A new framework for residents

The Accreditation Council for Graduate Medical Education develops new accreditation system.

By: Emily Miller
Pediatrics residents. Photo by Jesse S. Jones

Pediatrics residents. Photo by Jesse S. Jones

The characteristics of an empathetic practitioner — humanism, compassion, integrity and respect for others — make up one milestone in the new accreditation system developed by the Accreditation Council for Graduate Medical Education.The ACGME is shifting the focus of accreditation for graduate medical programs from a process-based evaluation to one that is more outcomes-based. Instead of focusing on a program’s ability to meet requirements set by the ACGME, the new system looks at residents’ preparedness in their chosen specialties.“It will be based less on whether or not you fill out the appropriate paperwork,” said Michael E. Mahla, MD, associate dean for graduate medical education at the UF College of Medicine. “The ACGME has really shifted to looking at the quality of the physician we are producing and whether he or she can meet societal expectations of doctors in the 21st century.”

Seven UF Health residency programs are currently under the new accreditation system, and by July 2014, all 65 UF programs accredited by the ACGME will be added.

“It has a very big impact on pretty much all the areas of health care here at the institution,” Mahla said. “If the programs are not accredited by the ACGME, then the hospital is not eligible to receive government funds to support resident training in that area.”

Under the new accreditation system, the ACGME will switch from periodic evaluations to  more continual reviews, examining programs yearly based on whether residents and fellows meet outcomes-based milestones within six domains of clinical competence.

Medical educator Lynne Meyer, PhD, MPH, said the hardest part of the change will be the shift in mindset.

“People are used to being evaluated on a one-to-five scale or a one-to-nine scale, and I think going with the milestones here, it’s not so much numerical grading,” she said. “The milestones have a lot of narrative description that describes each level, so it’s more of ‘Where do I fit in the description?’”

Mahla said the new system “is a good thing,” although it requires a lot more institutional resources and oversight than in the past.

“It provides more accountability for programs to make certain they are producing what society needs as far as health care providers,” he said.