Rheumatology Milestones 2.0: A Roadmap for Competency‐Based Medical Training of Rheumatology Fellows in the 21st Century

Abstract

Objective Since 2014, rheumatology fellows have been assessed not only based on their ability to provide patient care and possession of medical knowledge but also on their skill in serving as patient advocates, navigators of health systems, and members of a health care team. Such assessments have been carried out through the use of competency‐based milestones from the Accreditation Council of Graduate Medical Education (ACGME). However, a needs assessment has demonstrated interest in more context validity and subspecialty relevance since the development of the ACGME internal medicine (IM) subspecialty reporting milestones. The ACGME thus created a milestones working group, and the present study was undertaken to develop Rheumatology Milestones 2.0 as well as a supplemental guide to assist with implementation. Methods The working group, consisting of 7 rheumatology program directors, 2 division directors, a community practice rheumatologist, a rheumatology fellow in training, and a public member who is a rheumatology patient, was overseen by the ACGME vice president for milestones development and met through three 12‐hour, in‐person meetings to compose the rheumatology specialty milestones and supplemental guide within the ACGME Milestones 2.0 project. Results Informed by the needs assessment data and stakeholders, the working group revised and adapted the ACGME IM subspecialty reporting milestones to create a rheumatology‐specific set of milestones and a supplemental guide for their implementation. Conclusion The Rheumatology Milestones 2.0 provides a specialty‐specific, competency‐based evaluation tool that can be used by program directors, clinical competency committees, and others to assess the competencies of rheumatology fellows during training and help measure readiness for independent practice.

Incorporating Telemedicine in Rheumatology Fellowship Training Programs: Needs Assessment, Curricular Intervention, and Evaluation

“…As such, it is imperative that fellowship training programs incorporate VC delivery into curricula (14) to ensure breadth in the skills, attitudes, and knowledge of new entrants into the rheumatology workforce. VC curricula must integrate tenets of the ACGME Core Competencies (11) and Rheumatology Telehealth Competencies (10), while remaining flexible to address evolving areas of need.…”

“…Both collaboration groups sponsored a virtual rheumatology objective structured clinical examination (vROSCE) (February or March 2022) that included one station simulating a video teleconference patient encounter in the rheumatology outpatient setting. This station was created (by MBB, reviewed, edited, and approved by all coauthors) to evaluate FITs providing VC, and assessment was based on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies (11) and ACR Telehealth Competencies (10).…”

“…Participants. FITs from 2 collaborative groups, representing 7 (11) and ACR Telehealth Competencies (10).…”

Epilepsy Milestones 2.0: An updated framework for assessing epilepsy fellowships and fellows

“…The overall goals and limitations of Epilepsy Milestones 2.0 are analogous to those in other specialties and subspecialties, including anesthesiology, 12 child neurology, 9 forensic pathology, 13 hematology/oncology, 14 neurology, 10 pulmonary and critical care, 15 and rheumatology 16 . As members of the work group, we have no evidence that the new Milestones will improve the training of epileptologists or patient outcomes.…”

Rheumatology Education Needs a Splash of Color

“…Competencies, such as the Accreditation Council for Graduate Medical Education (ACGME) Rheumatology Milestones 2.0, CanMEDS, and EULAR's generic core competencies of health professionals in rheumatology, list skills required for independent practice. 21,22,23 These competencies guide curricular development as well as the assessment of clinical performance. The ACGME Rheumatology Milestones and CanMEDS framework reference some aspects of providing equitable care to underrepresented patient populations, and EULAR's generic core competencies emphasize patient-centered care without itemizing health equity.…”