PROFESSIONAL ISSUES

IOM considers licensing, medical education reforms

A call to assess clinical skills grates on doctors.

By Myrle Croasdale, AMNews staff. May 5, 2003.

Remember the new patient with the dizzy spells? He was actually an actor sent by the state medical board to evaluate your clinical skills for your relicensing application.

This type of clinical skills assessment could become reality if state legislatures heed the Institute of Medicine's latest report, "Health Professions Education: A Bridge to Quality."

The report calls for a collective effort by all health care disciplines to improve patient safety and health care quality by focusing on a set of core competencies in education.

Edward Hundert, MD, report committee co-chair and president of Case Western Reserve University, Cleveland, Ohio, said the multidisciplinary committee sought to create a vision of patient-centered clinical education.

One of the report's 10 recommendations has raised the ire of some physicians. It calls for state medical boards to evaluate physicians' clinical skills and knowledge of medical advances before renewing a license.

"We're one of the most tightly regulated professions," said John Armstrong, MD, AMA Young Physician Section trustee. "Assessment for competency is very difficult to measure. The clinical skills assessment exam is on the verge of being foisted on medical students."

Patrice Burgess, MD, chair of the AMA Young Physician Section, said young physicians in particular could be hurt by altering licensing or credentialing criteria. "It would be devastating for young physicians to have more hoops to jump through when they're already dealing with reimbursement, prompt payment, debt, medical liability," she said.

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