MedWorm: ACGME

Residency Training Oversight(s) in Surgery: The History and Legacy of the Accreditation Council for Graduate Medical Education Reforms.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Nauta RJ Abstract Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of duty hours to education, and the impact of fatigue on resident performance. Neurophysiologic adjuncts applied concomitantly to evaluation of didactic performance offer promise for data-driven definition of the optimal shift. Concurrently, the merits of specialty-specific oversight of graduate medical education remain under active consideration. PMID: 22269265 [PubMed - in process] (Source: The Surgical Clini...

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Residency Training Oversight(s) in Surgery: The History and Legacy of the Accreditation Council for Graduate Medical Education Reforms

Surgical Clinics of North America — Fri, 27 Jan 2012 11:25:19 +0100

Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of duty hours to education, and the impact of fatigue on resident performance. Neurophysiologic adjuncts applied concomitantly to evaluation of didactic performance offer promise for data-driven definition of the optimal shift. Concurrently, the merits of specialty-specific oversight of graduate medical education remain under active consideration. (Source: Surgical Clinics of North America)

Impact of a Six-Year Integrated Thoracic Surgery Training Program at the Medical College of Wisconsin [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Institution of a 6-year integrated thoracic surgery training program at the Medical College of Wisconsin led to a significant increase in number of applications. Additionally, the 6-year applicants appeared to be more academically accomplished than previous applicants to the traditional 2-year program. While early in the experience, it appears that interest in thoracic surgery is high among medical students and institution of a 6-year program has the potential to once again attract the "best and the brightest" to this specialty. (Source: The Annals of Thoracic Surgery)

The Perspective of the Vascular Surgery Trainee on New ACGME Regulations, Fatigue, Resident Training, and Patient Safety

Vascular and Endovascular Surgery — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: Vascular surgery trainees are concerned about further duty-hour restrictions on patient care, education, and training and fatigue mitigation has to be balanced against the need to adequately train vascular surgeons. (Source: Vascular and Endovascular Surgery)

The uneven distribution of women in orthopaedic surgery resident training programs in the United States.

The Journal of Bone and Joint Surgery. American volume — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSIONS: Significant differences in the representation of women exist among orthopaedic residency training programs in the U.S. Further examination of the characteristics of orthopaedic residency programs that are successful in attracting female residents, particularly the composition of their faculty as role models, will be important in furthering our understanding of how orthopaedic surgery can continue to attract the best and the brightest individuals. Changes in the cultural experiences in programs that have not trained female orthopaedic surgeons, such as an increased number of female faculty, and policies that emphasize diversity may provide a greater opportunity for our orthopaedic profession to attract female medical students. PMID: 22258016 [PubMed - in process] (Source: T...

A Nationwide Twenty Year Analysis of Resident Operative Trauma Experiences: Pre & Post Work Hour Reform

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:59 +0100

Conclusions: Secular trends prior to the 2003 work hour reform may have caused a marked decrease in operative trauma experience among general surgery residents. Radiologic advancements in intervention and imaging may have had a role in this decline. Rare cases, such as cardiac, pancreatic, and GU trauma, remain rare. Post work hour reform, operative trauma case volumes have stabilized. (Source: Journal of Surgical Research)

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The revised ACGME laparoscopic operative requirements: how have they impacted resident education?

Surgical Endoscopy — Wed, 11 Jan 2012 06:55:53 +0100

Conclusion Residency training programs have had to keep pace with evolving technology while preparing future surgeons to perform with confidence upon completion of residency training. The majority of residents feel their training has been adequate, but there are also a great number who believe they will need to continue their education in laparoscopic surgery to keep pace with this ever-evolving field. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-2103-5Authors Nicholas M. Brown, Department of Surgery, Room 3082, The University of Kansas School of Medicine-Wichita, 929 N. Saint Francis St, Wichita, KS 67214, USAStephen D. Helmer, Department of Surgery, Room 3082, The University of Kansas School of Medicine-Wichita, 929 N. Saint Francis St, Wichita, ...

Effect of the New Standards for Case Logging on Resident Operative Volume: Doing Better Cases or Better Numbers?

Journal of Surgical Education — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: Although some operative cases newly classified as major are technically advanced procedures (eg, Roux-en-Y gastric bypass), other cases are not (eg, breast lesion excision), which raises the issue as to whether the major case category has been diluted by less demanding case types. The implications of these findings may suggest preservation of case volumes at the expense of case quality. (Source: Journal of Surgical Education)

Webcasts for Resident Education

Ophthalmology — Sun, 01 Jan 2012 05:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) requires a certain number of hours of formal teaching in particular subjects in a fully accredited ophthalmology residency program. Fifty-two of 114 (45.6%) ophthalmology residency programs in the United States enroll 2 or 3 residents per year. These small programs may have limited expertise and resources to meet ACGME requirements in some subspecialties. They either send their residents for courses or invite experts from different institutions. Either method is expensive and requires time away from other responsibilities–both for the residents and the invited speaker. Webcast conferencing has been used as a tool for business communication/conferencing and education in fields like nursing, family medicine, and pathology. Ho...

The annual program review of effectiveness: a process improvement approach.

Famly Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Nadeau MT, Tysinger JW Abstract BACKGROUND AND OBJECTIVES: All residencies and fellowships are required by the Accreditation Council for Graduate Medical Education (ACGME) and local institutional policy to conduct an annual program review of educational effectiveness. However, a number of family medicine residencies were cited for having an inadequate annual review or for failing to document the review in 2008. The ACGME and university offices of graduate medical education provide program directors some guidance on conducting and documenting annual program reviews, but few articles describe a detailed process for such a review. In this article, the authors describe the systematic process their program uses to conduct and document an annual program review and argue that the...

The curriculum development process for an international emergency medicine rotation.

Teaching and Learning in Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: The resulting article describes the curriculum development process and provides a curriculum template for medical specialties to utilize when sending residents abroad. PMID: 22250939 [PubMed - in process] (Source: Teaching and Learning in Medicine)

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AGA Gastroenterology Training Exam (GTE): A Progress Report

Gastroenterology — Mon, 19 Dec 2011 05:00:00 +0100

Subspecialty fellowship program directors (PDs) are keenly interested in monitoring and enhancing their trainees' academic progress throughout their fellowship experience. In addition to assessing trainee clinical acumen and knowledge base, PDs are required to demonstrate growth in clinical performance to validate advancement to subsequent training years, for which training programs have been confronted with increasing requirements by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME has established core competency domains under which trainee progress can be objectively evaluated (medical knowledge, patient care, practice-based learning and improvement, systems-based practice, interpersonal and communication skills, and professionalism). These assessments potentia...

Orthopaedic Resident and Program Director Opinions of Resident Duty Hours: A National Survey.

The Journal of Bone and Joint Surgery. American volume — Wed, 07 Dec 2011 05:00:00 +0100

CONCLUSIONS: This national survey indicated significant differences between the opinions of orthopaedic residents and program (residency and fellowship) directors regarding the 2003 ACGME resident duty-hour regulations and the effects of these regulations on resident education and patient care. However, both residents and program directors agreed that the further reductions in duty hours in the 2011 rules may be detrimental to resident education and patient care. PMID: 22159864 [PubMed - as supplied by publisher] (Source: The Journal of Bone and Joint Surgery. American volume)

Increased rate of complications on a neurological surgery service after implementation of the Accreditation Council for Graduate Medical Education work-hour restriction.

Journal of Neurosurgery — Fri, 02 Dec 2011 05:00:00 +0100

Conclusions The morbidity rate on a neurological surgery service is increased after implementation of the work-hour restriction. Mortality rates remain unchanged. PMID: 22136642 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Effects of a Night-Team System on Resident Sleep and Work Hours

PEDIATRICS — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: Implementation of a night-team system was unexpectedly associated with decreased sleep hours. As residency programs create work schedules that are compliant with the 2011 Accreditation Council for Graduate Medical Education duty-hour standards, resident sleep should be monitored carefully. (Source: PEDIATRICS)

Neurology residency program at Cedars-Sinai wins accreditation

EurekAlert! - Medicine and Health — Mon, 28 Nov 2011 05:00:00 +0100

(Cedars-Sinai Medical Center) The Accreditation Council for Graduate Medical Education has approved a neurology residency training program at Cedars-Sinai Medical Center. Recruitment of the first group of three residents is under way through the 2012 "match," a process in which an independent organization pairs applicants with programs to meet the preferences of each. (Source: EurekAlert! - Medicine and Health)

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A novel approach to implementation of quality and safety programmes in anaesthesiology

Best Practice and Research. Clinical Anaesthesiology — Sat, 19 Nov 2011 00:52:00 +0100

Far too many patients suffer preventable harm from medical errors that add to needless suffering and cost of care. Underdeveloped residency training programmes in patient safety are a major contributor to preventable harm. Consequently, the Institute of Medicine has called for health professionals to reform their educational programmes to advance health-care safety and quality. Additionally, the Accreditation Council for Graduate Medical Education (ACGME) now requires education in ‘systems-based practice’ and ‘practice-based learning and improvement’ as core competencies of residency training programmes. The specific aim of this article is to describe the implementation of a novel programme designed to enhance residency education, meet ACGME core competencies and improve quality an...

Physician Assistant and Nurse Practitioner Utilization in Academic Medical Centers

American Journal of Medical Quality — Fri, 04 Nov 2011 04:00:00 +0100

The purpose of this study was to collect information on the utilization of physician assistants (PAs) and nurse practitioners (NPs) in academic health centers. Data were gathered from a national sample of University HealthSystem Consortium member academic medical centers (AMCs). PAs and NPs have been integrated into most services of respondent AMCs, where they are positively rated for the value they bring to these organizations. The primary reason cited by most AMCs for employing PAs and NPs was Accreditation Council for Graduate Medical Education resident duty hour restrictions (26.9%). Secondary reasons for employing PAs and NPs include increasing patient throughput (88%), increasing patient access (77%), improving patient safety/quality (77%), reducing length of stay (73%), and improvin...

Growth of a Simulation Lab: Engaging the Learner Is Key to Success

Disease a Month — Tue, 01 Nov 2011 04:00:00 +0100

High-fidelity simulation (HFS) is an important adjunct to clinical training for teaching health care workers. Currently, the American College of Surgeons has created a multilevel certification for surgical simulation centers. The American Society of Anesthesiologists Workgroup on Simulation Education has begun to characterize simulation centers for the purposes of “approval” as a site to provide continuing medical education credits. The Accreditation Council for Graduate Medical Education Residency Review Committee for Emergency Medicine has determined that simulation may serve as an adjunct for the documentation of competencies. The Society for Academic Emergency Medicine's Simulation Academy has recently made recommendations for accreditation and programmatic benchmarks for emergency...

Physiological Stress Responses of Emergency Medicine Residents During an Immersive Medical Simulation Scenario

Disease a Month — Tue, 01 Nov 2011 04:00:00 +0100

High-fidelity simulation is now considered a standard educational tool in many residency training programs. The Accreditation Council for Graduate Medical Education Residency Review Committee for Emergency Medicine now allows procedural skills completed in a simulated environment to count toward their overall procedural exposure during residency training. The rationale is that these simulated experiences provide a level of training realistic enough to allow the patient to perform better in an actual patient experience. Research has also shown that proficiency demonstrated in simulated settings can translate accurately into patient care and improve patient safety. (Source: Disease a Month)

Pocket card and dedicated feedback session to improve feedback to ward residents: A randomized trial

Journal of Hospital Medicine — Fri, 28 Oct 2011 04:00:00 +0100

CONCLUSIONS:A pocket feedback card and dedicated feedback session improved the quantity and quality of feedback delivered to IM residents by their attendings on the inpatient wards. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine)

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Inpatient staffing within pediatric residency programs: Work hour restrictions and the evolving role of the pediatric hospitalist

Journal of Hospital Medicine — Fri, 28 Oct 2011 04:00:00 +0100

CONCLUSIONS:Significant variation exists in how pediatric teaching services provide overnight coverage. While hospitalists are prevalent in pediatric training programs (84% overall, 67% day only), their role in direct patient care during the overnight hours has been limited thus far. New work hour restrictions will promote the need for more hospitalists. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)

Survey of Robotic Surgery Training in Obstetrics and Gynecology Residency

The Journal of Minimally Invasive Gynecology — Thu, 27 Oct 2011 03:35:28 +0100

Abstract: To examine the status of resident training in robotic surgery in obstetrics and gynecology programs in the United States, an online survey was emailed to residency program directors of 247 accredited programs identified through the Accreditation Council for Graduate Medical Education website. Eighty-three of 247 program directors responded, representing a 34% response rate. Robotic surgical systems for gynecologic procedures were used at 65 (78%) institutions. Robotic surgery training was part of residency curriculum at 48 (58%) residency programs. Half of respondents were undecided on training effectiveness. Most program directors believed the role of robotic surgery would increase and play a more integral role in gynecologic surgery. Robotic surgery was widely reported in resid...

National trends in minimally invasive and open operative experience of graduating general surgery residents: implications for surgical skills curricula development?

American Journal of Surgery — Mon, 24 Oct 2011 04:00:00 +0100

Conclusions: The results of this study demonstrate that general surgery residents in the United States are performing a greater number of minimally invasive and fewer open procedures for common surgical conditions. (Source: American Journal of Surgery)

The Predictive Value of General Surgery Application Data for Future Resident Performance

Journal of Surgical Education — Sun, 16 Oct 2011 01:32:16 +0100

Conclusions: Within our system, INTERVIEW, USMLE STEP1, and SKILL predict successful completion of a general surgery residency. In contrast to prior reports, female sex, ethnicity, medical school grades, or Alpha Omega Alpha Honor Society (AOA) status were not significant. The variable SKILL is novel and highlights the importance of nonacademic background data. Our data indicate STEP1 is an independent predictor of resident success in general surgery and should maintain an important role in general surgery applicant screening. The ideal screening threshold is likely > 215. (Source: Journal of Surgical Education)

Resident fatigue in 2010: Where is the beef?

American Journal of Surgery — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: These data show no decrease in junior or senior resident task performance over a 24-hour call period, and do not support the 2011 Accreditation Council for Graduate Medical Education maximum duty hour length of 16 hours. (Source: American Journal of Surgery)

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Educating Radiology Residents in the New Era: Implementation and Evaluation of Online End-of-Rotation Examinations

Academic Radiology — Thu, 06 Oct 2011 19:40:27 +0100

Conclusions: End-of-rotation examinations are relatively straightforward to implement and facilitate recurring, structured, and meaningful resident evaluation and feedback. Future studies will explore whether examinations such as these result in improved clinical competency. (Source: Academic Radiology)

Entry of US Medical School Graduates Into Family Medicine Residencies: 2010--2011 and 3-year Summary.

Famly Medicine — Sat, 01 Oct 2011 04:00:00 +0100

This article reports the 3-year average percentage from each medical school of graduates entering family medicine residencies and the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs in 2010. PMID: 22002773 [PubMed - in process] (Source: Famly Medicine)

An automated procedure logging system improves resident documentation compliance.

Accident and Emergency Nursing — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: There was a significant increase in the daily mean number of procedures logged after the implementation of APL. Recorded data were more complete and more accurate during this time frame. This innovative system improved resident logging of required procedures and helped our assessment of Accreditation Council for Graduate Medical Education (ACGME) Patient Care and Practice-Based Learning Competencies for individual residents. PMID: 21999559 [PubMed - in process] (Source: Accident and Emergency Nursing)

Systems-based Practice: Summary of the 2010 Council of Emergency Medicine Residency Directors Academic Assembly Consensus Workgroup-Teaching and Evaluating the Difficult-to-teach Competencies.

Accident and Emergency Nursing — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: This consensus process resulted in the development of a taxonomy of EM-specific domains for teaching and observable tasks for evaluating SBP. The concept of SBP is interlinked with the other general competencies and difficult to separate. Rather than develop specific SBP evaluation tools to measure the competency directly, SBP competency evaluation should be considered one element of a coordinated effort to teach and evaluate the six ACGME general competencies. PMID: 21999553 [PubMed - in process] (Source: Accident and Emergency Nursing)

Learning styles in otolaryngology fellowships

The Laryngoscope — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions:It was previously reported that 74.4% of otolaryngology residents prefer either converging or accommodating styles. We believe that the fellowship training environment calls for fellows to use more than one learning style to become proficient physicians, hence the trend toward potentially developing a balanced style when at this level. (Source: The Laryngoscope)

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Veterans Affairs general surgery service: the last bastion of integrated specialty care

American Journal of Surgery — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions: The VA hospital provides an authentic, broad-based, general surgery training experience that integrates complex surgical patients simultaneously. Opportunities for this level of comprehensive care are decreasing or absent in many general surgery training programs. The increasing level of responsibility and simultaneous care of multiple specialty patients through the VA hospital systems offers a crucial experience for those pursuing a career in general surgery. (Source: American Journal of Surgery)

Learning laparoscopic colectomy during colorectal residency: what does it take and how are we doing?

Surgical Endoscopy — Thu, 22 Sep 2011 05:47:52 +0100

Conclusions Performing more than 10 LR colectomies and more than 30 LL colectomies provided the vast majority of colorectal residents with the ability to be very comfortable with these procedures as they entered practice. A concerning number of trainees (46% of LL and 24% of LR trainees) did not reach this benchmark. The new general minimal American Board of Colon and Rectal Surgery (ABCRS) requirement of 50 laparoscopic resections seems appropriate but may require definition regarding the side of the procedure. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1906-8Authors Sharon Stein, Department of Surgery, Case Medical Center, University Hospitals, Case Western Reserve University, Cleveland, USAJonah Stulberg, Department of Epidemiology and Biostatis...

Determining Resident Clinical Performance: Getting Beyond the Noise

Anesthesiology — Tue, 20 Sep 2011 20:51:48 +0100

Conclusions: This study demonstrates a reliable and valid clinical performance assessment system for residents at all levels of training. (Source: Anesthesiology)

News From Annals Of Internal Medicine, Sept. 20, 2011

Health News from Medical News Today — Tue, 20 Sep 2011 09:00:00 +0100

1. ACP on Health Care Cost Crisis: Cost-Conscious Care Training Crucial for Residents Residents must prove competent in six general areas of medical practice to complete their training based on criteria established by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS). Steven E... (Source: Health News from Medical News Today)

Providing high-value, cost-conscious care: a critical seventh general competency for physicians.

Annals of Internal Medicine — Tue, 20 Sep 2011 04:00:00 +0100

Authors: Weinberger SE Abstract There is general agreement that the U.S. economy cannot sustain the staggering economic burden imposed by the current and projected costs of health care. Whereas governmental approaches are focused primarily on decreasing spending for medical care, it is the responsibility of the medical profession to become cost-conscious and decrease unnecessary care that does not benefit patients but represents a substantial percentage of health care costs. At present, the 6 general competencies of the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) that drive residency training place relatively little emphasis on residents' understanding of the need for stewardship of resources or for practicing in...

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Senior Pathology Resident In-Service Examination Scores Correlate With Outcomes of the American Board of Pathology Certifying Examinations.

American Journal of Clinical Pathology — Fri, 16 Sep 2011 19:52:38 +0100

Authors: Rinder HM, Grimes MM, Wagner J, Bennett BD, Abstract The Resident In-Service Examination (RISE) addresses 1 area of the Accreditation Council for Graduate Medical Education Outcome Project; RISE results demonstrate progressive attainment of pathology knowledge during training. We compared RISE scores with primary pathology board certification success for residents graduating in 2008 and 2009. Overall RISE and nearly all sectional scores in anatomic and clinical pathology were significantly higher for residents passing all certifying examinations at the first attempt vs residents who failed any examination. The risk of failing increased with each lower quartile of overall RISE score, such that 34% (2009) and 54% (2008) of residents in the lowest quartile failed at least 1 ...

US Teaching Hospitals May Suffer With New Limits On Physician Training Hours

Health News from Medical News Today — Mon, 12 Sep 2011 07:00:00 +0100

The new limits on hours that physicians-in-training can work will prove costly for U.S teaching hospitals, which will need to spend up to $1.3 billion a year, and possibly more, to effect the changes, a new UCLA study suggests. On July 1, the Accreditation Council for Graduate Medical Education (ACGME), the national body charged with overseeing the training of junior doctors as they complete their specialty training, put into effect strict duty-hour limits on interns and medical residents and instituted related changes to the training environment... (Source: Health News from Medical News Today)

New limits on physician training hours could prove costly for U.S. teaching hospitals

UCLA Newsroom: Health Sciences — Thu, 08 Sep 2011 16:00:00 +0100

Family Planning Training in US Family Medicine Residencies.

Famly Medicine — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSIONS: Family medicine residency programs are not offering training in the broadest range of family planning methods, and abortion training is uncommon. To address these gaps, family medicine educators need to work to increase training in all methods of contraception, including newer and procedural methods, and consider strategies for offering abortion training to interested residents. PMID: 21918937 [PubMed - in process] (Source: Famly Medicine)

Hidden in plain sight: residency coordinators' social support of residents in family medicine residency programs.

Famly Medicine — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSIONS: RCs in family medicine residencies report playing an important yet often unacknowledged role in the social support of family medicine residents and often serving as a conduit for information between residents and the administration. This role raises issues concerning the recruitment, supervision, training, and job expectations of RCs. PMID: 21918933 [PubMed - in process] (Source: Famly Medicine)

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Pilot trial of IOM duty hour recommendations in neurology residency programs: Unintended consequences

Neurology — Sun, 28 Aug 2011 23:00:00 +0100

Conclusions: The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation. (Source: Neurology)

Invited comment on: The surgical residency and ACGME reform: steep learning or sleep learning?

American Journal of Surgery — Sat, 27 Aug 2011 21:51:30 +0100

First, a disclaimer. I was on both the 2003 and 2010 Accreditation Council for Graduate Medical Education (ACGME) Duty Hours Taskforces. I am the current Chair of the Board of Directors of the ACGME and Chair of the Executive Committee of the American College of Surgeons (ACS) Board of Governors. Nothing contained within should be construed as official policy or the position of either organization I have the honor of serving. I have no financial conflicts to report. (Source: American Journal of Surgery)

Changes in Training and Education

The Journal of Urology — Wed, 17 Aug 2011 04:00:00 +0100

Historically urology training programs, like other surgical disciplines, followed the Halstedian apprenticeship model characterized by a progressive increase in responsibility during the duration of training. While this training model certainly has its merits and still clearly exists, educational programs must now be curriculum based and each must document that residents have become proficient in certain core competencies by the end of their training. As a result of the Accreditation Council for Graduate Medical Education Milestones Project, programs will soon be asked to judge whether residents meet certain competency based milestones during the course of their training, adding an additional layer of resident evaluation. There has been some discussion about a 2-tiered training system in w...

Pretraining and Posttraining Assessment of Residents' Performance in the Fourth Accreditation Council for Graduate Medical Education Competency: Patient Communication Skills [Original Article]

Archives of Surgery — Sun, 14 Aug 2011 23:00:00 +0100

Conclusions Patient communication skills need to be taught as part of residency training. With limited training, case-specific skills (herein, involving patients with cancer) are likely to improve more than general communication skills. (Source: Archives of Surgery)

Creating a Geriatric Medicine Fellowship Program in 10 “Easy” Steps

Journal of the American Geriatrics Society — Sun, 07 Aug 2011 23:00:00 +0100

The aging of the U.S. population poses one of the greatest future challenges for family medicine and internal medicine residency training. One important barrier to providing quality education and training in geriatric medicine to residents is a serious and growing shortage of practicing geriatricians and geriatrics faculty. The Accreditation Council for Graduate Medical Education currently accredits 45 family medicine–based and 107 internal medicine–based geriatric medicine fellowships in the United States. There are 13 American Osteopathic Association–certified geriatric medicine fellowship programs. In this article, the authors examine the rationale for the development of additional geriatric medicine fellowship programs and offer some practical suggestions and pointers for those i...

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The Phantom Menace of Sleep Deprived Doctors

NYT Health — Fri, 05 Aug 2011 15:14:19 +0100

Young doctors are no longer working long, stupor-inducing hours. So why aren’t hospitals any safer? (Source: NYT Health)

Correlation of Inservice Examination Scores with ACGME Core Competencies in an Emergency Medicine Residency Program

The Journal of Emergency Medicine — Sun, 31 Jul 2011 23:00:00 +0100

In recent years the Accreditation Council for Graduate Medical Education Core Competencies have been introduced into Emergency Medicine (EM) training programs. Attempting to extend beyond standardized test-taking and medical knowledge alone prompted the designation of six areas: patient care (PC), medical knowledge (MK), interpersonal skills and communication (ISC), professionalism (P), system-based practice (SBP), and problem-based learning (PBL). In addition, residents take written in-service examinations each year. We sought to examine the relationship between in-service examination (IE) scores and core competencies (CC). (Source: The Journal of Emergency Medicine)

Why we need open simulation to train surgeons in an era of work-hour restrictions.

Vascular — Thu, 21 Jul 2011 23:00:00 +0100

This article highlights the growing need for open vascular simulation as exposure to complex open vascular operations diminishes. The culture of, 'see one, do one, teach one' is fast becoming replaced by 'do many on a simulator, attain competency then perform under supervision in the operating room'. This will only be successfully achieved by the widespread incorporation of open vascular simulation into current vascular training programs if work hours remain limited and endovascular modalities continue to replace traditional open operations. PMID: 21784878 [PubMed - as supplied by publisher] (Source: Vascular)

Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment

Journal of General Internal Medicine — Thu, 21 Jul 2011 18:15:27 +0100

CONCLUSION Implementation decisions greatly affect the cost. Unless PAEs decline substantially, teaching hospitals will lose money. If PAEs decline modestly, the requirements might be cost-saving or cost-effective to society. Content Type Journal ArticlePages 1-9DOI 10.1007/s11606-011-1775-9Authors Teryl K. Nuckols, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, 911 Broxton Avenue, Los Angeles, CA 90095, USAJosé J. Escarce, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, 911 Broxton Avenue, Los Angeles, CA 90095, USA Journal Journal of General Internal MedicineOnline ISSN 1525-1497Print ISSN...

Interventional cardiology fellowship training in canada

Catheterization and Cardiovascular Interventions — Thu, 14 Jul 2011 23:00:00 +0100

Conclusion:Canadian IC training meets ACGME/ACC recommendations for procedural volume and academic activity. However, participation in outpatient clinics and compliance with administrative requirement of faculty and program assessment by trainee was suboptimal. Formal accreditation is highly desirable to standardize program content and administration for optimal IC training. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Assessing the Surgical Skills of Urology Residents After Preurology General Surgery Training: The Surgical Skills Learning Needs of New Urology Residents

Journal of Surgical Education — Sun, 03 Jul 2011 23:00:00 +0100

Conclusions: A discrepancy was determined between urology residents' perceptions of the importance of surgical skills and their proficiency with those skills. The duration of general surgery training might have an impact on self-assessed skills proficiency. Concordance was demonstrated between resident and faculty perceptions of residents' surgical skills and of general surgery rotations. (Source: Journal of Surgical Education)

Development of a Test to Evaluate Pediatric Residents - Knowledge of Ethics

Academic Pediatrics — Thu, 30 Jun 2011 23:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) requires residents to demonstrate professionalism and “an adherence to ethical principles.” Improving outcomes of resident education in this area is hindered by the absence of a standardized tool to measure ethics knowledge. (Source: Academic Pediatrics)

The Rapid Rise of Duke-NUS

DukeHealth.org: Duke Health Features — Tue, 21 Jun 2011 18:20:06 +0100

This summer, the first class of medical students at Duke-NUS Graduate Medical School in Singapore officially becomes its first graduates -- receiving the first joint degrees ever to be granted by its parent schools, Duke University and the National university of Singapore (NUS). It’s a major milestone in the short but action-packed history of Duke-NUS, which has grown in a mere six years from a promise on paper into a dynamic institution that is well on its way to becoming one of the leading medical schools in Asia. Exceeding All Expectations By any account, the school’s achievements are remarkable. Since its 2005 launch, it has gone from 16 faculty and staff to more than 850, including 83 regular-rank faculty -- many of whom are internationally recognized biomedical researchers. The s...

Educating Clerkship Students in the Era of Resident Duty Hour Restrictions

The American Journal of Medicine — Sat, 18 Jun 2011 19:07:13 +0100

In 2003, the Accreditation Council for Graduate Medical Education defined for the first time an upper limit on the number of hours that residents can work. This initial reduction in work hours was made with the goal of improving patient safety, resident education, and resident well-being. Now, 8 years later, further duty hour restrictions are slated to take effect July 1, 2011. These new reductions are largely a response to growing public concern about the effects of sleep deprivation on residents. Educators and residents alike have mixed opinions about the effects of prior and future duty hour restrictions on resident education. The potential effects of resident duty hour restrictions on medical student education have received less attention. (Source: The American Journal of Medicine)

HRS Policy Statement: Clinical Cardiac Electrophysiology Fellowship Curriculum: Update 2011

Heart Rhythm — Wed, 15 Jun 2011 23:00:00 +0100

A fellowship curriculum is important in the training of a clinical cardiac electrophysiologist. A clinical cardiac electrophysiology curriculum was first published in 2001 and was the basis for education in many fellowship programs. Over the last 10 years cardiac electrophysiology has continued to grow, evolve, and mature so that an update is currently needed. This update is focused on what a practicing electrophysiologist will need in the care of patient. It is not meant to be a mandatory education requirement or to supplant American Board of Internal Medicine (ABIM) or Accreditation Council for Graduate Medical Education (ACGME) requirements. Each section was written by one of the authors, but all authors have reviewed the entire document. (Source: Heart Rhythm)

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The Continuum of Pediatric Medical Education and Life-Long Learning

The Journal of Pediatrics — Tue, 14 Jun 2011 15:13:00 +0100

The Accreditation Council for Graduate Medical Education has outlined competencies for residents to attain, and the Milestones Project has helped delineate more specific goals for pediatrician development. Our medical schools and the American Board of Medical Specialties have also modified competencies applicable to corresponding stages of professional development. However, our curricula are bursting at the seams, and demands for attention to non-traditional competencies are increasing. How can educators ensure adequate skills, attitudes, and knowledge and prepare future physicians for practice in a system that is in transition politically, socially, and technologically? In view of all the changes taking place in medical education and clinical care, it is time to revisit the basic componen...

How post‐call resident doctors perform, feel and are perceived in out‐patient clinics

Medical Education — Wed, 08 Jun 2011 19:15:16 +0100

Conclusions The changes in activating and partnering talk that occur in post‐call residents are consistent with findings concerning sleep deprivation and speech. Female and male residents tended to attribute their post‐call performance to different factors. Setting limits on working hours might help to avoid potential negative impacts on post‐call resident feelings, and the impact of working hours on resident performance warrants further exploration. (Source: Medical Education)

Who teaches surgical airway management and how do they teach it? A survey of United States anesthesiology training programs

Journal of Clinical Anesthesia — Tue, 31 May 2011 23:00:00 +0100

Conclusions: The majority of anesthesiology training programs accredited by the Accreditation Council for Graduate Medical Education provide some form of skill-based instruction in surgical airway management for their residents. (Source: Journal of Clinical Anesthesia)

The Effect of Simulation Training on PALS Skills Among Family Medicine Residents.

Famly Medicine — Tue, 31 May 2011 23:00:00 +0100

Authors: Gerard JM, Thomas SM, Germino KW, Street MH, Burch W, Scalzo AJ The Accreditation Council for Graduate Medical Education requires that family medicine residents receive structured skills training on pediatric advanced life support (PALS) and should learn procedures for medical emergencies in patients of all ages. Traditional methods of training family medicine residents in PALS is challenging given their limited clinical exposure to critically ill patients. The primary objective of this study was to assess the effect of a 2-hour PALS training session utilizing high-fidelity mannequins on residents' psychomotor skills performances. PMID: 21656393 [PubMed - in process] (Source: Famly Medicine)

Analysis of AOA/ACGME Accredited Family Medicine Residency Programs.

Famly Medicine — Tue, 31 May 2011 23:00:00 +0100

Authors: Terry R, Hill F American Osteopathic Association (AOA) accreditation of Accreditation Council for Graduate Medical Education (ACGME) family medicine residency programs began in the early 1990s to increase the number of Osteopathic Graduate Medical Education (OGME) training positions in family medicine. Despite the rapid expansion of family medicine residencies accredited by both the AOA and the ACGME, little has been published about issues facing these programs. PMID: 21656392 [PubMed - in process] (Source: Famly Medicine)

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Resources for Physician Training in Drug Abuse and Addiction (Gaya Dowling Ph.D.)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 02 May 2011 23:00:00 +0100

In 2008, an estimated 71 million Americans used a tobacco product, 58 million binged on alcohol, and 20 million used an illicit drug in the past month?behaviors that contribute to multiple physical health, emotional, and interpersonal problems. Yet only a fraction of individuals who need specialty treatment receive it each year. Primary care physicians are in a unique position to alter this course by making addressing substance abuse a part of routine medical care. However, to do so, it must also become a routine part of medical education. This workshop presents new resources with scientifically accurate information that can easily be integrated into current curricula to educate physicians in training about substance abuse and addiction and the role they can play in addressing this devasta...

Sleep medicine training across the spectrum.

Chest — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Strohl KP There is now a new pathway and examination for sleep medicine, sponsored by the American Board of Internal Medicine, and a number of accredited sleep medicine fellowship programs through the Accreditation Council for Graduate Medical Education. This review takes an historical approach to discuss the process of education for sleep physiology and disorders not only in the postgraduate period but also at all levels of instruction. In reality, there is a continuum of knowledge that needs to be reinforced up and down the educational system, of which Sleep Medicine subspecialty training is just one part. Although progress has been made at all educational levels up to this point, the future of training and education will depend on a sustained effort at several levels from u...

2011 ACGME Duty Hour Week Proposal-A National Survey of Family Medicine Residents.

Famly Medicine — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Lo V, Ward C In July 2010, the Accreditation Council for Graduate Medical Education (ACGME) published its proposed duty-hour regulations. We conducted a national online survey to assess current family medicine residents' perceptions of the proposed changes. PMID: 21557100 [PubMed - in process] (Source: Famly Medicine)

Workforce Webcast Series Sheds Light on ACGME Regulations

SCCM RSS News — Mon, 25 Apr 2011 14:10:40 +0100

Meeting intensive care unit (ICU) workforce needs in light of current Accreditation Council for Graduate Medical Education (ACGME) regulations, as well as healthcare reform and changes in reimbursement, is a priority for hospital administrators and clinicians... (Source: SCCM RSS News)

Many residents under-report their work hours

BMJ Online First — Sun, 17 Apr 2011 23:00:00 +0100

I do not believe the results of any of the published studies performed in the US after 2003.1 The recommendations of the Accreditation Council for Graduate Medical Education (ACGME) have put faculty... (Source: BMJ Online First)

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Use of portfolios in otolaryngology graduate medical education

The Laryngoscope — Sun, 10 Apr 2011 23:00:00 +0100

Conclusions:Although portfolios are encouraged by the ACGME, and will ultimately become mandatory, they are not yet fully integrated in otolaryngology training programs. Only a minority of residents in this study thought portfolios enhanced education. (Source: The Laryngoscope)

Resident Selection

Ophthalmology — Thu, 31 Mar 2011 23:00:00 +0100

I would like to thank Nallasamy et al for highlighting important (and scary) issues in the ophthalmology resident selection. At the national level we are moving from the initial phases of simply teaching and assessing the Accreditation Council for Graduate Medical Education (ACGME) competencies in just residency programs to a more comprehensive strategy for incorporating and aligning the assessment methods for the competencies across the spectrum of our profession that will hopefully include practicing physicians (i.e., maintenance of certification) and our lifelong learning (e.g., continuing medical education) process. (Source: Ophthalmology)

Educational Perspectives: The 360-degree Assessment: A New Paradigm in Trainee Evaluation

NeoReviews recent issues — Thu, 31 Mar 2011 23:00:00 +0100

The 360-degree assessment is a new paradigm in medical evaluation in which a trainee is evaluated by multiple people in his or her sphere of influence. Evaluators measure identical parameters using the same rating scale, with an additional subset of uniquely designed items to capture areas particular to certain groups. This tool can help to identify differences between the trainee's self-assessment and ratings by other evaluators. Recent studies have shown that the 360-degree assessment is a reliable and valid instrument to improve physician performance. In addition, 360-degree feedback has been shown to provide training programs with a reproducible, quantifiable tool to assess the Accreditation Council for Graduate Medical Education (AGCME) competencies of their trainees. This review desc...

Discussion

Journal of the American College of Surgeons — Thu, 31 Mar 2011 23:00:00 +0100

I am pleased to have an opportunity to discuss this paper and tell you that in December of 2005, Jay Grosfeld, a new member of the organization, I'm proud to say, and I were asked by the Accreditation Council for Graduate Medical Education (ACGME) and the surgery Residency Review Committee to make an extended special site visit to Louisiana to review firsthand the manner in which the New Orleans surgical programs, Tulane, LSU, and Oschner, were dealing with the devastating effects of Hurricane Katrina. (Source: Journal of the American College of Surgeons)

Abdominal and thoracic focused assessment with sonography for trauma, triage, and monitoring in small animals

Journal of Veterinary Emergency and Critical Care — Thu, 31 Mar 2011 23:00:00 +0100

AbstractObjectives – To review the nonradiologist use of ultrasound (US) in the setting of emergency and critical care, the development, clinical applications, and standardization of veterinary abdominal and thoracic focused assessment with sonography for trauma (FAST) techniques.Etiology – Since the 1990s, the 4‐point FAST US technique has been used for injury surveillance in people with blunt and penetrating trauma. FAST screens for free fluid in the abdominal, pleural, and pericardial cavities with high sensitivity and specificity. More recently, an extended FAST scan was developed for the rapid detection of pneumothorax. These techniques and newly created scans have been applied to other critically ill, nontraumatized, subsets of human patients. As a resul...

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Resident Selection

Ophthalmology — Thu, 31 Mar 2011 23:00:00 +0100

Systems-based practice in graduate medical education: systems thinking as the missing foundational construct.

Teaching and Learning in Medicine — Thu, 31 Mar 2011 23:00:00 +0100

Conclusion: Residency programs should incorporate systems thinking models into their curricula. Trainees should be taught to understand systems at an abstract level, in order to analyze their own healthcare systems, and participate in quality and patient safety activities. We suggest that a developmental trajectory for systems thinking be developed, similar to the model described by Dreyfus and Dreyfus. PMID: 21516607 [PubMed - in process] (Source: Teaching and Learning in Medicine)

Systems-based practice assessed with a performance-based examination simulated and scored by standardized participants in the health care system: feasibility and psychometric properties.

Teaching and Learning in Medicine — Thu, 31 Mar 2011 23:00:00 +0100

Conclusions: A performance-based examination can provide a feasible and reliable assessment of systems-based practice. However, attempts to evaluate convergent validity and discriminant validity-by correlating systems-based practice performance assessments with mean global ratings of residents on the 6 competencies by faculty throughout training-were unsuccessful, due to a lack of independence between the rated dimensions. PMID: 21516602 [PubMed - in process] (Source: Teaching and Learning in Medicine)

Challenges with Duty Hour Reforms: A Survey of Residency Program Directors

The American Journal of Medicine — Tue, 29 Mar 2011 17:54:36 +0100

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) enacted duty hour limitations in response to public concern over excessive resident work hours and patient safety. Subsequently, residency programs made significant changes to their structure and schedules. For a variety of reasons, including the stress such changes put on the educational mission of teaching hospitals, programs struggle with duty hour compliance. (Source: The American Journal of Medicine)

The Use of a Multidisciplinary Morbidity and Mortality Conference to Incorporate ACGME General Competencies

Journal of Surgical Education — Sun, 27 Mar 2011 23:00:00 +0100

Conclusions: Like the practice of medicine, the occurrence of adverse outcomes is frequently multidisciplinary. An MM&M conference is useful in its potential to meet ACGME General Competencies, engender a culture of patient safety, and rapidly achieve quality improvement and systems health care delivery initiatives in a large academic medical center. (Source: Journal of Surgical Education)

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Policies To Reduce Medical Residents' Fatigue May Compromise Quality Of Training

Health News from Medical News Today — Wed, 02 Mar 2011 10:00:00 +0100

Recent Accreditation Council for Graduate Medical Education (ACGME) limits aimed to enhance patient safety may compromise the quality of doctors' training, according to a study by Mayo Clinic researchers published in the March issue of Mayo Clinic Proceedings. Patient safety has long been a critical concern for hospitals, in particular for those training new doctors... (Source: Health News from Medical News Today)

An overtired medical resident

Medicineworld.org: New Article Alert — Wed, 02 Mar 2011 04:23:46 +0100

Recent Accreditation Council for Graduate Medical Education (ACGME) limits aimed to enhance patient safety may compromise the quality of doctors' training, as per a research studyby Mayo Clinic scientists reported in the recent issue of Mayo Clinic Proceedings (http://www.mayoclinicproceedings.com)........ (Source: Medicineworld.org: New Article Alert)

Policies to reduce medical residents' fatigue may compromise quality of training

EurekAlert! - Social and Behavioral Science — Tue, 01 Mar 2011 05:00:00 +0100

(Mayo Clinic) Recent Accreditation Council for Graduate Medical Education limits aimed to enhance patient safety may compromise the quality of doctors' training, according to a study by Mayo Clinic researchers published in the March issue of Mayo Clinic Proceedings. (Source: EurekAlert! - Social and Behavioral Science)

Duty Hour Recommendations and Implications for Meeting the ACGME Core Competencies: Views of Residency Directors

Mayo Clinic Proceedings — Tue, 01 Mar 2011 00:00:00 +0100

CONCLUSION: Residency program directors' reactions to ACGME duty hour recommendations demonstrate a marked degree of concern about educating a competent generation of future physicians in the face of increasing duty hour standards and regulation. (Source: Mayo Clinic Proceedings)

Availability and Potential Effect of Rural Rotations in Emergency Medicine Residency Programs

Academic Emergency Medicine — Tue, 01 Mar 2011 00:00:00 +0100

Conclusions: Elective rural rotations at predesignated sites increase resident exposure to rural areas compared to programs without predesignated sites, but neither approach was associated with rural practice after graduation. EM residency programs that required a rural rotation had increased resident selection of rural jobs, but only 5% of programs had this requirement. (Source: Academic Emergency Medicine)

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Availability and potential effect of rural rotations in emergency medicine residency programs.

Accident and Emergency Nursing — Tue, 01 Mar 2011 00:00:00 +0100

American diagnostic radiology residency and fellowship programmes.

Annals of the Academy of Medicine, Singapore — Tue, 01 Mar 2011 00:00:00 +0100

Authors: Rumack CM American Diagnostic Radiology Residency and Fellowship programmes are Graduate Medical Education programmes in the United States (US) equivalent to the Postgraduate Medical Education programmes in Singapore. Accreditation Council for Graduate Medical Education (ACGME) accredited diagnostic radiology residency programmes require 5 years total with Post Graduate Year (PGY) 1 year internship in a clinical specialty, e.g. Internal Medicine following medical school. PGY Years 2 to 5 are the core years which must include Radiology Physics, Radiation Biology and rotations in 9 required subspecialty rotations: Abdominal, Breast, Cardiothoracic, Musculoskeletal, Neuroradiology, Nuclear and Paediatric Radiology, Obstetric & Vascular Ultrasound and Vascular Interventional R...

BWH Prepares for New ACGME Standards

BWH News — Fri, 18 Feb 2011 00:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) recently approved new work hour standards for residents and fellows—including changes that will affect far more than their work schedules. (Source: BWH News)

Certification and maintenance of certification: updates from the American Board of Pathology

Human Pathology — Mon, 14 Feb 2011 00:00:00 +0100

This article updates the pathology community on these changes. (Source: Human Pathology)

Resident education in 2011: Three key challenges on the road ahead

Surgery — Mon, 07 Feb 2011 00:00:00 +0100

This article summarizes 3 key challenges that lie ahead for surgical educators. First, the changes in duty hours in the past 7 years are summarized, and the conversation about added restrictions planned for July 2011 is reviewed. Next, the current state of the assessment of competency among surgical trainees is reviewed, with an outline of the challenges that need to be overcome to achieve widespread, competency-based training in surgery. Finally, the article summarizes the problems caused by increased reliance on handoffs among trainees as they compensate for decreased time in the hospital, and suggests changes that need to be made to improve safety and efficiency, including how to use handoffs as part of our educational evaluation of residents. (Source: Surgery)

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Cataract Surgical Skill Assessment

Ophthalmology — Tue, 01 Feb 2011 00:00:00 +0100

In the United States, the Accreditation Council for Graduate Medical Education (ACGME) has mandated that all residency training programs (including ophthalmology) teach and assess 6 general competencies (i.e., medical knowledge, communication and interpersonal skills, patient care, professionalism, practice-based learning, and systems-based practice). To fulfill the ACGME mandate ophthalmic residency programs need valid assessment tools to show that surgical competence has been achieved. We believe such assessment tools should be designed to teach as well as assess. Additionally, our experience around the world is that globally applicable teaching and assessment tools for surgical skill are desired but do not exist at present. Our objective is to develop a standardized, internationally val...

Generating developmentally appropriate competency assessment at a family medicine residency.

Famly Medicine — Tue, 01 Feb 2011 00:00:00 +0100

Authors: Baglia J, Foster E, Dostal J, Keister D, Biery N, Larson D Ten years after the Accreditation Council for Graduate Medical Education's (ACGME) mandate that residency programs evaluate learners' competency, research is needed to guide efforts to meet this challenge. During an innovative residency redesign, the authors developed a process to effectively measure "competence." This particular family medicine residency admits six residents per class year and is sponsored by an academic community hospital. Our objective was to generate developmentally appropriate observable behaviors that assess competencies. PMID: 21344328 [PubMed - in process] (Source: Famly Medicine)

A Simple Primer for Understanding Core Competencies

Journal of Surgical Education — Fri, 07 Jan 2011 00:00:00 +0100

Competency training is the foundation for nearly all residency-development initiatives. Defining competency models, assessing skill levels, and then analyzing gaps provides the essential information for a variety of measures that will help that train better doctors for the future. The 6 Accreditation Council for Graduate Medical Education (ACGME)-defined core competencies are perceived by many as confusing, difficult to follow, and sometimes challenging to fit into our lives as surgeons or surgeon educators. New residents and medical students who are exposed to this system for the first time need an easy, simplified way to understand the core competencies. Assimilating the basis of the core competencies is the first critical step. (Source: Journal of Surgical Education)

Recent Trends in American Board of Psychiatry and Neurology Psychiatric Subspecialties [ORIGINAL ARTICLES]

Acad Psychiatry — Wed, 05 Jan 2011 00:00:00 +0100

Conclusion: The initial interest in training and certification in some of the ABPN subspecialties appears to have slowed, and the long-term viability of those subspecialties may well depend on the answers to a number of complicated social, economic, and political questions in the new health care era. (Source: Acad Psychiatry)

Defining Professionalism

Pediatric News — Sat, 01 Jan 2011 00:00:00 +0100

DR. POWELL is associate professor of pediatrics at St. Louis University and a pediatric hospitalist at SSM Cardinal Glennon Children's Medical Center. “Oh, Dr. Powell, you don't want to come to this,” she said. I turned to look at the resident behind me as I held the door to the auditorium open for her. We were walking into a noon conference, mostly aimed at the residents but occasionally visited by attendings. She recognized me as a new attending at that academic center. But she could not have known anything about my prior activities elsewhere with various committees on medical ethics, health law, and ACGME (Accreditation Council for Graduate Medical Education) requirements. The title of the noon conference, “Professionalism,” had sparked my interest. I'd looked forward to it all...

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The Countdown

Journal of Surgical Education — Sat, 01 Jan 2011 00:00:00 +0100

We are 6 months away from entering the new world. That world will be governed by the new Accreditation Council for Graduate Medical Education (ACGME) duty hours and supervision standards. I suggest our training programs will be judged by how we face this challenge. We have several choices: We can continue to complain, we can work around the rules, or we could begin to design a new system of educational experiences that embrace the rules. (Source: Journal of Surgical Education)

Commentary: Building the Evidence Base in Support of the American Board of Medical Specialties Maintenance of Certification Program

Academic Medicine — Thu, 30 Dec 2010 08:05:27 +0100

In this issue, Lipner and colleagues describe research supporting the value of the examinations used in the maintenance of certification (MOC) programs of the American Board of Internal Medicine and the American Board of Surgery. The authors of this commentary review the contribution of this research and previous investigations that underscore the value of this component of the American Board of Medical Specialties (ABMS) MOC program. In addition, they point out that the MOC examination is one element of a comprehensive approach to physician lifelong learning, assessment, and quality improvement. The ABMS MOC program requires diplomates of the ABMS member boards to engage in continuous professional development in the six domains of competence and performance previously defined by the ABMS ...

Ultrasound Is Safe . . . Right?: Resident and Maternal-Fetal Medicine Fellow Knowledge Regarding Obstetric Ultrasound Safety

Journal of Ultrasound in Medicine — Thu, 30 Dec 2010 00:00:00 +0100

Conclusions—Currently, obstetrics and gynecology resident knowledge of obstetric ultrasound safety is low. Maternal-fetal medicine fellow knowledge is stronger overall; however, few are using the output display standard routinely in their last year of fellowship training. This study provides evidence of the need for improved education on the subject of obstetric ultrasound safety. (Source: Journal of Ultrasound in Medicine)

Professional values, value conflicts, and assessments of the duty-hour restrictions after six years: a multi-institutional study of surgical faculty and residents

American Journal of Surgery — Wed, 29 Dec 2010 00:06:17 +0100

Conclusions: The divide between residents and faculty members over conflicts between the restrictions, core values, and patient care poses a significant issue and represents a challenge in educating the next generation of surgeons. (Source: American Journal of Surgery)

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Systematic review: association of shift length, protected sleep time, and night float with patient care, residents' health, and education.

Annals of Internal Medicine — Tue, 21 Dec 2010 00:00:00 +0100

Conclusion: For the limited outcomes measured, most studies supported reducing shift length but did not adequately address the optimal shift duration. Studies had numerous methodological limitations and unclear generalizability for most outcomes. Specific recommendations about shift length, protected sleep time, and night float should acknowledge the limitations of this evidence. Primary Funding Source: Accreditation Council for Graduate Medical Education. PMID: 21173417 [PubMed - in process] (Source: Annals of Internal Medicine)

Competency-Based Education and Training in Internal Medicine.

Annals of Internal Medicine — Tue, 07 Dec 2010 00:00:00 +0100

Authors: Weinberger SE, Pereira AG, Iobst WF, Mechaber AJ, Bronze MS, Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to compet...

The core program director must…

Journal of Clinical Anesthesia — Fri, 26 Nov 2010 01:44:14 +0100

In 2003 the Residency Review Committee (RRC) for Anesthesiology of the Accreditation Council for Graduate Medical Education (ACGME) determined that the department chair no longer had to be the designated Core Program Director (CPD). For many who had been acting for the Chair as the Core Program Director for many years without the title, this change meant that individuals could be officially recognized as the CPD and formally appointed and anointed by the RRC as the Core Program Director. In 2008, after several years of discussion, the Society of Academic Anesthesia Chairs (SAAC) formed the Association of Anesthesia Core Program Directors (AACPD) and the Association of Anesthesia Subspecialty Program Directors (AASPD) as individual entities. These two associations, along with the Associatio...

Characteristics of anesthesiology residency program directors

Journal of Clinical Anesthesia — Fri, 26 Nov 2010 01:44:14 +0100

Abstract: The roles and responsibilities of anesthesiology core program directors have evolved, in part because the Anesthesiology Residency Review Committee of the Accreditation Council for Graduate Medical Education no longer requires that the department chair also serve in this role. We reviewed several core anesthesiology program director academic and demographic characteristics including age, academic rank, gender, duration of service, board certification and re-certification status, and whether the program director also serves as department chair. Anesthesiology core residency program directors range in age from 33 to 74 years, with a median of 52 years. Thirty-seven (28%) program directors are women. The majority (67%) have senior academic rank (professor or associate professor). Th...

Lack of association between resident doctors' well‐being and medical knowledge

Medical Education — Wed, 17 Nov 2010 16:07:08 +0100

Conclusions Resident well‐being appears to have limited association with competence in medical knowledge as assessed following web‐based courses on specific topics or using standardised general medical examinations. (Source: Medical Education)

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Erratum to: Enhancing the Informal Curriculum of a Medical School: A Case Study in Organizational Culture Change

Journal of General Internal Medicine — Tue, 16 Nov 2010 07:00:52 +0100

Content Type Journal ArticleDOI 10.1007/s11606-010-1577-5Authors Ann H. Cottingham, Medical Education and Curricular Affairs, Indiana University School of Medicine, 714 N. Senate Ave., EF-200, Indianapolis, IN 46202-3297, USAAnthony L. Suchman, University of Rochester School of Medicine and Dentistry, Rochester, NY USADebra K. Litzelman, Medical Education and Curricular Affairs, Indiana University School of Medicine, 714 N. Senate Ave., EF-200, Indianapolis, IN 46202-3297, USARichard M. Frankel, Medical Education and Curricular Affairs, Indiana University School of Medicine, 714 N. Senate Ave., EF-200, Indianapolis, IN 46202-3297, USADavid L. Mossbarger, Regenstrief Institute, Inc, Indianapolis, IN USAPenelope R. Williamson, Relationship Centered Health Care, Rochester, NY USADeWitt C....

Foreword: Wounds and Wound Healing

Surgical Clinics of North America — Sat, 13 Nov 2010 11:26:46 +0100

The Accreditation Council for Graduate Medical Education (ACGME) released its final ruling on resident supervision and duty hour restrictions to be enacted 1 July 2011. The full report can be found on their website www.acgme.org. You have noticed that the topic of this issue of the Surgical Clinics of North America is about wound healing and you may be wondering what does the ACGME report have to do with wound healing. In a word—expectations. (Source: Surgical Clinics of North America)

Accreditation Council For Graduate Medical Education To Honor Dr. Christian De Virgilio

Health News from Medical News Today — Thu, 11 Nov 2010 12:00:00 +0100

The Accreditation Council for Graduate Medical Education will honor Christian de Virgilio, MD, a principal investigator at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), with its Parker J. Palmer Courage to Teach Award for Program Director Excellence at its 2011 awards ceremony in Nashville, Tenn. The Council said it presents the award to program directors who have found "innovative ways to teach residents to provide quality health care." The Courage to Teach Award is named in honor of Parker J... (Source: Health News from Medical News Today)

Is The Accreditation Council for Graduate Medical Education (ACGME) Resident/Fellow Survey A Valid Tool to Assess General Surgery Residency Programs Compliance With Work Hours Regulations?

Journal of Surgical Education — Tue, 09 Nov 2010 00:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) uses the resident/fellow survey to assess residency programs compliance with ACGME work hours regulations. Survey results can have significant consequences for residency programs including ACGME letters of warning, shortened program accreditation cycle, immediate full program and institutional site visits, or administrative withdrawal of a program's accreditation. Survey validity was assessed by direct query of general surgery residents who answer the survey each year.A multiple-choice survey was created to assess all US general surgery residents' interpretation and understanding of the ACGME survey. The survey was distributed to all surgery residency program directors in the US in 2009. Responses were compiled via an online ...

LA BioMed researcher to receive Courage to Teach Award

EurekAlert! - Medicine and Health — Mon, 08 Nov 2010 05:00:00 +0100

(Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed)) The Accreditation Council for Graduate Medical Education will honor Christian de Virgilio, M.D., a principal investigator at LA BioMed, with its Parker J. Palmer Courage to Teach Award. (Source: EurekAlert! - Medicine and Health)

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The Impact of Resident Duty Hour Reform on Hospital Readmission Rates Among Medicare Beneficiaries

Journal of General Internal Medicine — Sat, 06 Nov 2010 20:11:14 +0100

Conclusions Among Medicare beneficiaries, there were no changes in hospital readmission rates associated with resident duty hour reform. Content Type Journal ArticleDOI 10.1007/s11606-010-1539-yAuthors Matthew J. Press, Department of Public Health and Department of Medicine, Weill Cornell Medical College, 402 E. 67th St., New York, NY 10065, USAJeffrey H. Silber, University of Pennsylvania School of Medicine, Philadelphia, PA USAAmy K. Rosen, VA Boston Health Care System, Boston, MA USAPatrick S. Romano, Division of General Medicine and Center for Healthcare Policy and Research, UC Davis School of Medicine, Sacramento, CA USAKamal M. F. Itani, VA Boston Health Care System, Boston, MA USAJingsan Zhu, University of Pennsylvania School of Medicine, Philadelphia, PA USAYanl...

Educational intervention is effective in improving knowledge and confidence in surgical ethics—a prospective study

American Journal of Surgery — Mon, 01 Nov 2010 00:00:00 +0100

Conclusions: Focused instruction using the American College of Surgeons ethics curriculum can effectively improve both knowledge and confidence about surgical ethics. (Source: American Journal of Surgery)

Operative Volume in the New Era: A Comparison of Resident Operative Volume Before and After Implementation of 80-Hour Work Week Restrictions

Journal of Surgical Education — Mon, 01 Nov 2010 00:00:00 +0100

Conclusions: Resident operative volume at our institution's general surgery residency program largely has been unaffected by implementation of the 80-hour work week. Residencies in general surgery can be structured in a manner to allow for compliance with duty-hour regulations while maintaining the required operative volume outlined by the ACGME defined categories. (Source: Journal of Surgical Education)

The Electronic Residency Application Service Application Can Predict Accreditation Council for Graduate Medical Education Competency-Based Surgical Resident Performance

Journal of Surgical Education — Mon, 01 Nov 2010 00:00:00 +0100

Conclusions: The ERAS application is useful for predicting subsequent competency based performance in surgical residents. Receiving honors in the surgery clerkship, which has traditionally carried weight when evaluating a potential surgery resident, may not be as strong a predictor of future success. (Source: Journal of Surgical Education)

Pathology subspecialty fellowship application reform 2007 to 2010

Human Pathology — Thu, 28 Oct 2010 23:00:00 +0100

We report on the data that informed this decision and discuss the pros and cons that are so keenly felt by the stakeholders in this as-yet-incomplete reform process. (Source: Human Pathology)

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Differences in Public Belief and Reality in the Care of Operative Patients in a Teaching Hospital

Journal of Surgical Education — Tue, 26 Oct 2010 00:00:00 +0100

Conclusions: These findings illustrate a difference between the public's beliefs in regard to the hours a surgeon should be permitted to work and the reality of a surgeon's work life. Although the public may not be aware of the surgeon's schedule at a given time, they do trust the surgeon would cancel if too fatigued. The majority surveyed were not aware of resident involvement, but they trusted the attending surgeon's judgment with deciding how much of the actual procedure he/she could perform. With work-hour restrictions and resident involvement continuing to evolve, keeping the public informed should be a priority. (Source: Journal of Surgical Education)

Residency Training at a Crossroads: Duty-Hour Standards 2010.

Annals of Internal Medicine — Sun, 17 Oct 2010 23:00:00 +0100

Authors: Volpp KG, Friedman W, Romano PS, Rosen A, Silber JH In 2003, the Accreditation Council for Graduate Medical Education (ACMGE) implemented a single duty-hour standard nationwide. The evidence to date suggests that this neither improved nor worsened patient outcomes. In June 2010, the ACGME proposed a new set of duty-hour standards for implementation in July 2011. The main disadvantage of this approach is that there is no ability to determine whether different standards would have worked better to reduce resident fatigue while improving patient safety. Many unanswered questions remain about how to design duty-hour standards, but relatively little evidence exists. In addition, the same approach may not work in all specialties and all hospitals. A more flexible, dynamic policy tha...

New ACGME Standards for Resident Duty Become Effective July 2011

Medscape Today Headlines — Thu, 14 Oct 2010 20:59:29 +0100

The Accreditation Council for Graduate Medical Education has announced the final resident duty hours and supervision standards that will go into effect next year. Medscape Medical News (Source: Medscape Today Headlines)

Duty Hour Limits Could Hurt Small, Rural Family Medicine Programs, Say Directors

AAFP Resident and Student Focus — Wed, 06 Oct 2010 22:35:00 +0100

After the Accreditation Council for Graduate Medical Education, or ACGME, approved new resident duty hour limits that especially affect first-year residents, Academy leaders and family medicine program directors are concerned that upper-level residents and faculty will shoulder too much of the workload and associated added expenses will force the closing of small programs. Moreover, they say, patient safety -- the original aim of the new restrictions -- may not necessarily be enhanced. (Source: AAFP Resident and Student Focus)

Procedural dermatology training during dermatology residency: A survey of third-year dermatology residents

Journal of the American Academy of Dermatology — Mon, 04 Oct 2010 00:00:00 +0100

Conclusion: This survey confirms dermatology residents received broad training in procedural dermatology in 2009, in keeping with ACGME/Residency Review Committee program guidelines. The results provide feedback to dermatology residency programs and are an invaluable tool for assessing, modifying, and strengthening the current procedural dermatology curriculum. (Source: Journal of the American Academy of Dermatology)

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Ethics Curriculum for Emergency Medicine Graduate Medical Education

The Journal of Emergency Medicine — Sun, 03 Oct 2010 23:00:00 +0100

Conclusion: The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. (Source: The Journal of Emergency Medicine)

ACGME Board Approves Final Duty Hour And Supervision Standards For Resident Education

Health News from Medical News Today — Fri, 01 Oct 2010 08:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) Board of Directors has approved a set of requirements that are a comprehensive approach to patient care, quality improvement, supervision, professionalism, transitions in care, and resident well-being. Included are graduated standards for duty hours for the nation's 111,000 residents training in ACGME accredited teaching institutions. The new standards will go into effect in July 2011... (Source: Health News from Medical News Today)

ACGME: Reduce Resident Duty Hours in First Year

Rheumatology News — Fri, 01 Oct 2010 00:00:00 +0100

The Accreditation Council for Graduate Medical Education has revisited its standards for resident duty hours and determined that some modifications should be made, mostly for first-year residents. All other residents should still be subject to an 80-hour work week and up to 24 hours of continuous duty, according to an article published online in the New England Journal of Medicine. (Source: Rheumatology News)

Personality Profiling of the Modern Surgical Trainee: Insights into Generation X

Journal of Surgical Education — Fri, 01 Oct 2010 00:00:00 +0100

Conclusion: Most current surgical trainees demonstrate the I personality type. This finding contrasts with established literature, which showed a preference for the E personality type among surgeons trained under the apprenticeship model of residency. As surgical training continues to evolve, it is imperative that we consider the personality traits of the modern trainee and how they might impact the development and implementation of our educational objectives and affect relationships among staff and resident trainees. (Source: Journal of Surgical Education)

Improving quality of NSAID prescribing by internal medicine trainees with an educational intervention.

Teaching and Learning in Medicine — Thu, 30 Sep 2010 23:00:00 +0100

CONCLUSION: A systematically applied education program targeted to a specific prescribing pattern produced significant improvement among internal medicine trainees. This model may assist training programs in reducing polypharmacy, or in other areas of trainee practice. PMID: 20936576 [PubMed - in process] (Source: Teaching and Learning in Medicine)

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Development of an audit method to assess the prevalence of the ACGME's general competencies in an undergraduate medical education curriculum.

Teaching and Learning in Medicine — Thu, 30 Sep 2010 23:00:00 +0100

CONCLUSIONS: The domains provide a useful framework for organizing didactic components. Faculty can also consider activities in light of the domains, providing a vocabulary for instituting curricular change and innovation. PMID: 20936571 [PubMed - in process] (Source: Teaching and Learning in Medicine)

The 80-Hour Work Week and Interest in Surgery

Journal of Surgical Research — Tue, 28 Sep 2010 00:00:00 +0100

The report by Zarebczan and colleagues entitled “The impact of the 80-hour week on student interest in a surgical career” addresses an important and timely topic in the field of medical education. The authors reviewed the responses of medical students to generic surgical clerkship surveys before and after the implementation of the Accreditation Council for Graduate Medical Education (ACGME) 80-h week. There was no significant difference in students’ level of interest in pursuing a surgical career between the pre- and post-80-h work restriction eras. The data suggest that the implementation of the 80-h work limit had no appreciable impact on the enthusiasm of medical students for pursuing a career in surgery. (Source: Journal of Surgical Research)

Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

Neurology — Mon, 20 Sep 2010 20:01:29 +0100

Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era. (Source: Neurology)

Pediatrics Milestones: A Developmental Approach to the Competencies

The Journal of Pediatrics — Wed, 08 Sep 2010 07:24:25 +0100

In 2009, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Pediatrics (ABP) partnered to create the Pediatric Milestone Project. One of the goals of this project was to reframe the 6 competencies in the context of the specialty, identifying markers of achievement (ie, milestones) along the path of residency training. They invited Carol Carraccio, MD, to be the project leader, and her first task was to establish an Advisory Board and a Working Group. Advisory Board members were recruited from the parent organizations as well as from the pool of national leaders in medical education, both from within and outside of pediatrics. The selected Working Group, composed of members of the Association of Pediatric Program Directors (APPD), one member of the Me...

Entry of US Medical School Graduates Into Family Medicine Residencies: 2009--2010 and 3-year Summary.

Famly Medicine — Tue, 31 Aug 2010 23:00:00 +0100

This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine. These numbers are retrospective analyses based on numbers reported to the AAFP from medical schools and family medicine residency programs. PMID: 20830619 [PubMed - in process] (Source: Famly Medicine)

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Resident Duty Hours to Be Reduced in First Year

Ob.Gyn. News — Tue, 31 Aug 2010 23:00:00 +0100

Duty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours Recommendations.

Accident and Emergency Nursing — Tue, 31 Aug 2010 23:00:00 +0100

Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report presents a review of the financing issues associated with any changes. ACADEMIC EMERGENCY MEDICINE 2010; 17:1004-1011 Â© 2010 by the Society for Academic Emergency Medicine. PMID: 20836785 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)

ACGME Plans to Reduce Resident Duty Hours in First Year

Pediatric News — Tue, 31 Aug 2010 23:00:00 +0100

Impact of the 80-Hour Workweek on Surgical Case Exposure Within a General Surgery Residency Program

Journal of Surgical Education — Tue, 31 Aug 2010 23:00:00 +0100

Conclusions: Despite an increase in the total number of major operative cases available, the volume of cases performed by residents has decreased after implementation of the Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions. Our data suggest that the impact of the 80-hour workweek has had a detrimental effect on the conventional resident training experience. (Source: Journal of Surgical Education)

The Impact of Laparoscopy on the Volume of Open Cases in General Surgery Training

Journal of Surgical Education — Tue, 31 Aug 2010 23:00:00 +0100

Conclusions: In addition to the limitations placed on residency training by other factors (including work hour restrictions), changing practice patterns within the field of general surgery have a significant impact on the exposure of residents to open surgery cases. This trend might have far-reaching implications with regard to the overall competency of graduating residents and raises concerns for the future direction of surgical education. (Source: Journal of Surgical Education)

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Study Finds Residents at VA Centers Report Greater Satisfaction After Duty Hour Limits Implemented

AAFP Resident and Student Focus — Fri, 27 Aug 2010 22:00:00 +0100

Resident physicians who rotated through U.S. Department of Veterans Affairs, or VA, medical centers between 2001 and 2007 report being more satisfied with their clinical training environment after the 2003 implementation of revised duty hour standards from the Accreditation Council for Graduate Medical Education, or ACGME. That's the key finding from a study published in the July issue of Academic Medicine. But family medicine educators caution that the finding may not hold true in non-VA settings. (Source: AAFP Resident and Student Focus)

Guidelines for Maintaining a Professional Compass in the Era of Social Networking

Journal of Surgical Education — Fri, 27 Aug 2010 00:00:00 +0100

Conclusions: Given the widespread use of SN websites in our surgical community and in society as a whole, every effort should be made to guard against professional truancy. We offer a set of guidelines consistent with the Accreditation Council for Graduate Medical Education and the American College of Surgeons professionalism mandates in regard to usage of these websites. By acknowledging this need and by following these guidelines, surgeons will continue to define and uphold ethical boundaries and thus demonstrate a commitment to patient privacy and the highest levels of professionalism. (Source: Journal of Surgical Education)

How Accurate Is the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey? Comparison Between ACGME and In-House GME Survey

Journal of Surgical Education — Mon, 09 Aug 2010 00:00:00 +0100

Conclusions: The results of the current study suggest that responses obtained on the ACGME survey may inaccurately reflect the magnitude of noncompliance found in certain areas. We propose that this discrepancy may be a result of the limited range of responses available on the ACGME survey. (Source: Journal of Surgical Education)

Need for Mechanistically Focused Research of Global Systemic Interventions in Palliative Care

Journal of Pain and Symptom Management — Sun, 01 Aug 2010 23:00:00 +0100

Palliative medicine has advanced remarkably in recent years. It is now recognized as a subspecialty by the American Board of Medical Specialties, Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association, and Centers for Medicare & Medicaid Services; currently, the field boasts 68 ACGME-accredited training programs. The number of American hospital-based palliative care and hospice programs has increased steadily, from 632 (15% of hospitals) in 2000 to 1,027 (25% of hospitals) in 2003. Increased research activity in palliative care is reflected in a large and growing body of evidence published in both the field-specific literature and in general medical, nursing, and social work journals. (Source: Journal of Pain and Symptom Management)

ACGME Plans to Cut First-Year Resident Hours

Clinical Endocrinology News — Sat, 31 Jul 2010 23:00:00 +0100

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How to Organize a Fellowship Program: Lessons Learned and How to Include Accreditation Council for Graduate Medical Education Competencies in the Curriculum [SPECIAL ARTICLE]

Journal of Clinical Oncology — Thu, 29 Jul 2010 22:01:48 +0100

(Source: Journal of Clinical Oncology)

2 Common Surgeries Unlikely To Be Affected By Guidance For Medical Training Requirements

Health News from Medical News Today — Mon, 26 Jul 2010 08:00:00 +0100

As the Accreditation Council for Graduate Medical Education seeks to improve patient care by further limiting the hours worked by medical residents, the Journal of Surgical Research will published a new study online on Monday reporting that outcomes in two common surgeries - appendectomy and laparoscopic cholecystectomy - were similar among residents who had worked less than 16 hours and those who had worked more than 16 hours... (Source: Health News from Medical News Today)

Rest requirements for residents unlikely to improve outcomes in 2 common surgeries

EurekAlert! - Medicine and Health — Mon, 26 Jul 2010 04:00:00 +0100

(Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed)) As the Accreditation Council for Graduate Medical Education seeks to further limit residents' work hours, a new study reports that outcomes in two common surgeries were similar among residents who had worked less than 16 hours and those who had worked more than 16 hours. (Source: EurekAlert! - Medicine and Health)

The Future of Emergency Medicine

The Journal of Emergency Medicine — Thu, 15 Jul 2010 23:00:00 +0100

Abstract: Background: The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care.Summary: In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard...

Duty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours Recommendations

The Journal of Emergency Medicine — Thu, 15 Jul 2010 23:00:00 +0100

Conclusion: One recommendation from the IOM was a required 5-h rest period for residents on call. Emergency department (ED) patient safety becomes an important concern with the decrease in the availability and in the patient load of a resident consultant that may result from this recommendation. Of greater concern is the already observed slower throughput time for admitted patients waiting for resident care, which will increase ED crowding and decrease patient safety in academic institutions. A balance between being overly prescriptive with duty hour restrictions and trying to improve resident wellness was recommended. Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report prese...

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ACGME Proposes Revised Guidelines for Resident Work Hours

SCCM RSS News — Mon, 12 Jul 2010 20:06:19 +0100

The Accreditation Council for Graduate Medical Education (ACGME) is proposing new standards for residents, calling for 16-hour shifts and more oversight of less-experienced physicians. The draft regulations aim to promote patient safety and reduce medical errors by enhancing work conditions for sometimes sleep-deprived junior physicians. Residents in their second year and beyond may still work 24 hours, and 80-hour maximum work weeks would remain for all hospital residents. All residents and their supervisors would be required to explain their roles to patients and note that supervisors are ultimately in charge of their care... (Source: SCCM RSS News)

ACGME Task Force Airs Latest Proposal on Residents' Duty Hours

AAFP Resident and Student Focus — Wed, 07 Jul 2010 20:15:00 +0100

The Accreditation Council for Graduate Medical Education, or ACGME, task force on resident physician training standards has released a draft of proposals that, among other things, provide more supervision of first-year residents, reduce first-year residents' duty periods to no more than 16 hours a day and set stricter requirements for duty hour exceptions. (Source: AAFP Resident and Student Focus)

The New Recommendations on Duty Hours from the ACGME Task Force

New England Journal of Medicine — Tue, 06 Jul 2010 23:00:00 +0100

This article explains the proposed changes and the rationale for them and invites input on the new requirements, which are scheduled for implementation in 2011. (Source: New England Journal of Medicine)

18. A Quality Improvement Project to Enhance Pediatric Resident Medical Record Documentation

Academic Pediatrics — Wed, 30 Jun 2010 23:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) requires residents to participate in a quality improvement project. Participation in QI projects especially when resident driven may provide an opportunity to address one or more of the six ACGME core competencies. (Source: Academic Pediatrics)

The American Surgical Education Association

Journal of Surgical Education — Wed, 30 Jun 2010 23:00:00 +0100

The recent conversation among program directors and surgical educators based on the proposed new duty hour recommendations from the Accreditation Council for Graduate Medical Education (ACGME) task force has been interesting to read. The responses were quick as they started the same day as the article was published in the New England Journal of Medicine. Some were vitriolic, others sanguine. Some were contentious and others were measured. All were concerned with more regulations without true evidence of benefit. (Source: Journal of Surgical Education)

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Marcia and Eugene Applebaum Surgical Learning Center

Journal of Surgical Education — Wed, 30 Jun 2010 23:00:00 +0100

The Marcia and Eugene Applebaum Surgical Learning Center is located within William Beaumont Hospital, which is a 1061 bed quaternary care and teaching hospital in Royal Oak, Michigan. In 2009, Beaumont was the largest acute care hospital in the United States, with over 57,000 admissions and 49,000 surgical procedures and the largest independent Academic Medical Center with 37 Accreditation Council for Graduate Medical Education (ACGME)-approved residency and fellowship programs. The Applebaum Surgical Learning Center occupies 5500 sq ft in the new South Tower, which is a central location for surgical services. The Surgical Learning Center earned Level 1 accreditation as a Comprehensive Education Institute from the American College of Surgeons in 2007, and was re-accredited in 2010. The cen...

Graduated Duty Hour And Supervision Standards Proposed By ACGME Task Force

Health News from Medical News Today — Fri, 25 Jun 2010 07:00:00 +0100

The Accreditation Council for Graduate Medical Education (ACGME) task force charged with reassessing resident training program standards today presented a comprehensive set of draft standards that revise requirements for supervision and duty hours to better match residents' levels of experience and emerging competencies, advancing both graduate medical education and quality patient care in the nation's teaching hospitals... (Source: Health News from Medical News Today)

The Feasibility and Effectiveness of a Pilot Resident-Organized and -Led Knowledge Base Review [RESEARCH ARTICLES]

Acad Psychiatry — Thu, 24 Jun 2010 20:24:49 +0100

CONCLUSION: The broad participation and acceptability of the course and the performance difference in PRITE scores between the psychiatry topics, the majority of which were reviewed, and neurology, which was not reviewed, suggest the potential for such a resident-organized and -led intervention to impact acquisition of medical knowledge through an enjoyable and effective approach. (Source: Acad Psychiatry)

AAMC Praises Draft Duty Hour Standards For Medical Residents

Health News from Medical News Today — Thu, 24 Jun 2010 11:00:00 +0100

AAMC (Association of American Medical Colleges) Chief Health Care Officer Joanne M. Conroy, M.D., issued the following statement on the Accreditation Council for Graduate Medical Education's (ACGME) proposed revisions to current duty hour requirements for medical residents: "The ACGME's draft duty hour standards send a clear message that keeping patients safe and providing high-quality care are the most important lessons a new physician must learn... (Source: Health News from Medical News Today)