Implementation and Preliminary Outcomes of the Nation's First Comprehensive 4-year Residency in Family Medicine

4Initiative, is the first family medicine residency program to require a comprehensive 4-year curriculum for all residents. METHODS: Over a 4-year time frame, the program transitioned from 8-8-8 to 6-6-6-6 staffing. The existing 3-year educational core of the program was left intact, and six additional core rotations and 7-month tracks of curricular enhancement were added. The residency practice transformed to a Patientcentered Medical Home (PCMH). RESULTS: Transition to a 4-year residency curriculum has proved smooth. Our funding model is sustainable, and practice income has increased. We have had no difficulty maintaining accreditation despite an innovative curriculum. A 4-year curriculum has resulted in substantially increased applicant interest and improved Match rates. The introduction of tracks has appealed to residents and has generated many positive spin-offs to the educational program as a whole. Transition to a PCMH has been of great value to both our patients and our learners. CONCLUSIONS: Transition to a comprehensive 4-year curriculum has been successful and has provided many benefits to our learners, practice, and edu cational program. Our graduates are substantially better prepared for practice.