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Graduate Medical Education—A System in Evolution
Orthopedic residency programs began as apprenticeships. Observation, imitation, and performing operations until deemed to be proficient by a single mentor was the method in which generations of surgeons were trained. Today, our system has evolved and is based upon a structured curriculum, and competence is not limited to technical abilities or number of cases. Residents are consistently supervised and observed in the development of their skills. Learning through simulation is standard practice. Programs must ensure that graduates are competent in their ability to communicate with patients and that they demonstrate professionalism and appropriate interpersonal skills. They must understand the health care system and be prepared for a lifetime of learning and improvement. Similarly, to remain accredited, residency programs must validate that they have the proper environment for learning. This includes a milieu of scholarship, oversight of work hours, and an atmosphere where residents may express concerns. Under the Next Accreditation System (NAS), teaching hospitals have regular external reviews to ensure that they provide the proper learning environment.1 Trainees and practitioners must focus on outcomes, patient safety, quality, and disparities in care. This results in the development of better surgeons and competent physicians who can practice in a complex and changing system. The public should be assured that the care provided to patients in teaching hospitals is not only appropriately supervised, but is at the highest level of quality. Dr. Cvetanovich describes our new paradigm that, in order for academic medical centers to remain accredited, we must constantly prove that our outcomes are as good or better than those at nonteaching hospitals.
Reference
1. Nasca, TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system—rationale and benefits. N Engl J Med. 2012;366(11):1051-1056. doi: 10.1056/NEJMsr1200117.
Graduate Medical Education—A System in Evolution
Orthopedic residency programs began as apprenticeships. Observation, imitation, and performing operations until deemed to be proficient by a single mentor was the method in which generations of surgeons were trained. Today, our system has evolved and is based upon a structured curriculum, and competence is not limited to technical abilities or number of cases. Residents are consistently supervised and observed in the development of their skills. Learning through simulation is standard practice. Programs must ensure that graduates are competent in their ability to communicate with patients and that they demonstrate professionalism and appropriate interpersonal skills. They must understand the health care system and be prepared for a lifetime of learning and improvement. Similarly, to remain accredited, residency programs must validate that they have the proper environment for learning. This includes a milieu of scholarship, oversight of work hours, and an atmosphere where residents may express concerns. Under the Next Accreditation System (NAS), teaching hospitals have regular external reviews to ensure that they provide the proper learning environment.1 Trainees and practitioners must focus on outcomes, patient safety, quality, and disparities in care. This results in the development of better surgeons and competent physicians who can practice in a complex and changing system. The public should be assured that the care provided to patients in teaching hospitals is not only appropriately supervised, but is at the highest level of quality. Dr. Cvetanovich describes our new paradigm that, in order for academic medical centers to remain accredited, we must constantly prove that our outcomes are as good or better than those at nonteaching hospitals.
Graduate Medical Education—A System in Evolution
Orthopedic residency programs began as apprenticeships. Observation, imitation, and performing operations until deemed to be proficient by a single mentor was the method in which generations of surgeons were trained. Today, our system has evolved and is based upon a structured curriculum, and competence is not limited to technical abilities or number of cases. Residents are consistently supervised and observed in the development of their skills. Learning through simulation is standard practice. Programs must ensure that graduates are competent in their ability to communicate with patients and that they demonstrate professionalism and appropriate interpersonal skills. They must understand the health care system and be prepared for a lifetime of learning and improvement. Similarly, to remain accredited, residency programs must validate that they have the proper environment for learning. This includes a milieu of scholarship, oversight of work hours, and an atmosphere where residents may express concerns. Under the Next Accreditation System (NAS), teaching hospitals have regular external reviews to ensure that they provide the proper learning environment.1 Trainees and practitioners must focus on outcomes, patient safety, quality, and disparities in care. This results in the development of better surgeons and competent physicians who can practice in a complex and changing system. The public should be assured that the care provided to patients in teaching hospitals is not only appropriately supervised, but is at the highest level of quality. Dr. Cvetanovich describes our new paradigm that, in order for academic medical centers to remain accredited, we must constantly prove that our outcomes are as good or better than those at nonteaching hospitals.
Reference
1. Nasca, TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system—rationale and benefits. N Engl J Med. 2012;366(11):1051-1056. doi: 10.1056/NEJMsr1200117.
Reference
1. Nasca, TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system—rationale and benefits. N Engl J Med. 2012;366(11):1051-1056. doi: 10.1056/NEJMsr1200117.
