Factors Associated with Family Medicine and Internal Medicine First-Year Residents' Ambulatory Care Training Time

Abstract

Purpose Despite the importance of training in ambulatory care settings for residents to acquire important competencies, little is known about the organizational and environmental factors influencing the relative amount of time primary care residents train in ambulatory care during residency. The authors examined factors associated with postyear 1 (PGY-1) residents' ambulatory care training time in Accreditation Council for Medical Education (ACGME)-accredited primary care programs. Method U.S.-accredited family medicine (FM) and internal medicine (IM) programs' 2016-2017 National Medical Education (GME) Census data from 895 programs within 550 sponsoring institutions (representing 13,077 PGY-1s) were linked to the 2016 Centers for Medicare and Medicaid Services Cost Reports and 2015-2016 Area Health Resource File. Multilevel regression models examined the association of GME program characteristics, sponsoring institution characteristics, geography, and environmental factors with PGY-1 residents' percentage of time spent in ambulatory care. Results PGY-1 mean (standard deviation, SD) percent time spent in ambulatory care was 25.4% (SD, 0.4) for both FM and IM programs. In adjusted analyses (% increase [standard error, SE]), larger faculty size (0.03% [SE, 0.01], P < 0.5% [SE, 0.2], P