What Regulatory Requirements and Existing Structures Must Change If Competency-Based, Time-Variable Training Is Introduced Into the Continuum of Medical Education in the United States?

Academic Medicine : Journal of the Association of American Medical Colleges
Jennifer R KoganOlle Ten Cate

Abstract

As competency-based medical education is adopted across the training continuum, discussions regarding time-variable medical education have gained momentum, raising important issues that challenge the current regulatory environment and infrastructure of both undergraduate and graduate medical education in the United States. Implementing time-variable medical training will require recognizing, revising, and potentially reworking the multiple existing structures and regulations both internal and external to medical education that are not currently aligned with this type of system. In this article, the authors explore the impact of university financial structures, hospital infrastructures, national accrediting body standards and regulations, licensure and certification requirements, government funding, and clinical workforce models in the United States that are all intimately tied to discussions about flexible training times in undergraduate and graduate medical education. They also explore the implications of time-variable training to learners' transitions between medical school and residency, residency and fellowship, and ultimately graduate training and independent practice. Recommendations to realign existing structures to supp...Continue Reading

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Citations

Feb 28, 2018·Academic Medicine : Journal of the Association of American Medical Colleges·Catherine R LuceyOlle Ten Cate
Feb 9, 2018·Academic Medicine : Journal of the Association of American Medical Colleges·Bridget C O'Brien
Jun 7, 2019·Academic Medicine : Journal of the Association of American Medical Colleges·Meg G KeeleySally A Santen
Aug 29, 2019·Academic Medicine : Journal of the Association of American Medical Colleges·Olle Ten Cate, Carol Carraccio
Dec 6, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Mary E McBrideLauren R Sorce
Aug 17, 2020·Medical Teacher·Hugh A Stoddard, Erica D Brownfield
Jan 30, 2021·European Journal of Dental Education : Official Journal of the Association for Dental Education in Europe·Elske HissinkNico H J Creugers
Jun 30, 2021·Academic Medicine : Journal of the Association of American Medical Colleges·Jacqueline de GraafOlle Ten Cate

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