Mar 20, 2018

Supporting Family Medicine Residents through Progress Testing

Education, Residency

A family doctor practicing in a rural area receives a patient with significant medical complications.

Does the family physician send the patient to a distant hospital? Does the physician call and wake the lab technician? Should the patient be sent home? This is just one of the scenarios outlined in the Family Medicine – Medical Expert Assessment of Progress (FM-MAP) tests for residents.

“While progress testing has been used in other areas and in undergraduate medical training, this test is the first of its kind for family medicine in Canada and to date, it remains the only one,” says Dr. Fok-Han Leung, Associate Professor at the Department of Family and Community Medicine.

Also referred to as ‘progress testing’, FM-MAP is an assessment test given to residents to follow their development at different stages of training using practice-level questions. It tests them as if they were practicing physicians, requiring a much higher level of knowledge integration.

For instance ‘If you were a family physician working in a rural area and a patient came in with a critical issue, do you put them in a helicopter, send them to a distant hospital or do you send them home?’ To answer the question, residents are required to think about what resources are available and how much they can take on safely with the actual diagnosis to answer the question.

The FM-MAP helps residents gauge their progress through comparison with their peers. With testing twice a year—four times over the course of training—trainees can monitor growth and gain information to help with ‘in-course’ corrections. Through the progress testing results, residents can assess their strengths, weaknesses and where they can benefit from additional study or experiences to improve.

Dr. Leung who spearheaded the program in 2009 with Dr. Karl Iglar. the previous Program Director of the Postgraduate program, says that the idea of progress testing initially faced some resistance.

“Residents were worried about the intended purpose of the test and if it would be truly formative. But now, residents see the value of monitoring progress. They are asking for more! The department has invested a lot of resources and physician hours into the FM-MAP and residents appreciate the value that it brings to their education.”

There is a limit to the number of cases that can be developed during a given period. Although progress testing has gone electronic, it is still labour intensive. Cases require physician development and writing time. Dr. Leung and multiple physicians spend over 100 hours each test to create cases.

Test results are very helpful for residents.

“We are aware that in medical training, one of the most challenging areas is knowing what you don't know,” says Dr. Leung. “The FM-MAP gives trainees and teachers a hint of insight in this area and allows them to better focus during their residency.”

By investing in progress testing, the postgraduate program keeps residents at the forefront of trainee-centred education.