Improve GME

3 innovative proposals earn funding to change residency training

Brendan Murphy , Senior News Writer

Projects aiming to better prepare residents for entry to practice, address health inequities and improve residency selection through preference signaling will move forward with funding from the AMA.

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The three proposals each will earn $20,000 in funding as winners of the AMA GME Innovation Challenge after being selected as the top project proposals from a group of 25 at the recent AMA GME Innovations Summit.



A “Shark Tank”-style competition, the GME Innovation Challenge received more than 125 submissions, 25 of which were presented at the virtual meeting this month. Five finalists advanced to a Q&A session with leaders in residency education on the event’s final day, with the three winning proposals being announced at the conference’s conclusion.

“The ideas that were selected reflect the interest people have in addressing those specific areas of graduate medical education—competency-based medical education and preparation for independent practice, health equity and understanding the communities we serve, addressing an increase in applications to residency programs and the anxiety that applicants may feel because of it,” said John Andrews, MD, the AMA’s vice president for GME innovations.

A project proposal submitted by Anita Blanchard, MD, professor of obstetrics and gynecology and associate dean for graduate medical education at the University of Chicago, aims to address heath inequities in the community surrounding the health system.

People who live in the South Side neighborhood surrounding the University of Chicago have life expectancies of up to 20 years fewer than residents in other areas of the city. Dr. Blanchard proposed a plan that would foster resident physician connections with the surrounding community while integrating community needs assessment into the GME curriculum.

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The proposal calls for all first-year residents to learn foundational skills in implicit bias, cultural humility and community awareness. Advanced residents will serve as community champion liaisons to foster meaningful, sustainable partnerships between their GME programs and UChicago Urban Heath Initiative, an organization that fosters robust urban revitalization efforts.

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Residency applications are on the rise, complicating matters for residency programs and the medical students applying. A proposal submitted by Jesse Burk-Rafel, MD, an assistant professor of medicine at New York University Grossman School of Medicine, calls for moving to a system that allows applicants to convey the seriousness of their interest to select number of residency programs.

Applicants would get a limited number of “roses”—a nod to a famed dating show—to give to programs at the time of submitting their residency application to signal their genuine interest in that program. “Roses” would be limited to a small number, perhaps five, and programs would know by receiving a rose that the applicant had used a scarce resource to indicate their sincere enthusiasm.

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A proposal submitted by Rebecca Jaffe, MD, an associate professor in the hospital medicine division at Thomas Jefferson University, looks to add a “pre-attendingship” to the end of residency training.

The proposal would allow graduating residents a final opportunity to integrate knowledge across competencies, encounter attending-level health systems science challenges in a controlled environment, and demonstrate readiness for practice before graduation.

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The initiative calls for pre-attendings to go through many of the tasks in their future, such as scheduling room coverage; maximizing safety, quality and productivity; billing for services; and interacting with collaborating health professionals. Supervision would occur at the “oversight” level, including weekly meetings with faculty to incorporate feedback, review performance metrics, and set goals for self-directed learning.

With more than 100 presentations over three days, the GME Innovations Summit was an extension of the AMA’s ongoing work to reshape GME. The AMA Reimagining Residency initiative has awarded more than $15 million in grants to institutions that will transform residency training to meet the workforce needs of America’s current and future health care system.

Learn about the eight other transformative residency-training projects awarded AMA grants.