History of the Department
of Community and
Family Medicine
Duke University Medical Center: Thirty-Five Years of Family Medicine (1972-2007)
The Duke Family Medicine Residency began in 1972 as a joint effort of Duke University Medical Center and Durham Regional Hospital. The program initially trained 13 residents per year and sent graduates all over the US but with almost 50% remaining in North Carolina.
In 1991 the program was consolidated at Duke University Hospital with selected rotations at the community hospital, Durham VA and Wake Medical Center in Raleigh. The compliment of residents in training also began to shrink as national interest in family medicine began to decline.
In May 2006, the Duke Family Medicine Residency Program announced that it would stop accepting new residents. The reasons behind the decision included issues with the applicant pool, resident attrition, and frustration of the faculty with training residents in a model of Family Medicine that they themselves no longer practiced. The announcement led to a considerable national reaction.
In the fall of 2006, Dr. Lloyd Michener, Chairman of the Duke Department of Community and Family Medicine, commissioned a team to evaluate: the RRC requirements for Family Medicine Residency training, the needs of the Durham community, the scope of practice of family physicians, and the resources available at Duke to produce an innovative Family Medicine educational program. The team, with input from residents, alumni, and an expert Advisory Panel convened by Duke's Chancellor, created a new design for the Duke Family Medicine Residency Program. The new program is designed to meet the needs of the people of Durham and similar communities, and to prepare physicians for leadership roles promoting health in their communities.
The key aspects of the re-designed residency program include:
- Ambulatory care as the core focus, with reduced in-hospital training.
- Prevention, early intervention, and systematic management of chronic disease.
- Team Training through use of the Team STEPPS curriculum (Team Strategies and Tools to Enhance Performance and Patient Safety).
- Team-based care, in the office and with community partners.
- Longitudinal model with minimal block rotations.
- Daily office hours in the second and third years.
- Community engagement and participation: including weekly sessions in the innovative community based clinics and programs of Duke's Division of Community Health. These programs provide services in neighborhoods, schools, and low income housing, to patients who would otherwise have difficulty accessing care.
- Community outcomes research project.
- Quality measurement and improvement, with direct resident involvement in all levels of the QI process.
- Clinical Leadership Training: includes a required Certificate in Clinical Leadership. A 4th year fellowship option is available, which culminates in a Master of Health Sciences Degree in Clinical Leadership (a collaborative program of the Duke Schools of Medicine, Nursing, Law, Business, and the Sanford Institute of Public Policy.
We are excited about our new, innovative residency. We strongly believe we are on the right track to train residents for the future.
