Majors and Masteries Frequenty Asked Questions

What is the majors and masteries program?

Why are you making this change?

What are the advantages to me as a resident?

What is a major?

What is a mastery?

What will the curriculum look like?

What will be in the Core Curriculum?

How will longitudinal experiences get built into my schedule?

Why are you using more longitudinal training models?

What are the major options?  What will they each look like?

What are the mastery options?  What will they each look like?

Why would I want to do a 4-year residency program?

Do I have to complete a major before I begin a mastery?

How will I be paid during the fourth year?

When would I take my Family Medicine Boards if I decide to do a mastery?

What is a learner’s portfolio and individualized instruction plan and why should I care about them in a residency program?

When would I get to choose my major or mastery and who will help me with this decision?

Am I guaranteed to get any major or mastery I want?

What if I change my mind, can I change Majors or Masteries?

If I decide to pursue a Mastery in an area which grants an advanced degree, how will that degree be paid for?

Why are you instituting a night float system and how will it work?

What if I decide to transfer to another residency?  How will that work?

What would a sample schedule look like?

What is the majors and masteries program? (To Top)

The “Majors and Masteries” program provides a flexible training program allowing residents the freedom to pursue individual passions, while achieving and maintaining excellence in the core skills that comprise Family Medicine’s broad basket of services. This program will provide traditional rotational experiences as well as innovative longitudinal and project-driven experiences that will train future family physicians who are self-directed lifelong learners, with expertise in both patient-centered care and systems-based practice.

Why are you making this change? (To Top)

There are 3 main driving forces behind this curricular change:

1)      The future of Family Medicine project challenges residency education to prepare physicians to practice under its new model.  Part of that model is for all physicians to provide a “basket of services” for a group patients and patient problems.  But it also challenges us to provide physicians who can provide specialized services or an area of expertise that they can offer to their community.

2)      Though most Family Medicine residencies’ curricula are essentially the same, the types of practice a family physician can join are myriad.  We feel it is necessary to offer choices to residents so they can better prepare for their future practice.

3)      The traditional model of block rotations and preceptor-based evaluations may not always approximate real life practice, teach lifelong learning skills, or accurately assess competence.  We feel by designing longitudinal experiences we will better prepare you to be a family physician of the 21^st Century.

What are the advantages to me as a resident? (To Top)

This model offers the resident a number of advantages including:

1)      Flexibility in training – you will be able to choose the area(s) you want to concentrate on and have dedicated time to work on these areas

2)      The option of gaining special skills – residents will be able to gain degress or special skills that might not be available to them in traditional residencies

3)      More feedback and confirmation of competence – we feel (and the ACGME agrees) that the days of saying that merely spending time with a urologist is not evidence that a resident  is able to take care of urologic problems..  You will experience innovative skills learning and assessments that will build your confidence and help you “prove” your competence to future practices and hospitals.

What is a major? (To Top)

A major is an area of concentration or expertise that you will develop during the traditional 3 years of residency.  You will have about 6 months of your residency dedicated to advanced training in your areas of interest.  This will give you time to gain the skills necessary to bring something special to your group or community.  Every resident will be required to choose a major.

What is a mastery? (To Top)

A mastery is for those who want to get advanced training or degrees.  A mastery will extend your residency to 4 years and will allow you to gain skills and experiences that are very difficult to achieve in 3 years.  Those gaining a mastery will graduate with advanced obstetrical skills, a MBA or a MPH.  Choosing to do a mastery is optional.

What will the curriculum look like? (To Top)

The curriculum will include the following:

1)      A Core Curriculum in Family Medicine completed during the first half of residency

2)      Majors and Masteries.  After the core curriculum each resident will choose a “Major” (area of specific interest) to pursue over the remaining half of a 3-year residency or they may choose to pursue a “Mastery” (area of specific interest with additional credentials or training) over the final 29 blocks of a 4 year residency.

3)      The addition of longitudinal experiences throughout the curriculum.

What will be in the Core Curriculum? (To Top)

The core curriculum is an 80 week curriculum commencing at the start of residency. Our curriculum is divided into 4 week blocks, thus the first 20 rotations (19 months) constitute this core. This gives residents an excellent foundation in Family Medicine as well as ensures that residents have relevant experiences before choosing their Major or Mastery.  The core rotations are as follows:

During your final 19 blocks (or 32 blocks if you choose a mastery)  all residents will continue to build on these core skills by completing the following required rotations:

2.5 additional blocks of inpatient medicine

2.5    blocks of night float

1.5 additional blocks of obstetrics

1    additional block of family and community medicine

4    blocks of sub-specialty days

2    additional blocks of electives

How will longitudinal experiences get built into my schedule? (To Top)

Longitudinal Experiences: We will teach a number of topics through longitudinal approaches, each having a set of practice specific competencies that must be achieved.  The time for these longitudinal experiences will be built into the residents’ schedule in the following ways

 Exploration Days –Residents will be scheduled in their normal rotational requirements (rotation, clinic and lectures) 9 half-days per week, with 1 half-day per week reserved for longitudinal experiences called Exploration Days .  Some of this time will be scheduled in a specific activity while other time will be reserved to complete required tasks. The following table lists the longitudinal experiences to be covered during the exploration days with a brief description.

Sub-specialty days – each resident will have 4 blocks dispersed over the second half of their residency during which they will gain experience in 5 sub-specialty areas (Urology, Otolaryngology, Ophthalmology, Dermatology and Palliative Care).  Weekly sub-specialty clinics will be attended by the residents during this time.  The rest of their time will be spent with their continuity patients.  Residents will document exposure to a list of common or not miss conditions in each sub–specialty.   Those topics not experienced during scheduled rotation time will be addressed utilizing self-directed learning. A competency assessment of knowledge, skills, and attitudes will be designed for each of these sub-specialty areas and will be completed successfully by each resident.

Why are you using more longitudinal training models? (To Top)

Learning theory states that knowledge is attained by constructing a framework then adding to this over time.  Spreading learning material out over time allows residents to apply knowledge in these areas earlier in their training but also allows them to have more medical experiences when working with the specialist, thus using their specialty training more effectively.  It also allows a more consistent schedule for both specialty preceptor and learner.

What are the major options?  What will they each look like? (To Top)

Currently, you would have the following majors available to you

1)      Community and International Medicine

2)      Sports Medicine

3)      Hospital Medicine

4)      Women’s Health

5)      Traditional training

6)      Individualized training

The following table will give you a brief description of the requirements for each major and what 6 rotations you will need to complete as well as what longitudinal projects you will need to do to satisfy the requirements of that major

What are the mastery options?  What will they each look like? (To Top)

You will have the option of choosing from the following Masteries:

1.      Community Health (will complete and receive a Masters of Public Health)

2.      Practice Management (will complete and receive a Masters in Business Administration)

3.      Advanced Obstetrics (Fellowship-like training in Obstetrics including Surgical Obstetrics)

 Mastery curricula will extend over 32 blocks (after your 20 core rotations) for a total of 4 years of training.  Your training in the area of mastery will begin during your second year and continue through the 4^th year.  You will also have training in the core skills throughout.  All masteries will require completion and presentation or publication of a thesis level project.  Scheduling will be variable and dependent on multiple factors including the number of residents who elect each mastery, coursework required, and project design and implementation. The following table describes the Masteries offered with a brief explanation of the special skills that will be achieved.

*Please note we were initially going to offer a Mastery in Hospital medicine.  After reviewing this, it was decided that at the present time this would not offer the graduate a significant enough competitive advantage over the major to pursue it at this time.  As times change, we will revisit this issue.

Why would I want to do a 4-year residency program? (To Top)

Some advantages of doing a 4-year residency include:

1.      Obtaining special skills or credentials not easily achievable in 3 years (e.g. a Masters degree or advanced surgical obstetrical training) – This will make you more marketable and more valuable to your patients and your community

2.      Training in the area of specialization while maintaining your skills in the basket of services.  Doing a post-residency and then a fellowship means essentially doing only the area of specialization for a year and during this time, one’s core skills could diminish.  Under our model you will continue learning and practicing your core skills throughout all 4 years of training

3.       Staying in the same place and working with the same team – not only will you not have to move but you will not have to get used to a different system, a whole new set of specialists (and their quirks), or a whole new set of faculty with different expectations

4.      Finishing in less time – in our model you will often complete your residency and advanced degree in less time than it would take to complete them both separately

5.      Receiving tuition support for a masters programs – though the exact amount has not been determined, the residency will pay for some or all of your tuition costs for your advanced degree

Do I have to complete a major before I begin a mastery? (To Top)

No.  During your second year you will choose a major OR a mastery.  You will begin working on whichever you choose during the second half of your second year.

How will I be paid during the fourth year? (To Top)

You will be paid at the Medical College of Wisconsin’s pay scale for a PGY-4 trainee.  Currently that salary is $49 750 per year.  There will be ample opportunity to supplement your income through various moonlighting opportunities.

When would I take my Family Medicine Boards if I decide to do a mastery? (To Top)

This question has been posed to the American Board of Family Medicine and we are waiting an answer.  However, there is neither a significant advantage nor disadvantage to taking it during or after your 4th year.

What is a learner’s portfolio and individualized instruction plan and why should I care about them in a residency program? (To Top)

An individualized instruction plan helps move you toward your life goals.  It helps you to understand your strengths and weaknesses, maximizing your strong points and improving on those that are less so.  We will use a number of tools over the 3 (or 4) years to help you maximize your trai