ABMS's Vision: Doubling Down on MOC
Since the American Board of Medical Specialties' (ABMS) "Vision Commission" issued its corporate white-paper "final report," it has become abundantly clear that the American Board of Medical Specialties (ABMS), medical subspecialty societies, and the entire Accreditation Council for Graduate Medical Education (AAMC, AMA, AHA, etc), have no intention of ending mandated re-certification (Source: Dr. Wes)
Source: Dr. Wes - September 24, 2019 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs

Physician Online Gaming for MOC Points
This email was forwarded to my inbox from a colleague who was invited to play this "8-week online computer game and clinical care competition" with colleagues for 4 MOC ® points from the University of California San Francisco in collaboration with the Accreditation Council for Graduate Medical Education (ACGME): From: "Trever Burgon, PhD" Date: January 12, 2019 To: ************* Subject: CME/ (Source: Dr. Wes)
Source: Dr. Wes - January 14, 2019 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs

Building a Charter on Physician Well-Being
Attention to physician well-being is ever-increasing, and solutions are beginning to emerge. Several of us previously published a Perspective in Academic Medicine calling for action in the graduate medical education (GME) world. This paper outlined recommendations at all levels of the health care system to mitigate burnout and promote well-being. However, while there are numerous position papers and suggestions for how to take on this mammoth issue, to date there has been no widely accepted codification of principles or set of commitments to guide organizational and individual action. In response to this need, the Collabor...
Source: Academic Medicine Blog - May 8, 2018 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective Source Type: blogs

Influencing your resident evaluations for success
Performance appraisals are an integral part of an organization’s assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the common goals of individual appraisals are to monitor progress, identify areas for growth, set goals, guide development, provide and elicit feedback through open communication, and document issues that may require disciplinary action or even alternative career guidance. Effective evaluation processes are transparent, objective, fair, predictable,...
Source: Kevin, M.D. - Medical Weblog - February 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/todd-rice" rel="tag" > Todd Rice, MD, MBA < /a > Tags: Education Hospital-Based Medicine Residency Source Type: blogs

ABMS/ABIM MOC Controversy: 2017 Year-in-Review
As we say goodbye to 2017, we say goodbye to a year of unprecedented exposure of the interconnected workings of the Accreditation Council for Graduate Medical Education and its member organizations, the American Board of Medical Specialties (ABMS), the American Medical Association (ABMS), the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), and the Council (Source: Dr. Wes)
Source: Dr. Wes - December 31, 2017 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs

The hidden threat of the 80-hour resident workweek  
In an article published by the Atlantic earlier this year, Ryan Park writes that neither truck drivers nor bankers work the kind of gruelingly long hours that doctors — particularly young doctors in their residency programs — do. It is no secret that residency life is demanding and exhausting. Over the last decade, it has also become controversial. Almost a test in itself, as if gauging doctors’ propensity for this field, residencies demand not only time and dedication of their young doctors, but also their unwavering attention and perfection in everything they do; a tall order for any individual who may ...
Source: Kevin, M.D. - Medical Weblog - November 27, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Education Hospital-Based Medicine Pediatrics Source Type: blogs

Doctor Of Osteopathic Medicine: A Growing Share Of The Physician Workforce
Conclusion The doctor of osteopathic medicine workforce is growing rapidly with no signs of decreases in the quality of students accepted or their success in matching into a residency training program, which has been steadily rising. Given the doctor of osteopathic medicine workforce’s higher likelihood of practicing in rural communities and of pursuing careers in primary care, doctors of osteopathic medicine are on track to play an increasingly important role in ensuring access to care nationwide, including for our most vulnerable populations. Note 1 Since some residencies are jointly accredited by both the ACGME an...
Source: Health Affairs Blog - October 23, 2017 Category: Health Management Authors: Edward Salsberg and Clese Erikson Tags: Health Professionals Population Health doctors of osteopathic medicine osteopaths physician supply Source Type: blogs

ABMS Launches New Initiative: Continuing Board Certification
The American Board of Medical Specialties (ABMS) and its twenty-four Member Boards have launched a major initiative, "Continuing Board Certification: Vision for the Future" (Commission). A collaborative process, the Commission will bring together multiple partners to vision a system of continuing board certification that is meaningful, relevant and of value, while remaining responsive to the patients, hospitals and others who expect that physician specialists are maintaining their knowledge and skills to provide quality specialty care. The Planning Committee to establish the Commission will include representativ...
Source: Policy and Medicine - October 13, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Residents need to learn medicine, not how to pass a test
In his famous novel, Moneyball, Michael Lewis illustrates the phenomenon of professional baseball scouts focusing on all the wrong characteristics when looking at players. He describes how scouts focus on fastball velocity as a way to compare pitchers, despite the lack of correlation between fastball speed and the quality of a pitcher. As it turns out, the most important factor in a pitcher is deception, not a high-velocity fastball. The goal, after all, is to get batters out, not throw the hardest pitch. Lewis theorizes that because pitch speed is easy to measure, and easy to compare, it became overemphasized. The princip...
Source: Kevin, M.D. - Medical Weblog - August 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/eric-w-toth" rel="tag" > Eric W. Toth, DO < /a > Tags: Education Emergency Medical school Residency Source Type: blogs

Maintainance of Conflict of Interest?
By WESTBY FISHER, MD In the May 2nd issue of the Journal of the American Medical Association (JAMA), the American Medical Association (AMA) discusses the subject of physician conflicts of interest in medicine. This puts them at an interesting juncture when the editor-in-Chief and executive editor of JAMA failed to disclose their relationship with the AMA and the AMA’s relationship with US physicians. The AMA still presents itself to the public and legislators as representing Americas’ doctors, even though representing US physicians’ interests has not been their financial priority for many years. In fact, ...
Source: The Health Care Blog - May 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Maintenance of Conflict of Interest?
By WESTBY FISHER, MD In the May 2nd issue of the Journal of the American Medical Association (JAMA), the American Medical Association (AMA) discusses the subject of physician conflicts of interest in medicine. This puts them at an interesting juncture when the editor-in-Chief and executive editor of JAMA failed to disclose their relationship with the AMA and the AMA’s relationship with US physicians. The AMA still presents itself to the public and legislators as representing Americas’ doctors, even though representing US physicians’ interests has not been their financial priority for many years. In fact, ...
Source: The Health Care Blog - May 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

The little-known ACGME guideline change every resident should know
On July 1st, 2017, the updated Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements will take effect. The increase in the maximum continuous work hour shift from 16 to 24 hours has surely received the most attention, and will likely continue to do so. However, the ACGME did make some significant improvements in this latest guideline update worth noting. Among them was a slight conjunctional switch from an “and/or” to an “and” that now requires all residency programs in the country to ensure both post-call rooms and transportation options for residents who may feel...
Source: Kevin, M.D. - Medical Weblog - April 3, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/christopher-gable" rel="tag" > Christopher Gable < /a > Tags: Education Medical school Residency Source Type: blogs

Defending the change in resident duty hour restrictions
After thirteen years of duty hours restrictions, it was important for the Accreditation Council for Graduate Medical Education (ACGME) to assess the impact those regulations had had on patient safety and resident training. So last year, on March 16 to 17, 2016, the ACGME convened a congress on resident duty hours in Chicago. It was evident to everyone who attended that the ACGME had made a real commitment to hear all the evidence and do what was best for our residents, our patients, and our profession. I was impressed by the thoughtful analysis presented at that meeting by many medical and surgical disciplines. Almost univ...
Source: Kevin, M.D. - Medical Weblog - April 2, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/robert-e-harbaugh" rel="tag" > Robert E. Harbaugh, MD < /a > Tags: Physician Residency Source Type: blogs

The secret horrors of sleep-deprived doctors
Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality): “I did my internship in internal medicine and residency in neurology before laws existed to regulate resident hours. My first two years were extremely brutal, working 110 to 120 hours/week, and up to 40 hours straight. I got to witness colleagues collapse unconscious in the hall...
Source: Kevin, M.D. - Medical Weblog - March 12, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/pamela-wible" rel="tag" > Pamela Wible, MD < /a > Tags: Education Hospital Residency Source Type: blogs

Don ’t Ease Resident Work Hour Restrictions
One evening in May, 1999, when I was an intern, I fell asleep at the wheel driving home from a 36-hour shift at the hospital. Drives like that occurred not infrequently in those days, and I had developed techniques to fight off fatigue. Singing at the top of my lungs was one. Opening my car window wide to the brisk Chicago winds was another. Sometimes I had to combine one or both of these with a third, literally prying open an eyelid with one hand while steering with the other. I am embarrassed to reveal today how poor my judgment was then. How could I have taken such risks, endangering not only myself but others as well? ...
Source: Health Affairs Blog - February 27, 2017 Category: Health Management Authors: Emmet Hirsch Tags: Featured Health Professionals general medical education physicians perspective resident work hours residents Source Type: blogs

Travel Ban Is Revealing —but Does Not Threaten American Medicine
BY JANE ORIENT, MD A 90-day ban on travel from seven countries has sparked tremendous outpourings of worry or outright opposition by some 33 medical organizations. “The community is reeling over the order, fearing that it will have devastating repercussions for research and advances in science and medicine,” states an article in Modern Healthcare. Certainly the order is disrupting the lives of individual physicians who have won coveted positions in American medical institutions and were not already in the U.S. when the order was issued. Also their employers have a gap in the work schedule to fill. War tears peo...
Source: The Health Care Blog - February 14, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Your doctors may be lying about how long they worked today
America’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie. Resident physicians are the doctors-in-training that millions of Americans come into contact with at teaching hospitals across the country. We work for three to seven years (it depends on the medical specialty) under the supervision of attending physicians. From admission to discharge, we are the often-tired, ever-present doctors who likely take part in your hospital care. We are supposed to follow rules that specify how many hours we are able to work in a single...
Source: Kevin, M.D. - Medical Weblog - February 12, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/christopher-lee-bennett" rel="tag" > Christopher Lee Bennett, MD < /a > Tags: Education Hospital Residency Source Type: blogs

What New Resident Work Hours Mean For Physician Well-Being And Patient Safety
Late last year, the Accreditation Council for Graduate Medical Education (ACGME) issued proposed revisions to the Common Program Requirements for residency and fellowship training. At the heart of the proposed new requirements is this philosophy: Residency education must occur in a learning and working environment that fosters excellence in the safety and quality of care delivered to patients today and in the future. The important corollary is that physician well-being is crucial to their ability to deliver the safest, best possible care to patients. In keeping with this philosophy, the proposed changes to the Common Progr...
Source: Health Affairs Blog - February 9, 2017 Category: Health Management Authors: Thomas Nasca Tags: Featured Health Professionals Quality ACGME duty hours graduate medical eduction Physicians resident training Source Type: blogs

A Vote To Reimagine Residency
I can’t say I knew much about medicine when I decided to become a physician. There were no physicians in my family. I had yet to learn about cells, anatomy, or antibiotics. I didn’t watch ER. I had no concept of health insurance, deductibles, or co-pays. But I understood fairness. And, as a young boy in Colorado, I watched loved ones—with addiction, cancer, and other ailments—suffer the misfortune of illness and the injustice of unmet medical needs. I saw in medicine an opportunity to find voice and to remedy the unfairness around me, to address failed policies. Medicine and Politics On November 8, ...
Source: Health Affairs Blog - December 13, 2016 Category: Health Management Authors: Jarrad Aguirre Tags: Featured Health Professionals ACGME general medical education physicians perspective residency Source Type: blogs

Changing resident work-hours doesn ’t address the root of the issue
The Accreditation Council for Graduate Medical Education (ACGME) released a proposal last month that will affect physicians in their first year of training after medical school. Currently, there are regulations to prevent these doctors from working more than 16 hours at a time. The new proposal wants to remove these limits, extending the maximum shift to 28 consecutive hours. There is an outpouring of public discourse on the issue with valid arguments on all sides. Should we keep the current restrictions or implement the new proposal? Here’s the thing: Neither side addresses the root of the issue. Permanent, cultural...
Source: Kevin, M.D. - Medical Weblog - November 20, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jamie-katuna" rel="tag" > Jamie Katuna < /a > Tags: Education Residency Source Type: blogs

The new hour restrictions for residents: Stop with the manipulation
On Friday, November 4, Thomas Nasca, MD, the chief executive officer of the Accreditation Council for Graduate Medical Education (ACGME), released a letter outlining the proposed changes to intern work hour restrictions and other regulations. Specifically, the proposed update is expanding the previous restrictions to the length of the intern (who is a physician in their very first year out of medical school) work day from 16 to up to 28 hours. Strong opinions regarding the proposals have been shared by veteran physicians, medical educators, medical student and resident groups. Overall, I have felt encouraged that these com...
Source: Kevin, M.D. - Medical Weblog - November 14, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-ward-and-nicole-zagelbaum" rel="tag" > Michael Ward and Nicole Zagelbaum < /a > Tags: Education Residency Source Type: blogs

Are Academic Radiology Departments Missing Out by Not Using Twitter?
Only 8 percent of academic radiology departments have Twitter accounts, and only 5 percent are active, with at least 1 tweet sent in a three month period, revealed the new study, “Enriched Audience Engagement Through Twitter: Should More Academic Radiology Departments Seize the Opportunity?” published on Journal of the American College of Radiology on May 13, 2015.   Twitter users Vinay Prabhu, MD, radiology resident and Andrew B. Rosenkrantz, MD, associate professor of radiology, both at  NYU Langone Medical Center, who conducted this study, observed anecdotally that Twitter might be an area of ...
Source: radRounds - July 15, 2016 Category: Radiology Authors: Alessandra Simmons Source Type: blogs

Why a study of medical resident hours was unethical
In a recent post, I wrote about the iCOMPARE research study that is comparing the effects of increasing medical residents’ consecutive duty hours with observing the currently prescribed limits on their shifts. According to the study protocol, the primary hypothesis of the research addresses the safety of patients: that mortality under the increased residents’ duty hours will not significantly exceed patient mortality under the current mandated standard for medical residents on duty. I argued that the study design is unethical based on what is known about sleep deprivation. The study’s goal — se...
Source: Kevin, M.D. - Medical Weblog - April 30, 2016 Category: Journals (General) Authors: Tags: Education Residency Source Type: blogs

Rethinking Our Medical Education and Publishing Bureaucracy
Medicine has an image problem. On one hand, medicine is full of wonder: incredible technology, incredible innovation, and incredibly bright people. On the other, medicine is full of avarice, full of greed, and full of waste, much of it by the very same folks who bring us all that medicine has to offer: the Accreditation Council for Graduate Medical Education (ACGME). The ACGME is an incredibly (Source: Dr. Wes)
Source: Dr. Wes - April 17, 2016 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs

How duty hour restrictions are hurting residency training
As I get near the completion of an intense 5-year orthopedic surgery residency program, I had an interesting interaction with our hospitals sub-committee specifically tasked to address duty hour and resident fatigue issues. As they gave examples from other departments about changes made to their programs regarding duty hours, a clear-as-mud connection was continually made. They spoke of “improvements” made as the result of residents stepping up to serve as whistleblowers in identifying duty hour violations within various programs. I quickly chimed in to get clarification. They were assuming that increasing comp...
Source: Kevin, M.D. - Medical Weblog - April 11, 2016 Category: Journals (General) Authors: Tags: Education Orthopedics Residency Source Type: blogs

Clarifying the Difference Between Medical Licensure and Board Certification
Editor’s Note: For more on this topic, check out the January issue of Academic Medicine. By: David Price, MD, FAAFP, FACEHP, senior vice president, American Board of Medical Specialties (ABMS) Research and Education Foundation, and executive director, ABMS Multi-Specialty Portfolio Approval Program Medical licensure and Board Certification mean very different things for physicians practicing in the United States and the patients for whom they care. A license is required to practice medicine in this country. Medical licensure indicates that a physician has met minimum requirements for the undifferentiated practice of...
Source: Academic Medicine Blog - January 12, 2016 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective American Board of Medical Specialties board certification Maintenance of Certification medical licensure Source Type: blogs

How Managerialists Turned Housestaff Training into a Zero-Sum Game: the Continuing Saga of the FIRST and iCompare Studies
Conclusion: the Problem is Managerialism    While the ongoing trials of housestaff sleep deprivation have been largely anechoic, the recent Washington Post commentary by Clark and Harari make questions about why in the world medical academics would have set up such trials and continue to defend them even more stark.But it seems that medical academics are boxed in, playing a zero-sum game.  They may know that there housestaff are overworked and sleep deprived, a situation that endangers the housestaff and their patients.  Yet every reasonable way one could imagined improving the situation would require s...
Source: Health Care Renewal - December 22, 2015 Category: Health Management Tags: academic medical centers amphetamines clinical trials generic managers managerialism medical ethics post-graduate medical education resident sleep deprivation Source Type: blogs

Update On Graduate Medical Education Positions
The Accreditation Council for Graduate Medical Education (ACGME) recently published its annual Data Resource Book (DRB). The ACGME DRB provides authoritative data on trends of interest to those involved in Graduate Medical Education (GME) and physician workforce policies. The new Book documents a small but steady growth in “pipeline” programs—which lead to initial board certification—and a larger percentage growth in the number of “continuing” programs and positions in subspecialties. It also documents that a large number of foreign medical school graduates continue to enter GME each yea...
Source: Health Affairs Blog - December 17, 2015 Category: Health Management Authors: Edward Salsberg Tags: Costs and Spending Featured Health Professionals Hospitals Medicare Graduate medical education medical pipeline National Resident Matching Program Source Type: blogs

Macy Foundation Goes On The Road To Spotlight Innovations In Doctor Training
Since the July 2014 release of the Institute of Medicine’s report calling for a more publicly accountable graduate medical education (GME) system, the report has sparked an often contentious discourse among stakeholders about who wins and who loses. Because of the political difficulty in making any changes at this time, little is happening at the federal level on GME. Yet the case for GME reform made in the IOM report, and in earlier reports from the Josiah Macy Jr. Foundation that examine the future of GME, remains as strong as ever. While, ultimately, we will likely need change in federal legislation, it’s cl...
Source: Health Affairs Blog - December 15, 2015 Category: Health Management Authors: George Thibault Tags: GrantWatch Health Professionals Payment Policy Graduate medical education Health Philanthropy Innovation Josiah Macy Jr. Foundation Physicians Workforce Source Type: blogs

Drinking the Managerialists' Kool-Aid? - Why Did Medical Educators Launch Trials of Increased Sleep Deprivation of Physician Trainees Apparently in Violation of the Nuremberg Code?
It all seemed so bizarre.  In 2014, with little fanfare, two large trials that imposed longer work hours and sleep deprivation on physician-trainees (interns and residents), ostensibly to combat the problem of excess hand-offs of patients among physicians.  Both trials involved multiple academic medical centers, including some of the most prestigious in the US.  Within a year, the American Medical Student Association (AMSA) and Public Citizen called for a federal investigation of the trials, calling them "highly unethical."This unprecented conflict between prestigious academic medical institutions ...
Source: Health Care Renewal - December 3, 2015 Category: Health Management Tags: clinical trials informed consent logical fallacies managerialism medical ethics nuremberg code resident sleep deprivation Source Type: blogs

Breaking The Graduate Medical Education Policy Logjam
This report proposed major reforms which would create a GME system with greater transparency, accountability and strategic direction that aligns with national needs. Stakeholder response to the IOM Report currently is being evaluated by Congress in the Health subcommittee of the House Energy and Commerce (E&C) committee. Their input from various stakeholders has been complex and lacking in consensus, thereby perpetuating the GME policy logjam, creating a daunting challenge and thereby decreasing prospects of any comprehensive legislative GME reform in this session of Congress. Since the introduction of the “resid...
Source: Health Affairs Blog - August 12, 2015 Category: Health Management Authors: Richard Rieselbach, David Sundwall, Kenneth Shine, Ted Epperly and Byron Crouse Tags: Costs and Spending Featured Health Policy Lab Health Professionals Medicaid and CHIP Medicare Organization and Delivery Population Health Quality COGME HHS House Energy and Commerce committee IOM report MACRA Primary Care Rur Source Type: blogs

Post-call MVA: a real and present danger
Earlier this month we blogged about Post-call accidents in the light of the tragic deaths of young doctors in motor vehicle accidents (MVAs) the day after calls. The DG did mention it here We also spoke about the various proposals that would be plausible to improve the oncall system. I am due for a meeting with clinical specialists from MOH hospitals in early August 2015, hence this issue can be brought forth for further discussion. Any improvisation to the oncall system needs to be looked at all angles, including the (i) availability of posts, workforce and resources; (ii) service needs; (iii) continuity of patient care,...
Source: Malaysian Medical Resources - July 29, 2015 Category: Global & Universal Authors: palmdoc Tags: - Dobbs - Health tips Call Fatigue MVA Sleep Source Type: blogs

Communicating the Value of Accredited Continuing Medical Education
Graham McMahon, who began his tenure as President and Chief Executive Officer of the Accreditation Council for Continuing Medical Education (ACCME) last month, announced a new resource that CME providers and other stakeholders can use and distribute to communicate the value of accredited CME. “The resource describes how accredited CME promotes engagement with healthcare professionals by providing them with opportunities for relevant, practice-based, independent education and improvement in a system that meets their needs, and promotes quality in patient care,” he states. The document includes facts about CME&rs...
Source: Policy and Medicine - June 8, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Developing Standards ‘Of, By, And For’ Older Adults: Reflections On Patricia Gabow’s Narrative Matters Essay
Imagine three people: a healthy 30-year-old, a 60-year-old with high blood pressure, diabetes and arthritis, and a 90-year-old who is frail and has dementia advanced to the point where her speech often doesn’t make sense. If I lined them up, any doctor could instantly tell me which was which. Ditto if each broke a bone and I showed the physicians only their x-rays. And if I asked the clinicians to predict each patient’s risk of complications and adverse events based on nothing more than the few words above, they would again rapidly and reliably make accurate assessments. Yet, for the most part, our health syste...
Source: Health Affairs Blog - May 29, 2015 Category: Health Management Authors: Louise Aronson Tags: Health Professionals Hospitals Narrative Matters Organization and Delivery Aging End-of-Life Care Health Policy Patricia Gabow standards of care Source Type: blogs

Understanding Competency-Based Medical Education
Editor’s Note: This post is the first of two on the topic of competency-based medical education. Check back next week to read more on this topic. By: Robert Englander, MD, MPH, Terri Cameron, MA, Amy Addams, Jan Bull, MP, and Joshua Jacobs, MD Dr. Englander is the former senior director of competency-based learning and assessment at the Association of American Medical Colleges (AAMC). Ms. Cameron is director of curriculum programs at the AAMC. Ms. Addams is director of competency-based admissions at the AAMC. Ms. Bull is lead specialist in competency-based learning and assessment at the AAMC. Dr. Jacobs is senio...
Source: Academic Medicine Blog - May 19, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective CBME competency framework competency-based medical education domains of competence milestones Source Type: blogs

Results From The 2015 GME Matches: GME Positions Continue To Grow
Recently the preliminary results from the 2015 National Resident Matching Program® (NRMP®) and the American Osteopathic Association (AOA) Match were released. While final Match data from the NRMP will be released later this spring, the preliminary results from both programs provide important insights on Graduate Medical Education (GME) trends of interest in the policy community. Three issues are of particular interest in the policy community: Are GME positions continuing to grow? While many people thought that GME positions would not increase after the Medicare program capped the number of positions the program w...
Source: Health Affairs Blog - May 1, 2015 Category: Health Management Authors: Edward Salsberg Tags: Featured Health Professionals AOA GME Graduate medical education Match Day matching programs NRMP Physicians Primary Care Source Type: blogs

Teaching Health Centers: Targeted Expansion For Immediate GME Reform
We describe examples of current or proposed programs which illustrate the potential of these modifications. Need for Immediate Targeted GME Expansion in Primary Care There is broad agreement on the need for adequate numbers of physicians prepared to work in primary care, geriatrics and psychiatry in urban and rural underserved areas. A 12,000-31,000 shortage over current primary care physician supply in the next ten years is anticipated, depending on modeling considerations such as physician retirement rates and entrance of advanced practice nurses to take up some of the duties physicians currently perform. Regional and st...
Source: Health Affairs Blog - April 24, 2015 Category: Health Management Authors: Richard Rieselbach Tags: Costs and Spending Health Policy Lab Health Professionals Organization and Delivery Graduate medical education teaching health centers THCGME Source Type: blogs

The Council On Graduate Medical Education (COGME)—Not Yet Ready For End-Of-Life Care
The objectives of COGME have been to assess physician workforce needs on a long-term basis, recommending appropriate Federal and private sector efforts necessary to address these needs, and to provide a forum to enable appropriate configuration of these needs. COGME’s duties in pursuing these objectives involve making policy recommendations to the Secretary of HHS, the Committee on Health, Education, Labor and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives with respect to: the supply, and distribution of physicians in the United States, current and future shortages o...
Source: Health Affairs Blog - December 4, 2014 Category: Health Management Authors: Richard Rieselbach, David Sundwall, and Kenneth Shine Tags: All Categories Medicaid Medicare Physicians Policy Politics Reform Workforce Source Type: blogs

Teaching Health Centers: An Attainable, Near-Term Pathway To Expand Graduate Medical Education
We describe a near-term and attainable pathway to expand GME that could gain consensus among these stakeholders. This approach would sustain and expand Teaching Health Centers (THCs), a recent initiative that directly funds community-based GME sponsoring institutions to train residents in primary care specialties, dentistry and psychiatry. We further propose selectively expanding GME to meet primary care and other demonstrable specialty needs within communities, and building in evaluations to measure effectiveness of innovative training models. Our proposal includes: Congressional reauthorization and funding of the THC GM...
Source: Health Affairs Blog - October 17, 2014 Category: Health Management Authors: Richard Rieselbach, Paul Rockey, Thomas Nasca, Kathleen Klink, Robert Phillips, Malcolm Cox, David Sundwall, John Frohna, and Katherine Neuhausen Tags: All Categories Disparities Health Care Costs Health Reform Hospitals Medicaid Medicare Physicians Policy Politics Primary Care Veterans Workforce Source Type: blogs

Physician Payments Sunshine Act: Organizations Respond to CMS
  September 2nd marked the last day for comments on CMS’ proposed rule to eliminate the accredited continuing medical education (CME) exemption from Sunshine Act reporting.  In an overwhelming display of support for the exemption, over 800 comments were submitted encouraging the agency to either maintain or expand the current exclusion. -Total comments supporting maintenance or expansion of the CME exemption:  820 -Total comments supporting elimination of the CME exemption:  approximately 20 -Percentage of comments supporting the CME exemption: 98% We have followed this issue closely, and recentl...
Source: Policy and Medicine - September 8, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

MDs in Missouri say, "Show me."
Here's a fascinating story in Governing about Missouri's approach to alleviating a physician shortage in rural areas.  (Thanks to the folks at Commonwealth Magazine for the tip in one of their daily newsletters.)  The lede:A new Missouri law allows recent medical school graduates to practice primary care in underserved areas without completing a residency in a teaching hospital.The Missouri State Medical Association, the law’s chief backer, is calling it an unprecedented effort to help deal with doctor shortages in rural and other underserved areas, but opponents raise questions about whether circumventing ...
Source: Running a hospital - July 27, 2014 Category: Health Managers Source Type: blogs

ACGME Turns Blind Eye Toward Issue of Physician Debt
"A new roadmap for improving residents’ professional skills was released Tuesday by the Accreditation Council for Graduate Medical Education (ACGME)" begins the press release. As I dove into this announcement a bit further, I discovered the origins of this initiative outlined in this executive summary (pdf) published by the ACGME on the "CLER Program:" The Accreditation Council for Graduate (Source: Dr. Wes)
Source: Dr. Wes - January 30, 2014 Category: Cardiology Authors: Westby G. Fisher, MD Tags: ACGME Source Type: blogs

Interview with Docphin Co-founder, Mitesh Patel
Anyone who’s had the experience of wading through databases of medical research papers has likely asked herself, “Isn’t there a better way?” That’s what Mitesh Patel and his team at Docphin thought of when they created their tool, hailed by TechCrunch as the “Bloomberg for Doctors.” A physician entrepreneur who’s also serving as a Robert Wood Johnson Scholar, Mitesh took time out of his schedule to answer a few of our questions about Docphin. Shiv Gaglani, Medgadget: What exactly is Docphin and what is its value proposition? Mitesh Patel: It’s been estimated that a...
Source: Medgadget - December 19, 2013 Category: Technology Consultants Authors: Shiv Gaglani Tags: Medgadget Exclusive Source Type: blogs

Getting sleep versus staying engaged with the patient
Lisa Rosenbaum has posted a thoughtful piece over at The New Yorker entitled "Why Doesn't Medical Care Get Better When Doctors Rest More?"  After introducing a story about a patient, she says,A few days later, the resident caring for the patient neared the teaching hospital’s witching hour: whether or not his work was done, he had to leave at 6 P.M. That’s because, a decade ago, largely in response to widespread concerns that tired residents were making too many errors, the Accreditation Council for Graduate Medical Education enacted nationwide rules that limited the number of consecutive hours r...
Source: Running a hospital - August 26, 2013 Category: Health Managers Source Type: blogs

Medical residents taking the lead on quality improvement
A note from my friends and colleagues at the Committee of Interns and Residents (CIR): Although medical residents are often the first line of contact for most patients in academic medical centers and teaching hospitals, medical residency offers little in the way of formal training on skills needed to keep patients safe from medical errors or on how to deliver high-quality, cost-effective care.To cope with the pressures of today’s health system and new rules requiring clinically competency in patient safety, the national organization representing 13,000 of the nation’s interns and residents is launching the...
Source: Running a hospital - August 23, 2013 Category: Health Managers Source Type: blogs