M.E. Whitcomb is a medical education consultant, Phoenix, Arizona.
Acad Med. 2016 May;91(5):618-20. doi: 10.1097/ACM.0000000000001049.
There is growing recognition within the medical education community that medical education in this country needs to be changed to better prepare doctors for the challenges they will face in providing their patients high-quality medical care. A competency-based medical education (CBME) approach was endorsed by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties approximately 15 years ago, and a self-designated group-the International Competency-Based Medical Education (ICBME) Collaborators-is now calling on members of the medical education community to join them in their effort to establish CBME as the approach to be used in transforming medical education, not only in the United States but also around the world.In response to an article in this issue by a group of ICBME Collaborators, the author argues that more evidence about the effectiveness of CBME is needed before a global shift to this approach is undertaken. It is time for major organizations and foundations that are committed to improving medical education to step forward and take the lead in partnering with the medical education community to conduct a critical evaluation of CBME. In addition, maintenance of certification, relicensure, and continuing medical education programs should be evaluated for their effectiveness in ensuring that physicians are clinically competent not only at the beginning of their career but also until the end.
越来越多的医学教育界人士认识到，美国的医学教育需要改革，以更好地培养医生，使其能够应对为患者提供高质量医疗服务的挑战。大约 15 年前，研究生医学教育认证委员会和美国医学专科委员会认可了以能力为基础的医学教育（CBME）方法，一个自称为国际以能力为基础的医学教育（ICBME）合作者的组织现在呼吁医学教育界的成员加入他们的行列，努力将 CBME 作为一种方法来改革医学教育，不仅在美国，而且在全世界。
针对本期杂志上一篇由 ICBME 合作者撰写的文章，作者认为，在全球转向这种方法之前，需要更多关于 CBME 有效性的证据。现在是时候让致力于改善医学教育的主要组织和基金会挺身而出，带头与医学教育界合作，对 CBME 进行批判性评估。此外，还应评估维持认证、重新认证和继续医学教育计划在确保医生不仅在职业生涯开始时而且在整个职业生涯中保持临床能力方面的有效性。
