Barriers to training family medicine residents in community health centers

Fam Med. 2010 Apr;42(4):248-54.


Background and objectives: Training partnerships between family medicine residencies (FMRs) and community health centers (CHCs) are a potential solution to the chronic problem of health workforce shortages in CHCs. We conducted a national survey to identify the barriers to training family medicine residents in CHCs.

Methods: We asked US family medicine residency directors to identify barriers to training residents in CHCs. Using grounded theory, three coders grouped responses by theme. We examined differences in barriers between residency programs that currently train in CHCs with programs that do not currently train in CHCs.

Results: A total of 51% (226/439) of residency program directors responded. Of these, 29% cited governance as a barrier to affiliation, 26% cited administrative complexity, 24% cited financial considerations, 21% cited leadership, and 18% cited access. Programs that trained in CHCs were more likely to cite financial considerations and administrative complexity than programs that did not train in CHCs.

Conclusions: Governance and administrative complexity are the most commonly cited barriers to effective CHC-FMR partnerships. Financial consideration and leadership issues are also common barriers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community Health Centers*
  • Family Practice / education*
  • Financial Management
  • Humans
  • Internship and Residency*
  • Leadership
  • Organization and Administration
  • Surveys and Questionnaires