Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs

Abstract

Background Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Methods Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002–2003 and AY 2006–2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. Results The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002–2003 and AY 2006–2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002–2003 to 31.6% (7390/23400) in AY 2006–2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002–2003 to 31.6% [4718/14941] in AY 2006–2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). Conclusion The number of graduates and the rate of continuing GME increased from AY 2002–2003 to AY 2006–2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice.

Prevalence and Predictors of Us Medical Graduates’ Federal F32, Mentored-K, and R01 Awards: A National Cohort Study

“…An earlier study of Accreditation Council for Graduate Medical Education-accredited GME programs reported that the proportion of US medical school graduates who continued in GME after completing requisite training for initial board certification differed substantially by specialty. In that study, across all specialties examined, 31.6% of US medical graduates overall continued in GME after completing initial specialty training, but there were striking differences between specialties—only 7.5% of trainees who completed initial specialty training in family medicine continued in GME, whereas 60.9% of those who completed initial specialty training in IM did so 57. Further research is warranted to examine the relationship between subspecialty training and receipt of federal research grants.…”

“…In that study, across all specialties examined, 31.6% of U.S. medical graduates overall continued in GME after completing initial specialty training; but there were striking differences between specialties—only 7.5% of trainees who completed initial specialty training in family medicine continued in GME, whereas 60.9% of those who completed initial specialty training in IM did so. (57) Further research is warranted to examine the relationship between subspecialty training and receipt of federal research grants.…”

Patterns of Change in ACGME-Accredited Residency Programs and Positions: Implication for the Adequacy of GME Positions and Supply of Physicians in the United States

“…These results are consistent with recent findings for obstetric graduates, as well as in the ACGME research that tracked residents in multiple specialties and programs. 8,9 Additional information from the Databook (not shown) suggests that the modest increase in the number of residents entering the pipeline is due to 2 factors: (1) some growth in primary care programs, primarily in 2012, resulting from the Health Resources and Services Administration's Teaching Health Center Graduate Medical Education funding program; 10 and (2) Number of Residents Entering Pipeline and Continuing GME Programs, by Academic Year Abbreviation: GME, graduate medical education.…”

Descentralización de los escenarios de enseñanza-aprendizaje de los posgrados de Ginecotocología Experiencia de la Clínica Ginecotocológica A

“…A lo largo de estos años de implementación, durante los cuales ya existe más de una generación de posgrados que han logrado su título de ginecotocólogos con formación en el interior del país, creemos que se ha demostrado a partir de las evaluaciones de los posgrados, pero sobre todo del logro del objetivo final que es el título de la especialidad, que la formación es posible en los diferentes CEDA, con dispositivos docentes innovadores. Si bien no es un punto que hayamos evaluado, sabemos que los profesionales médicos entrenados en centros de alta complejidad tienen más experiencia en el cuidado de ciertos casos que en los más prevalentes y simples (10) . Seguramente de acuerdo con las características asistenciales diferentes del CHPR, centro de referencia nacional de gineco-obstetricia, este cambio en la distribución de los escenarios asistenciales de aprendizaje impacte sobre la integralidad del abordaje de la especialidad.…”