Improve GME

$15 million AMA initiative targets gaps in residency training

In 2013, the AMA set out to reshape medical education from the ground up. Five years later, the Association’s efforts to build the medical schools of the future, which involved working in tandem with the 32 schools in the AMA Accelerating Change in Medical Education Consortium, have made strides toward creating a modernized medical school curriculum.

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Medical training, however, is a continuum. Learning begins in medical school then extends throughout a physician’s career. In an effort to expand the scope of its medical education goals, the AMA this week announced a new program aimed at transforming residency.

As it did with its original efforts to alter undergraduate medical education (UME), the AMA is looking to partner with training institutions on a funded, five-year commitment to best address the workforce needs of the current and future health care system.

“Applying what we’ve learned through our successful initiative to create the medical schools of the future, we’re embarking on a new effort to reinvent residency training to ensure our future physicians are able to make a seamless transition into residency and ensure they’re prepared for practice—while supporting their well-being and improving patient safety,” said AMA CEO and Executive Vice President James L. Madara, MD.

“During this unprecedented time of rapid growth and technological change in the U.S. health care system, the AMA is continuing to support significant redesign and innovation in physician training that will help physicians adapt and grow at every stage of their career, and ultimately improve the nation’s health,” Dr. Madara said.

Key areas for improvement

The Reimagining Residency initiative will take shape over the coming year. In January 2019, the AMA will post a request for proposals. Applicants will be solicited in the form of partnerships among U.S. graduate medical education (GME) sponsors, medical schools, health systems and specialty societies. The $15 million grant program will support innovative projects that promote systemic change.

Over the past year, the AMA has worked with health system leaders and stakeholders in residency training to create the GME National Advisory Panel. That group identified key areas that could be improved in GME training, from the time of transition from medical school to residency through residency graduation and entry into practice.

Projects submitted for consideration to be funded as part of the Reimagining Residency initiative should focus on those areas, which include the challenges associated with: 

  • Preparation for the transition to residency from medical school.
  • Development of skills during residency to enhance readiness for practice.
  • Modifying the learning environment to support well-being in training.

In addressing one of those challenges, Jacob Bidwell, MD, who was a member of the AMA’s GME National Advisory Panel, said it is time for medical leaders to turn their attention to ensuring smoother transitions to residency and practice.

“With patients, we transition them out of the hospital and into a nursing home or into clinics. I don’t think we do a very good job of transitioning the care of our students into residency,” said Dr. Bidwell, director of the family medicine residency program at Advocate Aurora Health Care in Milwaukee. He is also the vice president for academic affairs at Aurora.

“What we need to look at is standardizing how we transition the care of students into their residencies across the continuum. Just like we try to do with patients,” Dr. Bidwell said. “We could have protocols where there’s a solid transition in how we care for the students. Here are their special learning needs, here’s how they learn best, here were their deficiencies. We need very honest feedback from the medical schools to understand what a student’s strengths and weaknesses are.”

Building on med school success

Interested parties will be required to submit a letter of intent describing the goals and scope of their proposed project in February. Full proposals will be due in April. Grant recipients will be announced in June 2019.

The GME initiative follows a similar pattern to the initial announcement of the AMA’s Accelerating Change in Medical Education initiative. When that was announced in 2013, 82 percent of the nation's 141 accredited medical schools submitted letters of intent outlining their grant proposals.

Eleven schools were awarded initial grants totaling $11 million—the group expanded to include another 21 medical schools in 2015. To date, the program has impacted more than 19,000 medical students who will one day provide care for more than 33 million patients annually.