A Redesign of the ACGME Resident/Fellow Survey Through Expert Reviews and Cognitive Interviews.

Background: Since 2003, the Accreditation Council for Graduate Medical Education (ACGME) has surveyed residents and fellows in its accredited programs. The Resident/Fellow Survey is a screening and compliance tool that programs can also use for continuous quality improvement. However, stakeholders have reported potential problems with the survey's overall quality and credibility.

The ACGME Single Accreditation System: Alterations in the Force of Graduate Medical Education.

The Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) disturbed the gravitational forces of medical education when they entered into a historic agreement in August 2014. This agreement resulted in a 6-year journey to a single accreditation pathway for all residency programs and nearly all fellowship programs in the United States. It brought together the 2 traditions of medicine in the country for the first time in more than 100 years, unifying a critical phase of medical education for all physicians in the United States.

Elevating Resident Voices in Health Systems Change: Lessons From the Closure of Hahnemann University Hospital.

The closure of Philadelphia's Hahnemann University Hospital (HUH) in summer 2019 brought an abrupt end to its status as a sponsor of graduate medical education (GME). The Accreditation Council for Graduate Medical Education (ACGME) provided assistance to ensure that more than 550 residents and fellows in HUH's 35 ACGME-accredited programs were able to transfer to new programs in which they could continue their education. As the ACGME joined other organizations in responding to HUH's closure, it was apparent that the voices of residents and fellows should be emphasized in regulatory processes and policies that address substantial disruptions to GME and affect their education, their daily lives, and their professional futures.

Initial Validity Analysis of the Emergency Medicine Milestones.

Objectives: The Accreditation Council for Graduate Medical Education (ACGME) Milestones describe behavioral markers for the progressive acquisition of competencies during residency. As a key component of the Next Accreditation System, all residents are evaluated for the acquisition of specialty-specific Milestones. The objective was to determine the validity and reliability of the emergency medicine (EM) Milestones.

Transforming educational accountability in medical ethics and humanities education toward professionalism.

Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.

Interventions to address challenges associated with the transition from residency training to independent surgical practice.

Background: Concerns regarding preparation of residents for independent surgical practice are widespread and support for junior surgeons entering practice is variable across institutions and practices. The American College of Surgeons (ACS) Division of Education partnered with the Accreditation Council for Graduate Medical Education (ACGME) to convene a National Invitational Conference to define key issues relating to the transition to practice and develop recommendations to address various challenges.

Outcomes Of The National Invitational Conference: Leaders from ACS, ACGME, certifying boards, residency review committees, program director organizations, and professional societies representing the breadth of surgical specialties, along with other key stakeholders, were invited to participate in the 1.

The accreditation system after the "next accreditation system".

The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties and its member boards introduced the six domains of physician competency in 1999. This initiated a national dialogue concerning the elements of competency of the physician, and incorporation of these elements into the framework of evaluation of residents and fellows, as well as the educational programs within which they are trained. The next step in this process will be the ACGME's Next Accreditation System, which the authors describe in this commentary.

Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

Background: An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships.

Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?

Long hours are an accepted component of resident education, yet data suggest they contribute to fatigue that may compromise patient safety. A systematic review confirms that limiting duty hours increases residents' hours of sleep and improves objective measures of alertness. Most studies of operative experience for surgical residents found no effect, and there is evidence of a limited positive effect on residents' mood.

Commentary: the modesto story: back to the future?

In this issue of Academic Medicine, Broderick and Nocella describe the creative use of an educational consortium model to bring community providers together to solve the fiscal crisis faced by the local family medicine residency program, which was sponsored by a single-program sponsoring (hospital) institution. The authors of this commentary explore the specific adaptation of the educational consortium model to the previously single-program-sponsor setting, provide current numbers of accredited residency programs sponsored by educational consortia and other institutions, and speculate on the consortium model's potential to enhance community engagement and support for graduate medical education (GME) in the various settings in which GME is conducted in the United States.

Rethinking CME: an imperative for academic medicine and faculty development.

To help address the clinical care gap, a working group discussed the future of faculty development in academic medicine, explored problems within the large, current enterprise devoted to continuing medical education (CME), and described four domains core to its revitalization and reformation. These domains are (1) preparing and supporting an engaged clinician-learner, (2) improving the quality of knowledge or evidence shared, (3) enhancing the means by which to disseminate and implement that knowledge and evidence, and (4) reforming the patient, health care, and regulatory systems in and for which the process of CME exists. Reshaping these domains requires the consideration of a more seamless, evidence-based, and patient-oriented continuum of medical education.

Experiential leadership training for pediatric chief residents: impact on individuals and organizations.

Background: The past decade has seen a proliferation of leadership training programs for physicians that teach skills outside the graduate medical education curriculum.

Objective: To determine the perceived value and impact of an experiential leadership training program for pediatric chief residents on the chief residents and on their programs and institutions.

Methods: The authors conducted a retrospective study.

Commentary: the ACGME: public advocacy before resident advocacy.

In their insightful and provocative analysis in this issue, Drs. Lypson, Hamstra, and Colletti propose that the Accreditation Council for Graduate Medical Education (ACGME), with some modifications in process, might assume the role of unions or other collective bargaining units for residents. They make valid observations about aspects of the ACGME Institutional Requirements that pertain to resident safety and well-being and the environment in which residents learn and participate in care.

Use of critical incidents to develop a rating form for resident evaluation of faculty teaching.

Context: Monitoring the teaching effectiveness of attending physicians is important to enhancing the quality of graduate medical education.

Methods: We used a critical incident technique with 35 residents representing a cross-section of programmes in a teaching hospital to develop a 23-item rating form. We obtained ratings of 11 attending physicians in internal medicine and general surgery from 54 residents.

Impact of a physician-oriented intervention on follow-up in colorectal cancer screening.

Background: Complete diagnostic evaluation or CDE (i.e., colonoscopy or combined flexible sigmoidoscopy plus barium enema X-ray) is often not performed for persons with an abnormal screening fecal occult blood test (FOBT+) result.