HomeP⁴P⁴ Frequently Asked Questions

P⁴ Frequently Asked Questions

The call for proposals is now closed.

Timetable

The P⁴ call for proposals is divided into two stages. Eligible residencies must submit a general proposal outline using the Stage 1 online submission form. Following a careful review of all proposals, the P⁴ Steering Committee will invite selected residency applicants to submit a detailed, Stage 2-full proposal. Below is the application and selection process timetable:

September 1 - October 16 (midnight) - call for Stage 1 proposals open. Stage 1 closes at midnight October 16, 2006.

October 31 - Selected residencies receive invitations to submit detailed proposal (stage 2-full proposal) to residency applicants

October 31- Programs will be notified if they are not recommended for a stage 2 application.

December 15 - Deadline for stage 2- full proposal

Definitions

Q. What will be considered innovation?

A: It is anticipated that residencies will propose novel training models that move beyond modest pedagogical alterations to include changes to the content, structure and location of training.  With the expectation that proposals will align with the core components of the new model of care, possible innovations may address one or more areas of residency training such as:  a) scope and content of training, b) length of training, c) place of training, d) structure of training, and e) measurement of competency.  In addition, residencies are encouraged to propose other ideas that move beyond the scope of these domains.

An innovation that is only a deletion of a current RRC-FM requirement will not be considered by the Steering Committee.

Q. What is TransforMED?

A: Established in 2005, TransforMED is a not-for-profit affiliate of the American Academy of Family Physicians (AAFP) focused on studying and implementing transformed models of care that meet the needs of both patients and practices.  TransforMED is engaged in two national demonstration projects, one focusing on practice redesign, and P⁴ which focuses on preparing personal physicians to be effective in new models of practice.

Q. What is the New Model?

A: A “new model practice” is one that adopts the characteristics elaborated by Task Force 1 and modeled by Task Force 6 in the Future of Family Medicine Project [» www.futurefamilymed.org].  Such practices are envisioned to provide a medical home for people of any age where health care needs and problems can be assessed and care for them integrated in a highly personal way that is satisfying to both patients and practice members. Find out more about the new model.

Q. What is RAP and the role of RAP in the P⁴ Initiative?

A: The Residency Assistance Program (RAP) for family medicine began in 1975 to promote the development of quality graduate medical education in family medicine through the provision of consultative services.  The P⁴ Steering Committee recognizes the value and expertise of the RAP program and intends to utilize the expertise and services of RAP consultants to help selected programs achieve their objectives. 

General

Q. What is the overall goal of P⁴?

A: Grounded in the assumption that family medicine residencies are a key bridge in the development of physicians and must be environments in which residents can learn to adapt to inevitable changes in life and medicine, the P⁴ initiative’s purpose is to inspire and examine substantial innovation in the content, structure and location of training of family physicians and guide future revision in accreditation and certification requirements.

Q. Who is initiating and administering the P⁴ Initiative?

A: The Association of Family Medicine Residency Directors and the American Board of Family Medicine are the organizing institutions with assistance from other national organizations, including the Family Medicine Residency Review Committee and the Accreditation Council for Graduate Medical Education, the Residency Assistance Program and TransforMED, an affiliate of the American Academy of Family Physicians.  Other family medicine organizations, e.g. the Society of Teachers of Family Medicine, Association of Departments of Family Medicine, and the North American Primary Care Research Organization are poised to assist.

Q. How many residencies will be studied?

A: Up to 20 family medicine residencies will be selected.

Q. Who will review the proposals and select the residencies?

A: The P⁴ Steering Committee.

Q. What kind of assistance will be available to selected residencies?

A: Expert consultation will be provided by national authorities in graduate medical education, practice redesign, change management, collaboration, and evaluation.  RAP consultants, TransforMED facilitators and others will serve as key support to help the selected residencies achieve their proposed outcomes.   

Q. How will P⁴ funding be used to support the selected residencies?

A: Each participating residency will require their typical ongoing support from their sponsor.  The P⁴ initiative should not be viewed as a financing mechanism for acquisition of EHRs or other residency enhancements. It is anticipated that selected residency sites may need to identify additional local funding for development or evaluation expenditures.

The initial funding for the P⁴ initiative will be used to deploy consultants/facilitators to each of the residency sites, conduct collaboratives (national meetings) for all of the participating residencies and form the technical and administrative infrastructure for systematic evaluation of each proposed experiment.  Some funds may be available to support ½ of a full time equivalent person to work on evaluation for qualified residencies. 

Q. What type of staffing is expected to be put in place by the selected residencies?

A: Each residency participating in the project will constitute a set of experiments.  Measurement of processes and outcomes are essential and it is likely that each P⁴ residency will need, in addition to its champion(s) of innovation, approximately ½ of a full-time equivalent person, on site, committed to evaluation.  

Q. What are the benefits of participating in P⁴?

A: 

• Opportunity to influence future training of family physicians.  
• Recognition for your residency program and sponsoring institution as a leader in family medicine innovation.  
• Opportunity to test and compare ideas and strategies with other leading programs and expert evaluators.

Q. Can a program participate without engaging in rigorous evaluation?

A: No.

Eligibility

Q. Will preference or special consideration be given to residency programs with specific structures or locations?

A: No, all US ACGME accredited family medicine residencies are eligible to apply including those programs that are new and/or dually accredited.

Q. Will preference or special consideration be given to residencies that had previously applied to the TransforMED National Demonstration Project (NDP)?

A: Prior applicants are encouraged to apply but will not be given special consideration over other eligible residencies.   The Steering Committee considered the merits and scope of the two different demonstration projects.  P⁴ is not restricted to practice redesign.  It focuses on the entire residency program and is much broader in its scope, inviting experimentation with any aspect of training.  Thus, a different set of information and process is necessary for all applicants.

Q. Must an application address one or more of the five categories of innovation noted in the P⁴ call for proposals?

A: No, these categories are intended to spur ideas and illustrate possibilities.  The Steering Committee welcomes “Wild Card” ideas.  Preference will be given to those residencies that propose substantial innovation.  

Q. Can our proposal address more than one of the domains of innovation noted in the call for proposals?

A: Yes, your proposal may address one or more of the domains noted in the examples cited in the call for proposals.

Q. Is there any proposed innovations that are unacceptable?

A: Yes, the following innovations conducted alone will not be considered by the Steering Committee:

• Only a deletion of a current RRC requirement.
• Only a comparison of alternative pedagogical methods.
• Only an evaluation of alternative governance structures.
• Only an evaluation of alternative financing arrangements.

However, changes in teaching or evaluation methods or financing associated with a substantial revision of the residency program are welcome.

Q. Must my residency have a functioning electronic health record, advanced access, and other components described as the new model of care to apply?

A: No, there is no such stipulation. 

Application Process

Q. Who can apply?

A: All US ACGME accredited family medicine residencies are eligible to apply including those programs that are new and/or dually accredited.

Q. Can newly accredited residencies apply?

A: Yes.  Newly accredited programs are encouraged to apply.

Q. Can we submit one document (proposal) that addresses both sets of questions noted in stage 1 & 2 of the call for proposals?                                      

A: No, applicants must use the online call for proposal form for Stage 1.  The Steering Committee will invite carefully selected residencies to submit a more detailed full proposal during the second stage of the CFP process.  However, it would be to your advantage to carefully consider the stage 2 questions as you prepare your proposal and complete the stage 1 online call for proposal form.  

Q. When might we expect an invitation to complete stage 2 of the call for proposals?

A: October 31 is the target date that applicants will receive an invitation to submit a more detailed proposal.  Full proposals are due 12/15/06.

Q. If we are not selected to submit a more detailed full proposal (stage 2) when will we be notified?

A: October 31.

Q. Can you share a copy of a proposal?

A: No, a model proposal is not available.

Q. Where can I get help if I’m having technical difficulty with the online call for proposals form (stage 1)?

A: Contact Jay Fetter, P⁴ Project Manager, toll free at 800-274-2237 ext. 6724.

Q. Will I receive verification that our online application submission was received?

A: Yes, e-mail verification will serve to confirm receipt of your application.  However, submissions that do not provide all 9 components of the Stage 1 online proposal form or that exceed the word limit will not be reviewed by the Steering Committee. TransforMED staff must receive your online proposal and a copy of your most recent accreditation no later than midnight on October 16, 2006.

Q. Will submitting additional letters of support or endorsement improve the likelihood that our program will be selected?

A: No, do not submit additional materials beyond those requested in the CFP.  The CFP requests ONLY your most recent accreditation letter from the Family Medicine Residency Review Committee.  If your letter is not received by October 16, 2006, your proposal will not be considered.

Please submit a copy of your most recent accreditation letter via fax Marsha Cuele 913-906-6326.  TransforMED staff must have a copy of the letter no later than midnight on October 16, 2006.

Mailing information:
Jay Fetter
P⁴ Project Manager
4000 W. 114th Street, Suite 190
Leawood, KS 66211 

Q. Can we discuss our proposed innovation with P⁴ staff and Steering Committee before submitting the proposal?

A: The P⁴ staff and Steering Committee will answer questions as necessary, but will not provide individual consultation about the merits of proposals.

Q. Will you contact me if there is missing information in our application?

A: No, but you are welcome to contact staff by e-mail to confirm that your application is complete.

Q. Will selected residencies also be required to submit a separate innovation proposal to the RRC-FM?

A: The CFP process was designed to collect information that is consistent with the RRC-FM guidelines for experimental and innovative proposals.  Some proposals may warrant a request for additional information for review by the RRC-FM.  If so, the P⁴ Steering Committee will work closely with those residencies to prepare information.

Q. Can one or more residencies submit a joint proposal?

A:  No.

Q. What are the selection criteria for the P⁴ Initiative?

A: The Steering Committee will consider the following eight criteria:

• The importance of the proposed innovation for broad application likely to enhance the training of family physicians to be personal physicians.
• The reputation, experience, and leadership of the applicant residency program and its sponsors.
• The level of innovation as proposed.
• Alignment with New Model Practice characteristics and services.
• Capacity to evaluate proposed innovations and conduct the experiment
• Likelihood that proposed innovations will inspire students, residents, faculty and practicing physicians toward outstanding performance.
• Sustainability and financial viability.
• Ability to work well with other residencies, the Steering Committee, and TransforMED.

Evaluation

Q. How will evaluation be coordinated?

A:  P⁴ will fund an independent evaluation team to coordinate, with each residency, the evaluation of project-specific outcomes.  In addition, each residency will need, in addition to its champion(s) of innovation, approximately ½ of a full time equivalent person, on-site committed to evaluation. The participating residencies and the evaluation team will report to the P⁴ Steering Committee.

Submit a question (please allow one business day for a response).   Some questions may be added to the P⁴ FAQ.