Why we should reduce family practice training to two years.

Family practice (FP) should consider decreasing its residency training from three years to two years. These are troubling times for FP. The number of U.S. medical students choosing FP has declined, FP physicians have difficulty maintaining the broad range of skills they learned in residency, and salaries have flattened. FP provides the best training for physicians who care for undifferentiated or continuity patients of all ages in an ambulatory setting. The author proposes that FP should focus its training on this large health care niche and develop a two-year curriculum that reduces inpatient and specialty rotations while increasing time in the family health center. At the same time, he recommends a third or even a fourth year of training be used to develop skills in any number of specialty areas. FP salaries are unlikely to be affected by these changes, residents would rack up less debt, and savings in society's contribution to graduate medical education would be realized. Reducing the length of FP training to two years will make FP more nimble, adaptable, and cost-effective.