Shorter training is no solution for building the primary care physician workforce.

420 The Journal of the American Osteopathic Association June 2014 | Vol 114 | No. 6 Continuity of Care Training Over Time Is Essential for Family Physicians A family physician is required to possess a broad knowledge of health maintenance and disease processes that is inclusive of all body systems and how those systems interact. However, the length of postdoctoral training proposed for these new board-eligible, practice-ready osteopathic primary care physicians abbreviates both the didactic and clinical experiences, resulting in the probability that the expertise and professional uniqueness of these physicians will be diminished. The Commission’s report recommends a competency-based training model over the current timebased training model.1 The ACOFP counters that primary care specialties require progressive and longitudinal time and repeated patient contact that are learned through clinical training in a continuity of care environment. Experience in the development of primary care specialists in osteopathic graduate medical education programs has demonstrated that the 1650 patient care visits over 3 years required for osteopathic family medicine is an important factor in developing competency.2 Such depth of experience and breadth of both inpatient and outpatient clinical training are distinguishing features of physician training over other health care professionals who are not exposed to the complexity of patients encountered by a family physician. A standard mechanism remains to be determined for competency evaluation across multiple medical schools and residency programs. Also, although the proposed competency-based training model may decrease time and costs, the model could increase these factors, as well as require more faculty for competency evaluation when there is already a shortage of qualified faculty.3 The ACOFP believes that the Commission’s recommendations1 would result in limited clinical training and exposure. Whereas primary care physicians recognize the important role that nonShorter Training Is No Solution for Building the Primary Care Physician Workforce