Dr. Peterson is research director, American Board of Family Medicine, and assistant professor of family and community medicine, University of Kentucky, Lexington, Kentucky. Dr. Carek is professor and chair, Department of Family Medicine, University of Florida, Gainesville, Florida. Dr. Holmboe is senior vice president for Milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. At the time this Commentary was written, he was chief medical officer, American Board of Internal Medicine, Philadelphia, Pennsylvania. Dr. Puffer is president and chief executive officer, American Board of Family Medicine, Lexington, Kentucky. Dr. Warm is professor, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio. Dr. Phillips is vice president of research and policy, American Board of Family Medicine, Lexington, Kentucky.
Acad Med. 2014 Jun;89(6):840-2. doi: 10.1097/ACM.0000000000000250.
U.S. graduate medical education (GME) training institutions are under increasing scrutiny to measure program outcomes as a demonstration of accountability for the sizeable funding they receive from the federal government. The Accreditation Council for Graduate Medical Education (ACGME) is a potential agent of measuring GME accountability but has no interaction with physicians after residency training is completed. American Board of Medical Specialty (ABMS) member boards interact with physicians throughout their careers through maintenance of certification (MOC) and are a potential source of valuable data on physician competency and quality of care, both of which could be used to measure GME accountability.The authors propose that ABMS boards and the ACGME deepen their existing relationship to better assess residency training outcomes. ABMS boards have a wealth of data on physicians collected as a by-product of MOC and business operations. Further, many ABMS boards collect practice demographics and scope-of-practice information through MOC enrollment surveys or recertification examination questionnaires. These data are potentially valuable in helping residencies know what their graduates are doing in practice. Part 4 of MOC generally involves assessment of the quality of care delivered in practice, and ABMS boards could share these deidentified data with the ACGME and residency programs to provide direct feedback on the practice outcomes of graduates.ABMS member boards and the ACGME should broaden their long-standing relationship to further develop shared roles and data-sharing mechanisms to better inform residencies and the public about GME training outcomes.
美国研究生医学教育(GME)培训机构正面临越来越多的审查,以衡量其项目成果,作为其从联邦政府获得大量资金的问责制的证明。研究生医学教育认证委员会(ACGME)是衡量 GME 问责制的潜在机构,但在住院医师培训完成后,与医生没有任何互动。美国医学专科委员会(ABMS)成员委员会通过维持认证(MOC)与医生的整个职业生涯互动,是医生能力和护理质量的有价值数据的潜在来源,这些数据都可用于衡量 GME 的问责制。作者建议 ABMS 委员会和 ACGME 加深他们现有的关系,以更好地评估住院医师培训的成果。ABMS 委员会在 MOC 和业务运营过程中收集了大量医生的数据。此外,许多 ABMS 委员会通过 MOC 登记调查或再认证考试问卷收集实践人口统计学和执业范围信息。这些数据对于帮助住院医师了解他们的毕业生在实践中的工作情况非常有价值。MOC 的第 4 部分通常涉及评估实践中提供的护理质量,ABMS 委员会可以与 ACGME 和住院医师计划共享这些匿名数据,为毕业生的实践成果提供直接反馈。ABMS 成员委员会和 ACGME 应该扩大他们的长期关系,进一步发展共同的角色和数据共享机制,以便更好地向住院医师和公众通报 GME 培训成果。