Impact of a structured remediation program on academic performance of family medicine residents in difficulty: A training centre experience

Background Residents in difficulty represent a significant challenge in postgraduate medical education. Early, structured remediation may improve academic and clinical performance, yet regional evidence from family medicine training programs remains limited. Objectives To evaluate the impact of a structured remediation program on examination performance and clinical assessments of family medicine residents in difficulty, and to explore resident-perceived mechanisms contributing to improvement. Methods A mixed-methods study was conducted at a single accredited family medicine training center over three academic years (2022–2025). Quantitative analysis included a retrospective review of promotion examination scores and clinical assessment outcomes before and after participation in a standardized remediation program. Qualitative data were obtained through semi-structured interviews with participating residents and analyzed thematically. Wilcoxon signed-rank test, Stuart–Maxwell test, and multivariable linear regression were used to assess performance changes and predictors of post-course outcomes. Results Thirty-one first-year family medicine residents were included. Mean promotion examination scores improved significantly from 55.1 ± 2.4 pre-course to 79.0 ± 5.1 post-course (p < 0.0001). Clinical assessment outcomes improved from universal borderline or failing status to 100% pass rates (p = 0.0009). Perceived exam difficulty decreased significantly following remediation (p < 0.0001). Multivariable analysis showed that age, gender, and training sector were independently associated with post-course scores. Qualitative analysis identified five key themes underlying improvement: transformation of learning strategies, enhanced clinical exposure, mentorship support, feedback-driven reflection, and professional accountability. Conclusion A structured remediation program was associated with significant improvements in academic performance, clinical competence, and learner confidence among family medicine residents in difficulty. Early, supportive, and mentorship-driven remediation may represent an important component of postgraduate family medicine training.