title: Four years of training in family medicine: implications for residency redesign.
abstract: OBJECTIVE
  In light of the ongoing consideration for extending the length of residency education in family medicine in the United States, this paper reports the findings from a retrospective, qualitative study of six family physicians that elected to extend their residency training from 3 to 4 years.
  
  
  METHODS
  Each participant completed a written questionnaire and a structured personal interview focusing on various aspects of career development resulting from the additional year of training. The authors independently evaluated these interviews to identify major themes.
  
  
  RESULTS
  All the participants were found to have been involved in teaching medicine, valued a more flexible and expanded curriculum, and appreciated their individualized curricula-based on their respective career interests. Given the opportunity, each would opt again for a fourth year of training. There were mixed opinions as to whether the fourth year should be required of all family medicine residents. Other perceived benefits reported were: a better opportunity to find a personally satisfactory practice, additional time for gaining clarity about career plans, and a higher beginning salary as a result of the additional skills and experiences gained.
  
  
  CONCLUSIONS
  This study of mid-career physicians supports that a fourth-year (PGY4) curriculum in family medicine may enhance subsequent career satisfaction. Further studies of residents in other PGY4 training programs are necessary to assess outcomes comparing our findings as well as guide the discipline's leaders in residency redesign.
authors.affiliation: Department of Family Medicine, University of North Carolina, USA.
authors.forename: J Lewis
authors.initials: JL
authors.lastname: Sigmon
authors.forename: Vanessa
authors.initials: V
authors.lastname: McPherson
authors.forename: John M
authors.initials: JM
authors.lastname: Little
mesh_terms: D002321:Career Choice; D003479:Curriculum; D003710:Demography; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007588:Job Satisfaction; D036301:Qualitative Research; D012189:Retrospective Studies; D013663:Teaching; D013997:Time Factors