Gaps In Residency Training Should Be Addressed To Better Prepare Doctors For A Twenty-First-Century Delivery System

Abstract

Many observers have been concerned about a mismatch between the knowledge, skills, and professional values of newly trained physicians and the requirements of current and future medical practice. We surveyed and interviewed Kaiser Permanente's clinical department chiefs for internal medicine, pediatrics, general surgery, and obstetrics/ gynecology to ascertain their views of the perceived gaps in the readiness of newly trained physicians. Nearly half of those surveyed reported deficiencies among new physicians in managing routine conditions or performing simple procedures often encountered in office-based practice. A third of the chiefs noted deficiencies in coordinating care for patients. Filling these and other training gaps will require changes at many levelsfrom residency programs to Medicare reimbursement policies-to better prepare new physicians for the challenges of working in a health care system evolving to emphasize accountability, quality outcomes, cost control, and information technology.

Patients, Providers, And Systems Need To Acquire A Specific Set Of Competencies To Achieve Truly Patient-Centered Care

“…The same competencies and principles that underpin shared decision making among providers and patients should be used among policy makers and the health care community. 65 Additional research is needed to clarify the goals of engagement and address the following remaining questions: What is the desired role for patients in health care based on their unique personal and social context and care issues? What does longitudinal engagement look like?…”

Building the Plane As We Fly It

“…Developing milestone-based assessments will require the significant professional development of all key stakeholders involved in the GME enterprise. Studies by Crosson et al 14 and Mattar et al 15 highlight that despite being well over a decade into the Outcomes Project, physicians complete graduate medical training and enter the workforce lacking competence in a wide range of fundamental skills needed for safe and effective patient care. Such findings suggest that there are dimensions of physician practice in which we are neither teaching nor assessing our trainees effectively.…”

Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the wright center for graduate medical education teaching health center curriculum experience

“…The Next Accreditation System offers a relevant, data-driven roadmap of educational and patient care outcomes for these validations. Overall, WCGME THC century physician workforce than previously reported by Kaiser Permanente in 2011 [16].…”