Resident and fellow training programs implement new system

Possibly the biggest change in medical education in more than 100 years, the Next Accreditation System will totally change how resident physicians and fellows are trained.

NAS goes into effect across the country in July with seven specialties - internal medicine, pediatrics, emergency medicine, neurosurgery, radiology, urology and orthopaedic surgery - being the first to implement the system.

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By July 2014, all 23 medical specialties and their fellowships will have to implement the NAS. Learn more NAS.
By July 2014, all 23 medical specialties and their fellowships will have to implement the NAS.

"This is a well overdue paradigm shift," said Kelly Caverzagie, M.D., assistant professor, internal medicine. Dr. Caverzagie is a member of UNMC's Graduate Medical Education Committee, which is working closely with the UNMC Center for Continuing Education to implement the system.

"This marks one of the most significant changes in medical education since the Flexner Report came out in 1910," said Michael Wadman, M.D., associate professor and vice chairman of emergency medicine and assistant dean for graduate medical education.

With NAS, residents will be evaluated to see if they have achieved important educational outcomes called Milestones over the course of their training. The outcomes will continue to be categorized by six different general competencies:

  • Patient care;
  • Medical knowledge;
  • Interpersonal and communication skills;
  • Professionalism;
  • Practice-based learning and improvement; and
  • System-based practice.

"Right now, our system for evaluating residents is heavily weighted towards process and structure," Dr. Wadman said. "It's based on a resident accomplishing or completing certain tasks."

Dr. Caverzagie said the new system will take away the subjectivity of evaluating residents. "It will define the outcomes that we expect our residents to accomplish," he said.

Each residency program will provide semiannual reports to the Accreditation Council for Graduate Medical Education on the progress of their residents.

In addition, every 18 months, a Clinical Learning Environment Review will be conducted by the ACGME. The CLER visit will determine if residents are working in a positive and healthy learning environment and will help ensure quality improvement and patient safety.

Most residencies last from three to five years, but some last as long as seven years. UNMC has approximately 495 house officers in 42 programs.

Read more information on NAS.


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Register now for Feb. 18 NAS overview

To help College of Medicine faculty better understand this dramatic shift, the Graduate Medical Education Office and the Center for Continuing Education are collaborating on faculty development programs.

The first will be held at noon on Feb. 18 in the Durham Research Center Auditorium and is intended as a general overview of competency-based education and the basics of NAS. Register here.

The second will be an afternoon workshop on March 25 for faculty in the seven specialties who will transition to NAS in July. More information on that program will be forthcoming.