Skip to main content

The Fully Integrated Readiness Service Training (FIRST) Program is a pipeline to a family medicine residency and three years of service in underserved areas of North Carolina.

The Fully Integrated Readiness Service Training (FIRST) Program is a pipeline to a family medicine residency and three years of service in underserved areas of North Carolina.

Cristy Page, MD, MPH
Catherine Coe, MD

CHAPEL HILL, N.C. – Expanding on its work to transform the way future physicians are trained, the American Medical Association (AMA) today announced the final eight award recipients that will receive funding as part of its new Reimagining Residency initiative. Aimed at significantly improving residency training, the AMA is awarding $14.4 million to support eight innovation projects led by medical schools, residency programs, and health systems from across the country who have oversight over graduate medical education (GME). These projects will help ensure future physicians are prepared for and safely transition from medical school to residency, develop the skills needed to enhance their readiness for practice, and train in an environment that promotes their well-being.

The AMA awarded $1.8 million over five years to the UNC School of Medicine to support a significant expansion of the Fully Integrated Readiness for Service (FIRST) Program to new geographic areas of North Carolina and additional high needs specialties including family medicine, general surgery, pediatrics, and psychiatry. The FIRST Program was founded in 2015 by Cristy Page, MD, MPH, former chair of the Department of Family Medicine, and now Executive Dean of the UNC SOM, to link the family medicine workforce pipeline from medical school to residency, and to service in rural/underserved North Carolina. Participants have the opportunity to complete their medical degree in three years followed by the opportunity for placement with a Family Medicine Residency program of North Carolina, after which FIRST scholars will take part in three years of service in an underserved area of North Carolina. They receive ongoing support from UNC Family Medicine in partnership with the NC Office of Rural Health and Community Care, AHEC, Piedmont Health Services, and the North Carolina Academy of Family Physicians.

One of the unique qualities of the FIRST curriculum is the early integration of students into the clinical setting. Students work closely with a family physician while completing their coursework for unique, real-time application of new knowledge, focused in the skills needed for rural/underserved primary care.

“We’re extremely proud of the FIRST scholars,” said Page. “This AMA grant will allow us to expand FIRST to new communities across the state and to additional needed specialties in NC, implement a generalizable Health Systems Science curriculum for GME within UNC School of Medicine and across AHEC partner sites, develop competency-based assessment tools that span the educational continuum, and expand the CPR2 initiative.”

The awarded project — led by Drs. Clark Denniston, Julie Story Byerley, Catherine Coe, Beat Steiner, Gary Beck-Dallaghan, and Cam Enarson — seeks to use innovations of the FIRST Program to transform the continuum of medical education within UNC, and across NC AHEC partner sites. Additionally, the project aims to develop and implement a Health Systems Science curriculum for graduate medical education, build and validate assessment tools for use across the continuum, and focus on wellbeing of learners, staff, and faculty.

Catherine Coe, MD, Director of the FIRST Program said, “The structure of the program, integrating medical training across medical school, residency, and practice allows us to implement innovations throughout the training continuum and have a significant impact on longitudinal training, workforce development, and ensure readiness for practice.”

The AMA is providing $1.8-million, 5-year grants to fund each of the following eight innovation projects aimed at promoting systemic change in residency training.

  • California Oregon Medical Partnership to Address Disparities in Rural Education and Health (COMPADRE)—Oregon Health & Science University and University of California, Davis
  • Fully Integrated Readiness for Service Training (FIRST): Enhancing the Continuum from Medical School to Residency to Practice—University of North Carolina School of Medicine
  • NYU Transition to Residency Advantage—NYU School of Medicine
  • Promotion in Place: Enhancing Trainee Well-Being and Patient Care Through Time-Variable Graduate Medical Education—Partners HealthCare System, Massachusetts General Hospital, and Brigham and Women’s Hospital
  • Reimagining Residency: Ensuring Readiness for Practice Through Growing Interprofessional Partnerships to Advance Care and Education—Maine Medical Center
  • Residency Training to Effectively Address Social Determinants of Health: Applying a Curricular Framework Across Four Primary Care Specialties—Montefiore Health System in New York
  • The Graduate Medical Training “Laboratory”: An Innovative Program to Generate, Implement and Evaluate Interventions to Improve Resident Burnout and Clinical Skill—Johns Hopkins University School of Medicine, Stanford University School of Medicine, and University of Alabama at Birmingham School of Medicine
  • The GOL2D Project (Goals of Life and Learning Delineated): Collaboration Across Academic Health Systems to Better Align GME with Learner, Patient and Societal Needs—Vanderbilt University Medical Center and University of Mississippi Medical Center

These projects are being sponsored by organizations with oversight of graduate medical education. The organizations will join the AMA’s Accelerating Change in Medical Education Consortium and work together to evaluate successes and lessons learned, and promote wide dissemination and adoption of successful innovations:

Read more from the AMA here.