Developments and Innovations in Resident and Fellowship Education

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.

Computer-based video training is effective in teaching basic surgical skills to novices without faculty involvement using a self-directed, sequential and incremental program

“…In addition, limits on resident work hours and the introduction of shorter residency training paradigms have left residents with less time to acquire an increasingly complex set of skills. 2 , 3 It is, therefore, advantageous for medical students and junior trainees to learn basic skills outside the operating room in order to maximize their operative experience.…”

“…Furthermore, as training paradigms shorten, and the complexity of surgical procedures increase, surgical residents are under pressure to demonstrate competency with fewer training hours. 1 , 2 , 3 Thus it behooves medical schools and training programs to teach basic skills as early as possible, optimally prior to exposure in an operating room. Early training would allow the trainee to focus time in the operating room on the conduct of the operation and the acquisition of more complex skills.…”

Concordance between Experiences of Bereaved Relatives, Physicians, and Nurses with Hospital End-of-Life Care: Everyone Has Their “Own Truth”

“…One-third of the relatively young participating physicians had discussed imminent death with the patient themselves. The provision of clinical care in the learning environment of a teaching hospital is challenging; junior doctors need adequate supervision to learn more about end-of-life care, truth telling, and breaking bad news [43,44].…”

Statement From the Society for the Advancement of Transplant Anesthesia: White Paper Advocating Desirable Milestones and Competencies for Anesthesiology Fellowship Training in the Field of Lung Transplantation

“…The sciences of lung transplantation, anesthesiology, and medical education have all evolved significantly since the first human lung transplant by Dr James Hardy in 1963. [1][2][3] Whereas developments in the advancement of lung transplantation were primarily surgical in the beginning, soon breakthroughs in medical therapies followed, with multidisciplinary collaboration resulting in the creation of the International Society for Heart and Lung Transplantation (ISHLT) Registry in 1983. 4,5 Educational advancements, including the development of the Accreditation Council for Graduate Medical Education (ACGME) in 1981 followed by the development of Anesthesiology milestones in 2014, have been aimed at assessing and improving success of residency training programs in furthering patient care.…”