“Disruptive change” is a buzzword for many industries, and health care is no exception. Changes in practice payment methodologies and locations of service affect the learning environment and settings for medical education, as well as the knowledge and skills that residents in internal medicine should acquire during their training. At the same time, graduate medical education (GME) is undergoing an internal evolution to make programs more based on the development of competencies and centered on the educational needs of individual trainees.
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