Fifteen Years of Family Medicine Residency Training in the United Arab Emirates: A Mixed-Methods Evaluation of Program Evolution, Educational Outcomes, and Lessons Learned

Background Family medicine plays a central role in strengthening primary healthcare systems and addressing evolving population health needs, particularly in regions undergoing rapid healthcare transformation. Over the past 15 years, the Emirates Health Services (EHS) Family Medicine Residency Program in the United Arab Emirates (UAE) has aimed to develop a competent family medicine workforce capable of delivering comprehensive, community-oriented, and patient-centered care. Methods This sequential mixed-methods study evaluated the evolution and perceived educational outcomes of the EHS Family Medicine Residency Program between 2009 and 2025. Quantitative data were collected using a structured survey administered to program alumni and current fourth-year residents (R4), while qualitative data were obtained through focus group discussions with residents, alumni, and faculty members. Quantitative analyses included descriptive statistics, non-parametric subgroup comparisons, and Spearman correlation analyses. Qualitative data were analyzed using inductive thematic analysis. Findings were integrated during interpretation. Results Of 71 eligible participants, 64 completed the survey (response rate: 90.1%), including 56 alumni and eight current R4 residents. Overall satisfaction with the residency program was high, with a median satisfaction score of 4.55/5.00. Faculty teaching, supervision, and academic day activities received the highest ratings, whereas hospital-based training and work-life balance demonstrated comparatively greater variability. Median perceived competency and preparedness scores were 4.36/5.00 and 4.37/5.00, respectively. Satisfaction demonstrated moderate positive correlations with perceived competency (Spearman ρ = 0.60, p < 0.0001) and preparedness for independent practice (ρ = 0.64, p < 0.0001). Outcome scores differed across post-residency duration groups, with alumni more than 10 years post-residency reporting the highest satisfaction, perceived competency, and preparedness scores. Qualitative findings suggested substantial program evolution toward a more structured, learner-centered, and competency-oriented training model, with strengths in academic-clinical integration, supervision, assessment systems, ambulatory learning, and resident professional development. Persistent challenges included workload pressures, administrative burden, and variability in hospital-based supervision. Conclusion Over the past 15 years, the EHS Family Medicine Residency Program has undergone substantial development toward a more structured and competency-oriented training model. Participants generally perceived the program positively in relation to supervision, educational experiences, preparedness for independent practice, and professional development. Ongoing operational and workload-related challenges warrant continued program refinement and longitudinal evaluation.