Ten medical schools are testing new residency preparation guidelines from the Association for American Medical Colleges (AAMC) as part of a five-year pilot program to improve the transition from medical school.
In June, AAMC released the Core Entrustable Professional Activities for Entering Residency in an effort to eliminate the gap between residency directors' expectations and students' abilities. It identifies 13 activities that new residents should be able to do on their first day:
- Take a patient's history and perform a physical exam;
- Prioritize a differential diagnosis;
- Recommend and understand common screening and diagnostic tests;
- Enter orders and prescriptions;
- Document patient encounters in the patient's record;
- Provide an oral account of a patient encounter;
- Ask clinical questions and seek evidence to improve patient care;
- Complete a patient handover;
- Participate as a member of a care team;
- Recognize a person requiring urgent care;
- Obtain informed consent;
- Perform general procedures; and
- Contribute to a culture of safety and improvement.
The 10-college cohort—which includes the University of Illinois College of Medicine and the School of Medicine at New York University—will meet for the first time this month. Many of the schools are still developing curriculum, but some are already working on preparing students more thoroughly.
At the College of Human Medicine at Michigan State University (MSU), students already do a lot of simulation work, such as turning over patients to another physician once their shift ends. "We're developing standardized ways to communicate what needs to be understood about those patients for the doctors who's taking over," says Dianne Wagner, MSU's associate dean for college wide assessment.
At Vanderbilt University's School of Medicine, students now are working with a coach to track and improve their strengths and weaknesses via skills assessments. They also begin hospital clerkships during their second year, instead of waiting until the third (Smith-Barrow, U.S. News & World Report, 10/6).