The transition from undergraduate medical education (UME) to graduate medical education (GME) is fraught with challenges, not the least of which is that it is a discontinuous time of professional development.
The Coalition for Physician Accountability is a group of U.S. organizations—including the AMA—that are concerned with the oversight, education and assessment of medical students and physicians throughout their medical careers. The coalition assembled the UME-GME Review Committee (UGRC) and in 2021, the committee issued 34 recommendations to improve the UME to GME transition, but not enough progress has been made to implement them.
An AMA webinar recently featured an overview of the committee’s recommendations and focused on these two:
- Supporting targeted coaching of resident physicians.
- Helping learners develop individualized learning plans for the start of residency.
A CME module drawing on the webinar, “Addressing Challenges in the Transition From Medical School to Residency: Taking Action on the UGRC Recommendations,” is designated by the AMA for a maximum of 1 AMA PRA Category 1 Credit™.
The module is part of the AMA Ed Hub™, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources, all in one place—with activities relevant to you, automated credit tracking, and reporting for some states and specialty boards.
Learn more about AMA CME accreditation.
Earlier this year, the AMA convened more than 45 experts from across the medical education continuum to discuss the UGRC recommendations and contemplate practical next steps.
The group was asked which of the recommendations—organized into nine themes, including collaboration and continuous quality improvement, outcome framework and assessment processes, and health and wellness—could take effect the most quickly in the context of precision education.
The group landed on these two.
Recommendation No. 27: “Targeted coaching by qualified educators should begin in UME and continue during GME, focused on professional identity formation and moving from a performance to a growth mindset for effective lifelong learning as a physician. ... Educators should be astute to the needs of the learner and be equipped to provide assistance to all backgrounds.”
Recommendation No. 30: “Meaningful assessment data based on performance after the MSPE [medical school performance evaluation] must be collected and collated for each graduate, reflected on by the learner with an educator or coach, and utilized in the development of a specialty-specific, individualized learning plan to be presented to the residency program to serve as a baseline at the start of residency training.”
Learners are often asked to do conflicting things during their medical education, noted Benjamin Kinnear, MD, associate professor of combined internal medicine and pediatrics at the University of Cincinnati College of Medicine.
These competing priorities can include:
- Taking time for reflection and metacognition despite being overworked and underpaid.
- Being vulnerable in the clinical learning environment despite constantly being assessed.
- Remaining resilient despite being constantly getting hit with moral injury.
“We need coaching because we're human,” Dr. Kinnear said. He also touched on what coaching should address, how coaching can impact clinical outcomes and where to look for help in creating a coaching program.
Learn more with the AMA about academic coaching in medical education.
Individualized learning plans are “part of an ideal educational handover from medical school to residency,” said Amber Pincavage, MD, associate professor of medicine and co-director of the third-year medicine clerkship at the University of Chicago Pritzker School of Medicine.
The reason this recommendation is so important is that it can be tied back to the mission of medicine, Dr. Pincavage noted.
“This could improve patient safety. It could lower mistrust during the transition between UME and GME. It could promote collaboration in education,” she said. It can also “increase engagement of learners in the process and help them build skills for lifelong learning and a growth mindset.”
But what resources are required to create individualized learning plans? Coaching, again, is one.
“Also technology—having a shared mental model of what competencies we are looking for,” Dr. Pincavage said. A third is even more straightforward: simply getting medical students to “start thinking about what they need for the transition.”
The AMA’s Facilitating Effective Transitions Along the Medical Education Continuum handbook looks at the needs of learners across the continuum of medical education—from the beginning of medical school through the final stage of residency. Download the handbook now.