The growth of specialization in graduate medical education (GME) and physician practice continues at a rapid rate, generating increasing national attention. Although the major educational, accrediting, and certifying bodies have mechanisms for approving new areas of study and practice, the results of their efforts have not been consistently congruent. This article presents information about GME since the beginnings of its standardization and accreditation in the early 20th century, its growth during and following World War II, and the variations among accredited specialties and subspecialties, certificates, and self-designated practice areas that have resulted from this long period of unstructured growth. JAMA. 2000;284:1284-1289
ABSTRACTWhen it struck the US Gulf Coast in 2005, Hurricane Katrina severely disrupted many graduate medical education residency/fellowship programs in the region and the training of hundreds of residents/fellows. Despite the work of the Accreditation Council for Graduate Medical Education in responding to this natural disaster and facilitating communication and transfer of residents/fellows to other unaffected training programs, the storm exposed the gaps in the existing system. Subsequently, the Accreditation Council for Graduate Medical Education, with the aid of its member organizations, including the American Medical Association, developed a new disaster recovery plan to allow for a more rapid, effective response to future catastrophic events. These policies were instrumental in the rapid relocation of 597 residents/fellows from the University of Texas Medical Branch at Galveston after the landfall of Hurricane Ike in September 2008. As a further accommodation to affected trainees, medical certification boards should be as flexible as possible in waiving continuity requirements in the event of a disaster that affects residency/fellowship programs.(Disaster Med Public Health Preparedness. 2010;4:S71-S74)
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