Learner-directed intentional diversification: the experience of three P4 programs.

BACKGROUND: This paper presents early outcomes of three residency programs participating in Preparing the Personal Physician for Practice (P4), family medicine's innovative residency redesign initiative. The three programs allow learner-directed diversification and either allow or require extra time, up to 4 years of residency, to complete these experiences. Residents endorse the changes by two measures: they choose a wide variety of areas of concentration, and a significant minority (40%) of residents chose to extend their residency training to 4 years, a proportion that grew significantly from 2006 to 2008.