Competency Matrix for Medical Residency Programmes in Endocrinology and Metabolism

Abstract

Introduction Medical competencies have become the focus of Medical Education at all levels around the world. In this context the Medical Residency Programs (MRP) in Brazil have begun to seek a competency-based curriculum to improve the specialist training. Objective To develop a proposed Competency Matrix for Medical Residency Programs in Endocrinology and Metabolism (MREM). Methodology The study was divided into four phases. The first phase consisted of a bibliographical review and construction of the Pilot Matrix. In the second phase the Pilot Matrix was applied to endocrinologists from Belém, with subsequent data analysis and construction of the Structured Matrix. The third phase started with the implementation of the Structured Matrix at the Brazilian Congress of Endocrinology and Metabolism – CBEM 2016 with a total of 49 responses. Based on the Delphi methodology, the 230 competencies of each one of the matrices were analyzed and a questionnaire containing competences with a discrepancy level greater than 10% was created, including some suggestions from the experts. In the fourth and last phase, also using Delphi methodology, the questionnaire was sent by email and data analysis and construction of the MREM proposal was performed. Results In the second, third and fourth phases, the response rate of Endocrinologists was 73.3%, 51% and 76.4%, respectively. With the Southeast region of Brazil presenting the largest number of participants. There are 219 competencies in the Pilot Matrix, 230 in the Structured Matrix and 244 in the final MREM proposal. The competency areas of Diabetes and Obesity, Metabolic Syndrome and Alterations of Appetite were those which showed major change and suggestions. In all phases, only 2 competencies were excluded. The suggestions made in the third phase were unanimously accepted. Conclusion The MREM proposal was concluded with 21 areas and 244 competencies, 33 classified as prerequisites, 157 as essential competencies, 36 as desirable and 18 as advanced. The competencies were distributed as follows in the MCPRMEM: “Fundamental” field with 100 competencies, with 15 prerequisites, 65 core competencies, 14 desirable and 6 advanced ones; “Specific Knowledge” field with 132 competences, with 18 prerequisites, 87 essential competences, 19 desirable and 8 advanced; and “Complementary Training” field with 12 skills, no prerequisites, 5 core competencies, 3 desirable and 4 advanced skills.