Abstract
Background
Medical trainee education has drastically changed over the past 30 years significantly since the inception of the Accreditation Council for Graduate Medical Education (ACGME) in 1981. With an emphasis on patient safety, regulations and oversight from the ACGME have drastically changed the way many programs function with respect to trainee responsibilities, duty hours, and resident supervision.
Questions/Purposes
The purpose of this review is to summarize significant changes and innovations implemented by the ACGME and their proposed effects on trainee education. While there is an emphasis on musculoskeletal radiology fellowship training, the majority of the regulations and guidelines are applicable to all training programs.
Methods
Articles, commentaries, and policies focusing on ACGME requirements were reviewed, with a focus on musculoskeletal radiology.
Results
Changes in ACGME policies have resulted in significant structural modifications in how training programs are designed, specifically with respect to curriculum standardization, measuring outcomes of trainee performance, and integration of residents and fellows into hospital-based quality improvement and patient safety initiatives.
Conclusion
With an eye to continued training program advancement and improvement, the goal of universal oversight and standardization in medical training remains to produce forward-thinking physicians with an emphasis on lifelong learning, patient care, and quality improvement.
Similar content being viewed by others
References
Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Musculoskeletal Radiology. Effective July 1, 2013
Accreditation Council for Graduate Medical Education. The ACGME at a glance. Available at http://www.acgme.org/acgmeweb/About/ACGMEataGlance.aspx Accessed February 14, 2014
Amis ES Jr, Baker SR, Becker GJ, et al. Panel discussions in radiology: changes in radiology training and new examination format. AJR American Journal of Roentgenology. 2008; 191: W217-W230.
Asch DA, Parker RM. The Libby Zion case: one step forward or two steps backward? New England Journal of Medicine. 1988; 318: 771-775.
Baker SR, Luk L, Clarkin K. The trouble with fellowships. Journal of the American College of Radiology. 2010; 7: 446-451.
Baker SR, Oif E, Roy R, Meehan TM. A survey of radiology chairpersons’ perceptions of the relative importance of education of medical students, residents, and fellows. AJR American Journal of Roentgenology. 2010; 195: 974-978.
Berquist TH. Postgraduate musculoskeletal fellowship training in the United States: current trends and future direction. Skeletal Radiology. 2003; 32: 337-342.
Block L, Wu AW, Feldman L, Yeh HC, Desai SV. Residency schedule, burnout and patient care among first year residents. Postgraduate Medical Journal. 2013; 89(1055): 495-500.
Bochner M. Effects of the 2003 match on the radiology fellowship application process. Journal of the American College of Radiology. 2004; 1: 422-426.
Cohen MD, Gunderman RB. Academic radiology: sustaining the mission. Radiology. 2000; 224: 1-4.
Collins J. Getting the most out of a radiology department education committee. Academic Radiology. 2002; 9(8): 960-963.
Deitte L, Chertoff JD, Mainiero MB, Strife JL, DeStigter KK. Challenges and opportunities in restructuring radiology residencies: the APDR Residency Restructuring Committee report. Journal of the American College of Radiology. 2010; 7: 507-511.
Eschelman DJ, Sullivan KL, Parker L, Levin DC. The relationship of clinical and academic productivity in a university hospital radiology department. AJR American Journal of Roentgenology. 2000; 174: 27-31.
Flemming D, Davis KW, Dinauer PA, et al. Musculoskeletal radiology curriculum for radiology residents. Journal of the American College of Radiology. 2007; 4: 636-639.
Flemming D, Mosher T, Walker E, Bernard S, Brian P, Petscavage J. Data driven design of a new fourth year MSK elective. Society of Skeletal Radiology 2013 Annual Meeting. Skeletal Radiology. 2013; 42: 1027.
Hetts SW. The ACGME residency review committee for diagnostic radiology: a resident’s perspective. Journal of the American College of Radiology. 2005; 2(6): 548-551.
Howell RE. Resident duty hours: the rest of the story. Journal of the American College of Radiology. 2004; 1: 104-107.
Institute of Medicine. Crossing the quality chasm. Washington DC: National Academies Press; 2003.
Iyer RS, Bhargava P, Sandstrom CK, Dicks DL, Reddy GP. Establishing a fellowship education committee. Journal of the American College of Radiology. 2013 Sep; 10(9): 718-720.
Mainiero MB, Davis LP, Chertoff JD. Resident duty hour limits: recommendations by the IOM and the response from the radiology community. Journal of the American College of Radiology. 2010; 7: 56-60.
Mir HR, Cannada LK, Murray JN, Black KP, Wolf JM. Orthopaedic resident and program director opinions of resident duty hours: a national survey. Journal of Bone and Joint Surgery (American). 2011; 93(23): e1421-e1429.
Mulcahy H, Chew FS, Mulcahy MJ. Radiologists’ expectations of changes in radiology fellowship training programs. Journal of the American College of Radiology. 2012; 9: 352-357.
Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system: rationale and benefits. New Engl J Med. 2012 Mar 15; 366(11): 1051-1056.
Nicholson BT, Paladin AM, Oldham SA, et al. The next accreditation system in radiology: a report from the APDR residency structure committee. Journal of the American College of Radiology. 2013. doi:10.1016/j.jacr.2013.06.009. Epub ahead of print.
Nicholson BT, Sizemore AW, Gay SB. The new radiology residency fourth year under the new curriculum: a survey of current residents’ thoughts and suggestions about its design and purpose. Journal of the American College of Radiology. 2010; 7: 294-298.
Pavlov H. Radiology and imaging (1905–2012), in Anatomy of a Hospital: Hospital for Special Surgery 1863–2013, Levine DB ed. 2013 Hospital for Special Surgery. pp. 339–368.
Resnick D. Musculoskeletal imaging education and training programs: retrospective review after 35 years at the University of California, San Diego (UCSD). Skeletal Radiology. 2012; 41: 1191-1194.
Rumack CM. American diagnostic radiology residency and fellowship programmes. Annals of the Academy of Medicine, Singapore. 2011; 40: 126-131.
Shetty SK, Resnik CS. Fellowship directors’ perceptions of the 2005 NRMP radiology fellowship match. Academic Radiol. 2006; 13(1): 121-130.
Webber GR, Baumgarten DA, Chen Z, Wang Z, Mullins ME. A survey of diagnostic radiology residency program directors and the increasing demands of program leadership. Journal of the American College of Radiology. 2013; 10: 523-526.
Weiss K, Wagner R, Nasca T. Development, testing, and implementation of the ACGME clinical learning environment review (CLER) program. J Grad Med Educ. 2012; 4: 396-398.
Yablon CM, Jacobson JA, Flemming DJ, Carrino JA. Radiology fellowship with a focus on musculoskeletal imaging: current challenges and future directions. AJR American Journal of Roentgenology. 2013; 200: 379-382.
Yablon CM, Wu JS, Newman LR, Downie BK, Hochman MG, Eisenberg RL. A needs assessment of musculoskeletal fellowship training: a survey of practicing musculoskeletal radiologists. AJR American Journal of Roentgenology. 2013; 200: 732-740.
Disclosures
Conflict of Interest:
Carolyn M. Sofka MD has declared that she has no conflict of interest.
Human/Animal Rights:
This article does not contain any studies with human or animal subjects performed by the any of the authors.
Informed Consent:
N/A
Required Author Forms
Disclosure forms provided by the authors are available with the online version of this article.
Author information
Authors and Affiliations
Corresponding author
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
ESM 1
(PDF 1224 kb)
Rights and permissions
About this article
Cite this article
Sofka, C.M. Developments and Innovations in Resident and Fellowship Education. HSS Jrnl 10, 225–229 (2014). https://doi.org/10.1007/s11420-014-9396-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11420-014-9396-6