The UCSF AoD program allows residents to participate in 6 distinct specialized experiences during their latter 2 years of training. We have demonstrated that it is feasible to implement these educational opportunities with favorable outcomes in the domains of resident satisfaction, recruitment, board performance, and scholarship. We believe this success relates to the AoD program providing relevant and compelling educational experiences, tailoring mentoring, and creating smaller educational communities. Residents and fellows from all specialties can participate in such a program because of the transformation from a single residency program to a campus-wide program.
We demonstrate that AoD participation helps residents decide on potential career pathways. Many residents recognize a wide variety of career options in broader professional roles. Social cognitive career theory describes a learner's perception of increased self-efficacy with career-related tasks when they experience success in new endeavors. These experiences greatly influence future career choices among developing professionals.10
Our curriculum design enables residents to make their initial postresidency career choices after having experienced a broad range of options.
To successfully implement the AoD program, we needed to create more ambulatory time in the latter 2 years of residency and restructure resident schedules into 2-month blocks. Planning for AoD educational activities involved creation of introductory core material for new participants and a 2-year curriculum appropriate for each learner level. Faculty members were recruited by each AoD leader to provide curricular content; these faculty members also served as advisors and mentors. With the incorporation of most AoDs into the UCSF Pathways program, learners from many disciplines are able to participate together, which enables our AoD faculty to assume campus-wide leadership roles.
Another challenge was recruiting expert faculty and providing them with time and resources to plan and deliver the curriculum as well as to mentor residents. Key AoD faculty members are now financially supported and receive academic recognition for their administrative, educational, and mentoring work.
Our descriptive study has several important limitations. First, it is an educational innovation at a single, large academic institution with a depth and breadth of faculty expertise that supported such an ambitious undertaking. However, we believe that this program could be adapted, in full or in part, by many institutions that have motivated faculty with similar curricular expertise. Second, we were unable to include a comparison group to examine differences in satisfaction, career path, and scholarly productivity because most residents participated in the program. Finally, we do not have longitudinal data regarding the ultimate effect of the AoD program on resident career choices.
Our innovative AoD program has contributed to a transformative change in medical education at our institution by serving as a nidus for the UCSF Pathways to Discovery program, which offers specialized, longitudinal training experiences for medical students, residents, and fellows as well as for learners from the other health care professional schools at UCSF.11
As the AoD program has merged with Pathways, our residents have new opportunities to work and learn collaboratively across different specialties and professions. Importantly, our program enables us to address the call for individualized learning tracks.4
More broadly, our experience demonstrates that academic institutions can continue to ensure that residents obtain outstanding clinical training while simultaneously creating opportunities for residents to experience expanded careers during their traditional residency education.