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December 6, 2016

Shifting Approaches for Evaluation of Resident Performance: From Competencies to Milestones

Author Affiliations
  • 1Medicine, Weill Cornell Medical College, New York, New York

Copyright 2016 American Medical Association. All Rights Reserved.

JAMA. 2016;316(21):2197-2199. doi:10.1001/jama.2016.16399

Outcomes measures have replaced process measures as the new currency of quality. For example, the quality of care for patients with diabetes is now measured by results of hemoglobin A1C tests, not just the percentage of patients who received the test. The same shift has occurred in graduate medical education (GME). Competency-based education serves to hold residency programs accountable for the outcomes of its graduates.

In 2001, the Accreditation Council of Graduate Medical Education (ACGME) implemented its Outcomes Project defining 6 core professional competencies for physicians.1,2 Residency training programs and advanced subspecialty fellowships were asked to measure the competence of trainees in patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. For the first time, all ACGME-accredited programs were using a standard language to describe performance of physicians in training.