Take a look around your hospital, and you've probably noticed quite a few new faces.
Orientation for new residents and fellows typically occurs during the last few weeks of June. During orientation, trainees get acquainted with your hospital's policies and procedures as well as an overview of the education they will receive.
But the look of graduate medical education is on the cusp of change. Graduate medical educators in all specialties got a glimpse of the future of residency and fellowship education when the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Internal Medicine (ABIM) released a draft of the milestone framework for internal medicine on behalf of the internal medicine milestones taskforce.
These are the first milestones for any specialty to be released, but task forces are developing milestones for pediatrics and general surgery as well.
"This is a step forward to advance a plan for developing competency-based education and training," says William Iobst, MD, director of education at the ABIM, who lead the facilitation of the milestones effort.
The draft framework, Developmental Milestones for Internal Medicine Residency Training, lays out a progression of competency residents should follow for each of the ACGME's six core competencies, which residents must meet in order to graduate. The milestones set forth specific behavioral anchors for each competency and a timeframe in which residents should achieve proficiency in that area, Iobst says.
"You should be able to tell a very precise story about where the resident is in his or her training," Iobst says. "The milestones will also allow residents to understand what is expected of them and how they're progressing along that road to competence."
The milestones will also strengthen the validity of trainee evaluation data. With every resident in a particular specialty being graded against the same standard, there can be more meaningful data collection across all specialties. Program directors can use comparative data to identify the strengths and weaknesses in their educational curriculum and make the appropriate adjustments.
As the milestone project is an ACGME-initiative, one must assume that it will be factored into the accreditation process in some way. However, exactly how is unknown.
The ACGME and milestones task force call on faculty, program directors, coordinators, and other stakeholders to provide their feedback on the milestones via a survey located on the ABIM's Web site.
Major organizations will also be asked to comment on the milestones. After feedback is gathered and reviewed by the task force, the group will continue to refine the framework. Eventually the milestones will be pilot tested for a few years before it's rolled out to all internal medicine programs, Iobst says.