QuAlIty MAtterS OHSU Part of National Effort to Create “Residency-Ready” M.D. Graduates By Jennifer Smith, OHSu School of Medicine think bAck tO when you began your residency training. How competent did you feel? Could you enter and discuss medication orders, for example? Prioritize differential diagnoses? A growing body of literature shows a performance gap in the transition from medical school to residency training. Combine this with feedback from residency program directors about the clinical preparedness of entering residents, and U.S. medical schools are faced with a challenge: Produce M.D. graduates who are residency-ready—on day one of their training. The OHSU School of Medicine is part of a national pilot to create a solution. Along with nine other schools nationwide chosen by the Association of American Medical Colleges (AAMC), OHSU will test the implementation of Core Entrustable Professional Activities (EPAs) for Entering Residency. “The EPAs pilot is very much aligned with OHSU’s M.D. curriculum transformation,” said George Mejicano, M.D., senior associate dean for education, OHSU School of Medicine. “Medical schools have a responsibility to produce graduates who are not only caring and confident, but competent in specific tasks which are expected of a novice physician. From this solid foundation, they can progress more readily along the trajectory toward mastering skills.” The EPAs are a clear, concise list of 13 activities which graduating medical students should be able to do without OHSU School of Medicine is part of a national pilot to help create "residency-ready" M.D. students. direct supervision on the first day of residency, such as gathering a patient history, collaborating as a member of an interprofessional team and recommending tests. OHSU’s cohorts in the pilot are Columbia University College of Physicians and Surgeons, Florida International University, Michigan State University, New York University, University of Illinois College of Medicine, University of Texas Health Sciences Center at Houston, Vanderbilt, Virginia Commonwealth University and Yale University. According to the AAMC, about 70 medical schools—or half of the U.S. LCME-accredited schools—applied to join. Graduate medical education programs across the country are similarly adapting to a system in which learners are assessed through competency-based outcomes. The ACGME’s Next Accreditation System includes a set of such outcomes—called milestones—for each specialty. Milestones do not specify how residency programs should assess a trainee’s performance; the EPA model is being adopted in a number of specialties as a mechanism for building such a framework. At the end of the AAMC pilot, each of the participating schools will have an assessment model in place for the Core EPAs. The AAMC hopes to have all its member medical schools incorporate the Core EPAs into their graduation requirements in 10 years. OHSU’s work will directly inform this nationwide effort to develop standard EPAs for graduating medical students. 20 Medicine in Oregon www.TheOMA.org
OMA Spring 2015 Magazine
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