Graduate Medical Education
Apply now for graduate med ed volunteer roles
AMA members: Apply now for the opportunity to enhance your professional development and serve in the following medical education-related roles:
- Residency Review Committee for Emergency Medicine
- Residency Review Committee for Orthopaedic Surgery
- American Board of Emergency Medicine
Hurry, the deadline for applications is Oct. 1.
Questions? Contact Evelyn Sherrill.
International graduates face residency crunch
International medical graduates (IMGs) face significant hurdles when attempting to become licensed in the United States, according to a recent article in The New York Times.
The process, which can take up to a decade for those who make it through, typically includes an application to verify medical school transcripts and diplomas as well as an English fluency evaluation. IMGs also need to perform well on the three steps of the United States Medical Licensing Examination and obtain U.S. recommendation letters after volunteering or working in a hospital, clinic or research organization.
After all of these steps are complete, the physician must then face the biggest challenge: winning one of the coveted slots in the medical residency system. This must be done even if the doctor previously completed a residency in a country with an advanced medical system, such as Britain or Japan. The only exception is for physicians who completed their residencies in Canada.
The residency bottleneck has steadily worsened after the number of residency slots was capped by Congress in 1997. Since then, the number of U.S. medical school graduates has increased while the number of residency slots has remained mostly stagnant, resulting in greater competition for the available training positions.
Unfortunately, the president's budget contains steep cuts in graduate medical education (GME) slated for the coming decade. With a looming shortage of physicians, GME financing must be secured and workforce options expanded.
Learn more and lobby Congress to protect GME via the AMA's grassroots advocacy website, SaveGME.org.
Integrating residents, fellows into quality improvement and patient safety efforts
Register now for "A Collaborative Approach to Integrating Residents and Fellows into QI and Patient Safety," an audio conference hosted by the Association for Hospital Medical Education on at 1 p.m. Eastern on Oct. 8.
Presenters include Meghan Walsh, MD, MPH, chief medical education officer, Hennepin County Medical Center; and John S. Andrews, MD, associate dean for graduate medical education, University of Minnesota.
Wanted: Better ambulatory care training
Residency programs need to think creatively about the ambulatory care training experience, writes Harvard Medical School instructor James A. Colbert, MD, in a recent article in the New England Journal of Medicine.
Nationally, internal medicine residents spend more than two-thirds of their training in inpatient settings. Yet after finishing their training, a majority will ultimately practice in ambulatory care settings, where they will face a growing proportion of Americans with chronic disease, Dr. Colbert writes. Therefore, training in ambulatory medicine and chronic disease management for all internal medicine residents is necessary to achieve better primary care.
Redesigning residency training is a huge undertaking, Dr. Colbert admits, but he points to a few locations where doing so has been rewarding for the institution and its patients. For example, a curricular redesign at the University of Cincinnati led to an improved experience for residents in their primary care clinic and much higher levels of patient satisfaction, along with fewer no-shows and improved outcomes in patients with chronic disease.
Colbert also believes that improving the clinic experience for residents could be a boon for primary care recruitment. High-functioning residency clinics could equip both future internists and subspecialists with the necessary tools to treat chronic disease and might even convince more trainees to choose careers in primary care.
News and notes
- Why doesn't medical care get better when doctors rest more? (New Yorker blog)
- Limiting residents' work hours didn't hurt patient safety, but cut time spent with patients, studies say (Modern Healthcare blog)
- Teaching hospital five-year mortality trends in the wake of duty hour reforms (Journal of General Internal Medicine)
- In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns spend their time? (Journal of General Internal Medicine)
AMA resources for residency programs and trainees
- Help your residents master the ACGME general competency requirements.
- Mentor students, residents and fellows via AMA program.
- Learn about the AMA Resident and Fellow Section.
- Learn about the AMA Council on Medical Education.
- Follow the AMA professional ethics Twitter page, and look for the #MedEdAMA hashtag for tweets on the AMA's Twitter page about medical education.