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Physician
Education for a Changing
Health Care Environment - Continued, 13th Report
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VI. ASSURING QUALITY AND ACCOUNTABILITY IN PHYSICIAN EDUCATION
FINDING 6: The assurance of consistent quality in medical education will become increasingly critical as clinical
teaching outside the traditional hospital setting expands and as teaching strategies become more diverse. Methods designed to assess performance evaluation at multiple sites and assure the longitudinal development of
knowledge, skills, and attitudes are becoming increasingly important.
Recommendations:
- Medical educators should continuously assess both short-term and longitudinal outcomes in the learner, the teacher, and
the program.
- Assessment techniques must be selected to provide reliable and valid measurement of educational outcomes across a variety of teaching environments.
- Academic health centers, educational programs, and accrediting agencies should continue to develop monitoring and assessment approaches that meet the needs of different constituencies.
VII. FINANCING THE EVOLUTION OF GRADUATE MEDICAL EDUCATION
FINDING 7: The system of funding graduate medical education through teaching hospitals has inherent limitations and
disincentives that inhibit the development of ambulatory experiences and community-based educational programs. There is still no consensus on how to appropriately fund and expand the curriculum to reach into community settings.
Recommendations:
- A stable reliable source of funding for graduate medical education is essential. While it is appropriate to assume that the
Federal government through the Medicare program will continue to support graduate medical education, COGME endorses
efforts to ensure that all payors, including the Federal government, support an equitable share of medical education costs.
- Medical schools, teaching hospitals and major stakeholders should prepare to finance physician education programs that
incorporate the changes recommended in this report. Most of the funds to support these changes will require shifting existing
internal resources within the academic enterprise.
- Funding for residency programs must provide the flexibility to meet the educational needs of residents. Program funding
should be structured to enable residents to attain the knowledge, skills, attitudes and values that will meet both
the profession’s goals and community needs.
- The value of graduate medical education to the sponsoring institution should be determined through a candid and explicit
assessment of its financial, educational, and service contribution to the achievement of the institution’s mission.
VIII. SUSTAINING QUALITY AND VITALITY IN MEDICAL EDUCATION
FINDING 8: Creating and sustaining the educational changes required to respond to the changing medical environment will continue to be a challenge given the pressures of the medical marketplace and the complex missions of medical schools, academic medical centers and other teaching hospitals.
Recommendations:
- Medical schools, residency training programs, and teaching hospitals must balance their competing roles and reaffirm
their educational mission. They should embrace the task of meeting societal need through the education of their graduates.
- The standards for accreditation and financial support of residency programs should be revised to encourage and facilitate new curriculum content, and opportunities to acquire additional knowledge, skills, attitudes and values.
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