Family Practice Resident Expectations by Year From Faculty and Resident Perspectives: A Quality Improvement Initiative

Background: The transition from student to physician requires substantial commitment and work from residents as well as guidance from program faculty. The Accreditation Council for Graduate Medical Education (ACGME) has standardized certain academic requirements for U.S. residency programs; however, faculty expectations of residents according to year in the program are less formal and more a hidden curriculum. Setting expectations for residents to consult could better help residents navigate their graduate medical education experience and achieve the level of excellence expected by ACGME. Purpose: Our quality improvement study aimed to: 1) determine what the expectations of family practice residents were based on feedback from faculty members and current residents; and 2) share these expectations with residents. Methods: A preintervention survey was emailed to family medicine program faculty and residents regarding resident expectations according to year in the program. Based on the results of the preintervention survey, expectations were outlined in a handout according to year in the program and were presented to current residents during scheduled didactic time. Residents who responded to the preintervention survey were then asked to respond to the postintervention survey. Fisher exact tests were used to compare preand postintervention survey responses. Results: Overall, 64% (14 of 22) of faculty and 64% (18 of 28) of residents responded to the preintervention survey. While 79% of faculty expressed that they had specific expectations for residents, 77% felt that residents did not know these expectations. Additionally, while residents (94%) believed faculty had expectations of them, only 33% knew what the expectations were. Following intervention, 15 of 18 residents responded, with 79% now reporting they knew what the expectations were (P = 0.02). The handout was found useful by all those queried, and 85% felt it clarified expectations. Conclusion: At baseline, residents and faculty knew there were expectations for residents as they progress through the program, but those expectations were not explicit. Despite the lack of vertical communication, the expectations from both groups were surprisingly similar. A handout delivered electronically and at didactic sessions was deemed useful and clarified expectations