MEDICAL EDUCATION
Learning curve Revamping residency program accreditation
BY AMY LYNN SORREL Start- ing in July, big changes are coming for faculty mem- bers who train aspiring U.S. physicians.
The new Accreditation Council for Graduate Med- ical Education (ACGME) rules for residency train- ing program accreditation come largely in response to calls for increased quality and patient safety. Tracking the maintenance-of-certifi- cation process for practic- ing physicians, the shift intends to prepare future physicians to practice in a rapidly changing care deliv- ery system. The rules also aim to reduce administra- tive burdens on programs so they can focus less on administrative compliance and more on educational innovation.
Many aspects of accred- itation stay the same: Fac- ulty still evaluate residents on prescribed core compe- tencies, and programs re- port that information along with board pass rates, clini- cal data from case logs, and faculty and resident surveys, for example. Requirements for duty hours and supervision remain in place, and site visits still occur. Some new requirements under the Next Accreditation Sys- tem (NAS), however, represent significant change: Resident evaluations now incorporate specialty-specific criteria called “milestones” to judge residents’ progress. ACGME will be less hands-on: Programs in good standing only have to undergo a wholesale, on-site review every 10 years, instead of every
Houston urologist Michael Coburn, MD, helps lead the charge on new accreditation rules aimed at aligning graduate medical education with the demands of today’s health care system and turning out well- prepared physicians.
two to five, and can skip voluminous reporting re- quirements and regular site visits. Instead, ACGME will accredit programs on an ongoing basis through annual electronic data col- lection and as-needed site visits. ACGME leaders say graduate medical educa- tion (GME) has come un- der increasing pressure to demonstrate that the bil- lions of dollars dedicated to training the nation’s physicians are actually doing what they are sup- posed to: produce doctors well trained in a broad range of skills and core competencies. To that end, the NAS better enables ACGME to measure residents’ prog- ress and collect data to compare educational outcomes, says Houston urologist Michael Coburn, MD. He chairs the ACGME Residency Review Commit- tee (RRC) in urology. The changes will help
“standardize the nature of training such that the public and other stakeholders can feel assured what it takes to be deemed competent in urology in one part of the country is the same as elsewhere and trust that everyone is getting adequately trained and reaching a high level of proficiency in that train- ing,” he said. ACGME is aware of the learning curve, and RRCs will take that into account during the transition, adds Dr. Coburn, who leads Baylor College of Medicine’s Department of Urology.
April 2014 TEXAS MEDICINE 27
JODY HORTON
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