Chasing Perfection and Catching Excellence in Graduate Medical Education.

Published

Journal Article

The author reflects on the chapter titled "Preserving Excellence in Residency Training and Medical Care" in Dr. Kenneth Ludmerer's book Let Me Heal: The Opportunity to Preserve Excellence in American Medicine. Rather than assuming that the status quo represents excellence, however, the author asserts that we must make an informed judgment regarding the quality of graduate medical education (GME) by applying an evidence-based approach, carefully measuring performance against specific criteria. But what are the right criteria to judge excellence in GME? The author posits that the first criterion for excellence is the foundational concept identified by the Josiah Macy Jr. Foundation, that of accountability to the public. The author argues that for GME to be truly excellent it must produce a workforce "of sufficient size, specialty mix, and skill" needed to serve the public good. For GME to be truly excellent it must produce the right composition (reflecting the population it serves), use the right pedagogy, and be embedded within the right clinical learning environment. Implementation of competency-based education must be bolder and accelerated. The process of culling out service from education in GME must be more honest, not because all service cannot in some ways be educational but because it is simply too expensive to squander a single minute of time in training. Finally, the epidemic of burnout must be addressed urgently and innovatively.

Full Text

Duke Authors

Cited Authors

  • Andolsek, KM

Published Date

  • September 2015

Published In

Volume / Issue

  • 90 / 9

Start / End Page

  • 1191 - 1195

PubMed ID

  • 26177530

Pubmed Central ID

  • 26177530

Electronic International Standard Serial Number (EISSN)

  • 1938-808X

International Standard Serial Number (ISSN)

  • 1040-2446

Digital Object Identifier (DOI)

  • 10.1097/acm.0000000000000844

Language

  • eng