Implementing radical curriculum change in a family medicine residency: the majors and masteries program

Fam Med. 2011 Jul-Aug;43(7):514-21.


Background and objectives: There have been dramatic changes in the specialty of family medicine and the American health care system in the more than 40 years since the formation of the specialty. As a result, there is urgent need for experimentation and innovation in residency training to better prepare family physicians.

Methods: Waukesha Family Medicine Residency used a strategic planning process to identify four guiding concepts for a new model of residency education: intentional diversification; options for advanced training in a fourth year of residency; longitudinal, competency-based training; and strong fundamental background in family medicine skills. These concepts guided radical restructuring of the curriculum.

Results: The new Majors and Masteries curriculum begins with 19 months of training in core family medicine skills. Residents then elect to pursue a Major or Mastery in an area of interest. Majors are completed within 3 years, while Masteries are completed in 4 years and include advanced training (MPH, MBA, advanced obstetrics). Since implementation, residents have selected a broad range of Majors, three residents have elected advanced training in three different mastery areas, and resident recruitment has not been disrupted.

Conclusions: The Majors and Masteries curriculum and the process used to implement it may benefit other residencies considering radical curriculum change.

MeSH terms

  • Accreditation
  • Clinical Competence / standards
  • Curriculum / trends
  • Electronic Health Records / standards
  • Electronic Health Records / trends
  • Evidence-Based Medicine / standards*
  • Evidence-Based Medicine / trends
  • Family Practice / education*
  • Family Practice / organization & administration
  • Humans
  • Internship and Residency / organization & administration*
  • Internship and Residency / trends
  • Organizational Case Studies
  • Organizational Innovation
  • Patient Care Team / organization & administration
  • Patient Care Team / trends
  • Patient-Centered Care / organization & administration*
  • Patient-Centered Care / standards
  • Patient-Centered Care / trends
  • Program Development / methods
  • Wisconsin