To provide residents with twenty-first century skills, timeless core values, and a solid sense of professional and personal balance that will allow them to thrive in practice and to feel competent meeting the growing primary care needs of our society in  most  urban, suburban, and rural environments.

• To serve our community by providing a medical home that is patient and family-centered, committed to timely access, team-based care, comprehensive inpatient and ambulatory clinical services, a deep understanding of chronic disease management principles, and where the active practice of clinical Quality Improvement methodology drives all of our patient care.

To foster an environment of respect for cultural and socioeconomic diversity in caring for the underserved, especially our ethnic and senior populations in Vancouver and Clark County.

As we enter the latter half of this decade, Family Medicine continues to undergo substantial evolutionary change. The Future of Family Medicine Project  has been a concerted effort by our national leadership to define our specialty, how  Family Physicians fit into the current framework of organized medicine, and how we will meet the challenges of a future characterized by a worsening national physician shortage, a rising trend among medical students to seek haven within  specialties and subspecialties that some argue are more devoted to preserving physician lifestyle and income than providing accessible, affordable, comprehensive, and preventive health care. This is occurring in a nation more in need of that broad array of medical services than ever before in our  history.

The faculty, residents, and staff of Family Medicine of Southwest Washington committed to embracing this future in March of 2003. Through participation with the Institute for HealthCare Improvement  , we launched our transformation by implementing the concept of Office Redesign and by creating a new clinical care environment called Advanced Access, the second generation of Open Access. This was instituted at our Family Medicine Center practice in January of 2004. To accomplish this, we first had to analyze all aspects of our clinical operations, including how they interfaced with resident education. Most of 2003 was spent redesigning systems, workflow, staff job functions, understanding the needs of our patient population, and matching them with our internal capabilities. The product of this work has been impressive:

• An Advanced Access clinic environment that has been recognized regionally and nationally
• High levels of continuity with the patient's primary resident physicians
• Significantly decreased need for our patients to seek Emergency Department care
• Development of clinical care teams to facilitate effective chronic disease management models for Diabetes, Asthma, Medical Management of Chronic Pain, and Anticoagulation Management
• Group Visits for patients with Diabetes, both in English and Russian languages
• Current development of similar health management programs for Cardiovascular Disease Risk, Depression, Obesity, and Oral Health

This is a time when many residencies across the nation are only beginning the Quality journey, hoping to ultimately achieve all facets of the "New Model" articulated in the Future of Family Medicine project. FMSW has been measuring its effectiveness and outcomes, developing the next cycle of improvements to our systems, and engaging in practice-based learning and improvement for almost three years.

Our commitment is to redefine a traditionally solid and balanced approach to resident education, with even more focus on harmony between inpatient and ambulatory learning, case and practice-based conferences, Musculoskeletal Medicine, and enhanced customization of elective experiences that will be flexible enough to meet the increasingly varied and changing educational needs of our future residents. This is being accomplished without detracting from the elements on which our program has built a strong reputation:

• Adult Medicine
• Maternity Care
• Pediatrics, Newborn, and Neonatal Care
• Procedural Medicine
• Practice Management

In melding a strong tradition that blends procedural and cognitive skills with a contemporary focus on Quality and Innovation, FMSW stands in a position of leadership, vision, and strength to help residents find their way into future practice careers with confidence, preparedness, and clarity.