By Elena Gardner, MPH; Rob Owens, PhD; Katie Fortenberry, PhD; Karly Pippitt, MD; Susan Cochella, MD; University of Utah Health, Salt Lake City, UT

Background

Family physicians play a major role in the provision of mental and behavioral health (MBH) care, and much of the training for this role occurs during residency.¹ Mental and behavioral health is a required component of the Accreditation Council for Graduate Medical Education (ACGME) guidelines for family medicine residency accreditation, and the American Academy of Family Physicians (AAFP) provides curriculum guidelines for human behavior and mental health for family medicine residencies.²,³ Some studies have explored the quality of MBH training for medical trainees, but these are often limited in scope and do not describe a process for compiling and systematically analyzing curricular content.⁴ This education column does not present results of such an analysis but instead describes a process for implementing a comparative analysis of MBH training in a family medicine residency program.

Methods

The family medicine residency program at the University of Utah (UUFMR) received a Health Resources and Services Administration grant to enhance and develop MBH training. We implemented a process to examine how guidelines regarding MBH topics are currently integrated into didactic sessions and rotations. To examine the current integration of MBH topics, we inventoried objectives. UUFMR curricular faculty were then asked to categorize all training activities as highly related, moderately related, or unrelated to MBH. Using their responses, we identified highly related training activities to be developed or enhanced. This process occurred in 6 stages: preparation, survey development, survey administration, survey data analysis, comparative analysis, and sharing and use of results (Table 1).

Results

Survey results were used to identify areas in which to focus development and enhancement efforts according to AAFP guidelines and project goals. Overall, the major lesson learned was that an implementation process that promotes flexible and balanced communication, presents opportunities for iterative feedback, and leverages relationships to engage clinical faculty is essential when working to integrate MBH topics into family medicine residency curricula.

Conclusion

Evaluating the current curriculum is critical for training family physicians who are well prepared to tackle the challenges they will encounter in practice. This evaluation enables faculty to efficiently identify and address gaps so that the curriculum is comprehensive and reflects current best practices. Effectively meeting this goal involves open communication, feedback cycles, and respectful relationships.

Next Steps

Our findings were presented to the project steering committee and used to enhance and develop didactic sessions and rotations focused on mental health and related topics across the age spectrum. The authors will repeat this process later in the grant cycle to demonstrate greater integration of MBH topics across the curriculum.

References

1. American Academy of Family Physicians. Mental and Behavioral Health Care Services by Family Physicians (Position Paper). All Policies. Published 2023. Accessed June 7, 2024. https://www.aafp.org/about/policies/all/mental-health-services.html

2. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Family Medicine. Family Medicine. Published July 2024. Accessed June 7, 2024. https://www.acgme.org/globalassets/pfassets/programrequirements/120_familymedicine_2024.pdf

3. American Academy of Family Physicians. Human Behavior and Mental Health. Curriculum Guidelines. Published 2020. Accessed April 12, 2024. https://www.aafp.org/students-residents/residency-program-directors/curriculum-guidelines.html

4. Kawada S, Moriya J, Wakabayashi H, Kise M, Okada T, Ie K. Mental health training in family medicine residencies: international curriculum overview. J Gen Fam Med. 2023;24(2):63–71. doi:10.1002/jgf2.608