The nation's system for training physicians is in dramatic need of a complete overhaul to adequately provide future patient care, says a report from the Josiah Macy Jr. Foundation, which issued 14 recommendations to make that happen.
"Although notable changes have occurred in graduate medical education (GME) over the past decade, including the introduction of a competency-based framework and limitations on duty hours, many people feel that much broader reforms are needed to keep pace," says the 39-member panel that authored the report.
The panel, consisting of physicians and surgeons as well as medical school deans and faculty members, said the nation will be short more than 100,000 doctors by the middle of the next decade, in part because of the current system's entrenched ways of educating and assuring the quality of the physician workforce.
"Unless we in academic medicine are self-critical and show a willingness to change, the political and public support for graduate medical education will disappear," warns Macy President George Thibault, MD, in a statement. "This is a huge enterprise built on tradition, but the system has to change to be more responsive to public needs."
One of panel’s key recommendations is that medical education should shift from gauging competency by months and years of training to actual measurements of individual physicians' readiness for independent practice. This is because medical school residents "vary significantly in how quickly they achieve competency, yet the current system of training all residents for a fixed duration fails to recognize or accommodate this reality."