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Resident and Fellow Policy Manual

ACGME Outcomes Project/ACGME General Competencies:

Overview

In September 1997, the Accreditation Council for Graduate Medical Education (ACGME) endorsed a shift in focus of residency accreditation from structure and process to educational outcomes.  The old structure/process model determines only whether a program has the potential to educate residents while the outcome model determines whether residents are actually being educated.  The ultimate goal from the ACGME perspective is to improve the quality of graduate medical education and thereby, to enhance the quality of medical care.  The ACGME Outcome Project is a long-term initiative to support this process and includes five areas of activity:

  • Promote development and use of general and specialty-specific competencies and related learning objectives;
  • Identify and develop dependable methods of assessing the achievement of competency-based learning objectives;
  • Define optimal and practical assessment systems;
  • Define and implement an expanded role for continuous improvement processes within programs; and,
  • Develop resources to support changes in educational processes.

The first step in the process was completed in February 1999, when the ACGME endorsed six general competencies applicable to all physicians:

  • Patient care
  • Medical knowledge
  • Interpersonal and communication skills
  • Professionalism
  • Practice-based learning and improvement
  • Systems-based practice.

These six competencies have also been endorsed by the American Board of Medical Specialties (ABMS).  The ACGME has specified that each "residency program must require its residents to develop the competencies in the 6 areas to the level expected of a new practitioner."  Toward this end, programs must define the specific knowledge, skills, and attitudes required and provide educational experiences as needed in order for their residents to demonstrate the competencies.  The competencies are not intended to replace or substitute for existing curricular, but rather to act as organizing principles for the curricular of all core specialty programs.  Individual specialties will refine the competencies to meet specialty-specific needs.  Programs will review and refine existing learning objectives in the context of the competencies and where necessary develop new learning objectives.  Project activities are currently focused on identification and development of measurement tools.

In addition, programs must describe the process used by the program to link educational outcomes with program improvement and be able to discuss the program changes that have been made based on data derived from the resident/fellow assessment methods that have been implemented.