At first glance, the data surrounding the physician education journey can appear to be discouraging.
And the challenges do not stop there, physicians also face difficulties in their careers.
Despite the challenges, many individuals continue to pursue their goal of becoming a physician. In total, 48,156 applicants applied for the Main Residency Match in 2023. Our medical education institutions can provide a supportive undergraduate learning environment and a clear transition to graduate medical education, helping future physicians to create a thriving educational pathway that can meet the needs of our healthcare system. By working hand in hand, medical students and almost 200 medical education institutions in the USA can pave the way for a successful and fulfilling career in medicine.
The transition from undergraduate medical education (UME) to graduate medical education (GME) can be challenging. Many medical students graduating yet report they feel underprepared for postgraduate training. While competency-based medical education (CBME) provides a framework for describing learner progression throughout training, specific approaches to CBME implementation vary widely across educational settings. Alignment between various methods used across the continuum is critical to support transitions and assess learner performance.
An Updated Competency Framework
The Association of American Medical Colleges (AAMC), the America Association of Colleges of Osteopathic Medicine (AACOM), and the Accreditation Council for Graduate Medical Education (ACGME) are co-sponsoring an initiative to create a common set of foundational competencies for UME programs in the United States. Their approach is aligned with the recommendations of the Undergraduate Medical Education-Graduate Medical Education Review Committee (UGRC) report. Initiated in September 2021, this project aims to offer new foundational competencies by January 2024 and beyond. To maintain consistency, this group has committed to utilizing the six core competency framework, or Competency-Based Medical Education (CBME). Existing sets of competencies, such as Entrustable Professional (EPAs) and the AAMC Physician Competency Reference Set (PCRS), will be built upon and future competencies will be informed by the substantial work that has been done. By focusing on observable skills, values, and attitudes that can be assessed, it may be the case that EPAs will be refined or new EPAs will be developed. These governing bodies recognize that there had been a need to examine and update competencies, not only to better transition students to residency but to enhance patient outcomes.
New Competencies Are Needed
One competency that has received greater attention in the post-pandemic landscape is Interpersonal and Communication Skills. Due to the pandemic, changes in the delivery of medical education created a small group of physicians who missed out on the same training as their peers. Improving the approach to clinician behavior can foster greater patient trust, better outcomes, and overall improved patient quality of life. Incorporating patient care, communication, and wellness into both student and resident programs of study is critical. To ensure that future physicians are well equipped with essential skills, it is important to prioritize getting students back to the bedside, learning simple strategies to deliver difficult news to patients, recentering patient values in the treatment process, active listening, rapport building, and conversational skills. Programs should provide appropriate time for trainees to engage in these interactions with patients.
Engaging Students in Patient Care
Furthermore, we need to innovate new ways to spark interest and promote active participation in enhancing Patient Care during and after medical education. In response, the American Medical Association (AMA) launched the Reimagining Residency initiative in June 2019, aiming to transform the physician pipeline for a better experience for trainees and patients. So far, 11 projects have been chosen for funding, and 37 medical education institutions have joined hands to revolutionize medical education across the continuum. One of the notable projects involves improving the Undergraduate Medical Education (UME) to Graduate Medical Education (GME) transition. Their goal is to ensure that the right resident is in the right program and is ready to start their residency on day one.
Managing Match Day Panic
The UME to GME transition is a critical part of a future physician’s journey. One of the biggest events during this transition is Match Day. However, the months, weeks, and days leading up to this single moment are often filled with anxiety and panic. Many M.D. and D.O. applicants fear that they might not match in their desired competitive specialties or match at all. As a result, are driven to overapply, which is expensive, burdensome to programs, and doesn’t improve their match outcomes. To address Application Fever, there are a few potential solutions including information strategies from institutions, application limits, and marketplace incentives. One of the AMA Reimagining Residency projects utilized a robust coaching model leading up to Match Day and included a “warm handoff” for interns into their residency programs, while another program created an alignment index that allowed applicants to self-assess and receive a list of specialties most related to their characteristics and experiences. Greater adoption of a holistic approach with several solutions could relieve the fear and panic surrounding Match Day for future physicians.
Positive Change for a Thriving Physician Pipeline
So despite the challenges surrounding physician education and training, individuals continue to pursue careers in medicine, and medical education institutions can provide a supportive environment to improve outcomes for medical students and patients. MedHub remains committed to helping institutions and programs lead the way in creating positive change and a sustainable, thriving physician pipeline. Connect with our UME and GME Consultants to learn the ways in which we can support your team and organization with innovative solutions.