Are Medical Residents Prepared for Population Health Management?

Jared Kaltwasser

Why the United States might want to look abroad for ideas to improve training protocols.

Most residents in family medicine programs say they are prepared to perform population health management (PHM), according to a new study. But the report also suggests graduates of international medical schools are ahead of their American counterparts when it comes to PHM training.

Researchers from the University of Kentucky looked at the American Board of Family Medicine’s 2014 and 2015 certification examination registration questionnaire to see how residents responded to a question on PHM preparedness. Altogether, 69% of the 6135 residents say they are either “extremely” or “moderately” prepared to perform PHM. Those respondents represent 442 family medicine programs.

Erica K. Schuster, a third-year medical resident at the university and co-author of the study, noted that 1 reason for the high confidence of residents is generational comfort with technology. But that’s not the only explanation.

“However, I do also feel that there has been a push for improving student and resident training using electronic health tools,” she says. “Technology has been incorporated into their medical education and training in various forms from day 1.”

Schuster says an area of focus for the study was finding out whether there were certain characteristics of residency programs—such as program size or rurality—that corresponded with lesser or greater preparedness for PHM. To her surprise, no such correlations were found in the data.

“In many ways, I think that is an encouraging finding,” she says. “It at least demonstrates that institutions with fewer resources are still training residents in ways that leave them feeling prepared.”

International medical graduates self-reported higher than average levels of preparedness for PHM, according to the findings. That’s in line with a 2015 study showing international students are performing PHM more frequently once they graduate and enter practice.

The same 2015 study also suggested that female graduates were more likely to perform PHM than male graduates, though Schuster says her research found no such correlation. She noted that one of the limitations of the study is that feeling prepared isn’t the same thing as actually being prepared.

“Clearly, there is at least some discrepancy between feeling prepared and actually being prepared, though to what degree is hard to say without further studies specifically evaluating this link,” she says.

The study also notes that the accuracy of the survey relies on students’ familiarity with the meaning of the term “population health management” means. Namely, that it’s not just about managing the healthcare of a certain population, but rather leveraging data and analytics to accomplish that goal.

Going forward, Schuster and her co-author, Lars Peterson, MD, PhD, wrote that American residency programs should look overseas for ways to improve PHM preparedness. They noted that the United Kingdom and Canada both now implement PHM training into their undergraduate medical programs.

“Our finding combined with past data suggests that there is something unique about foreign medical education efforts to implement PHM that may be more successful than efforts made by United States counterparts, which continue to struggle to implement PHM into undergraduate training despite current efforts,” they wrote.

The study is titled “Resident and Residency Characteristics Associated With Self-reported Preparedness for Population Health Management.” It was published in the November/December issue of Family Medicine.Thumbnail image has been resized. Courtesy of Commonist, Wikimedia Commons.