By: Allison McCarthy, MBA | amccarthy@barlowmccarthy.com

A client recently held an educational event for its family medicine residents. While the goal was to help the residents make post-training career decisions, the underlying assumption was to build awareness of the health system’s practice opportunities.

The event was successful in many ways – a solid turnout of residents, great networking, open dialogue, a lovely venue and a keen sense of accomplishment for the host leadership team.

For me, the big “aha moment” was learning how much residency training orientation influenced practice preferences. Given its location, the residency clinic serves a lower income population. The clinic structure resembles a community health center – with a full range of outpatient services in a single location. The residents noted how well supported the clinic model was not only  for their patients’ health care needs, but also for the benefit of providers – with the structure acting as a built-in referral compliance vehicle. When they need a patient to receive diagnostic testing or behavioral health services, the resident is confident care is received as the patient transitions from one office suite to another.

So, when asked what type of practice venue they were looking for post-training, most of them said they would prefer a community health center environment. Beyond those initial observations, they noted the ability to do full spectrum family medicine (including obstetrics), the team environment, caring for the under-served, and other positive aspects of those practice environments.

Certainly, that would be good news if this health system had practice opportunities in community health centers. But this system’s practice offerings are all in traditional physician office settings. While the medical group leadership and I believed that improved connection with their own residents would be a natural resource for the primary care recruitment pipeline, the event discussion made it clear that it would require more work than that.

In the short term, the system must target primary care residents from other programs that more closely emulate the system’s primary care practice model. In the long term, the organization will need to do one of two things to retain more of its family medicine residents:

  • Increase the exposure to traditional physician practice settings in the residency curriculum;
  • Change the system’s practice venues to settings with larger practice teams and multi-disciplinary service offerings.

As physician recruiters, we know that geographic exposure greatly influences practice choices. But we may be less attuned to the impact of the residency model on future career decisions – including the training venue, culture, patient population, case mix and other factors. That means our resident lead-generation efforts need to be more targeted. If the training setting doesn’t match the practice offerings, even if there is organizational and geographic affinity, the work may be in vain.