Competencies for the Adaptable Physician: Training Residents to Care for Vulnerable Populations

ABSTRACT

The US faces a need for more primary care physicians to care for an increasingly vulnerable population. The advancing age, growing diversity, high burden of chronic illness and socio-economic decline of the population requires medical educators to produce primary care physicians with expertise in public health, quality improvement and interprofessional teamwork in addition to our traditional focus on clinical excellence. In this article, multidisciplinary faculty of the Initiative on Poverty, Justice and Health from the University of Cincinnati Academic Health Center and other faculty working with vulnerable populations describe our vision of a new breed of primary care doctor, the Adaptable Physician, and the competencies needed to provide high quality, community-oriented primary care to vulnerable populations. Through a structured consensus process, we have developed six competencies and associated specific knowledge, skills and attitudes of the Adaptable Physician and have mapped these to the ACGME competencies to facilitate curriculum development in primary care residency programs. We propose a national consensus process for the stakeholders in primary care to define the competencies needed to care for vulnerable populations at individual and population levels and to improve care provided in diverse settings.

Keywords:

Primary care, vulnerable populations, medical education, health professions education, competencies, curriculum development, poverty, adaptable physician, public health, interprofessional teamwork, quality improvement, health disparities.