients; 3) utilization of the community’s health resources and 4)
community participation and assimilation [3].
Family Medicine (FM) residencies across the United States (US)
fulfill the Community Medicine (CM) requirements in various ways.
Several existing programs use a Community-Oriented Primary Care
(COPC) model [4] while others offer a global approach by working
with various community partners to target a variety of health concerns
[5,6]. Some residencies offer training in community health centers [7],
other programs use concentrated CM experiences while others extend
their training and offer related degrees (i.e. MPH or MBA) [8]. Most
programs have experiences with underserved populations but very
few formalized relationships exist between community organizations
and educational institutions [3-9]. Few programs utilize longitudinal
curriculums while others use block rotations [10-12]. In 2002, Plescia
et al. found 89% of FM programs had formal curricula in place to
teach CM yet only 24% reported more than one month exclusively
dedicated to the CM components [3]. Minimal research describing
and evaluating comprehensive longitudinal CM curriculums for FM
residents has been published since this assessment. Fisher (2003)
described a comprehensive curriculum which combined both an
annual block and a semi-longitudinal approach to teaching CM but
training did not begin until the second year [11].
To address these training deficits, we designed a novel Community
Medicine (CM) curriculum for Family Medicine (FM) residents. Our
rotation incorporates annual concentrated block experiences within
a longitudinal curriculum that spans the three-year residency. e
purpose of the CM rotation is to train residents to 1) identify and
intervene in the community’s health problems, 2) respond to particular
health issues of local cultural groups and care for them, 3) coordinate