Suzanne M. Allen, M.D., M.P.H.
Vice Dean for Academic, Rural and Regional Affairs
University of Washington School of Medicine
Big Sky Faculty Development Conference
March, 2015



Medical education overview
Definitions
Future directions in medical education
AMA + AAMC
ACGME
(27 RC’s)
LCME
Medical School
Premedical
MCAT
AMCAS
AAMC
ACCME
Certification Continuing
+ MOC Medical
Education
Residency
+
Fellowship
USMLE
NBME
ABMS
(24 Boards)
International
Medical
Graduates
Medical
Practice
Licensure
+ MOL
FSMB
NRMP
ECFMG
70 Medical
Boards
Slide from 2010 Presentation at AAMC Annual Meeting by Deborah Powell.

Competent - The ability to do something well,
successfully or efficiently. Merriam-Webster
and Oxford dictionaries

Competencies are the measurable or
observable knowledge, skills, abilities, and
behaviors critical to successful job
performance. Washington State Human
Resources website

Milestones - an important point in the
progress or development of something : a
very important event or advance Merriam-
Webster Dictionary

Milestones - competency-based
developmental outcomes (e.g., knowledge,
skills, attitudes, and performance) that can be
demonstrated progressively by residents and
fellows from the beginning of their education
through graduation to the unsupervised
practice of their specialties ACGME

EPA – Entrustable Professional Activity –
routine professional live activities of
physicians based on their specialty and subspecialty Ten Cate & Scheele
This figure was originally published in Miller GE, The Assessment of
Clinical Skills/Competencies/Performances. Acad Med 1990;Sept;65(9 suppl):S63-S67.
Copyright Wolters Kluwer 1990. Reprinted with permission.

Transitioning away from seat time, in favor
of a structure that creates flexibility, allows
students to progress as they demonstrate
mastery of academic content, regardless of
time, place, or pace of learning. US
Department of Education website
ACGME competencies - introduced to better
define what physicians should know and be able
to do
1. Medical Knowledge
2. Patient Care
3. Professionalism
4. Interpersonal and Communication Skills
5. Practice-based Learning and Improvement
6. Systems-based Practice: system
improvement



ACGME introduced as part of accreditation in
2013/2014
Each specialty and sub-specialty developed
own milestones
http://www.acgme.org/acgmeweb/tabid/43
0/ProgramandInstitutionalAccreditation/Nex
tAccreditationSystem/Milestones.aspx




Entrustable professional activities (EPA)–
essential professional work that defines a
discipline
Pediatrics included EPAs in the milestones
Internal Medicine working on EPAs
Society of Teachers of Family Medicine
working on EPAs for family medicine



LCME requires educational objectives that are
based in outcomes valued by the profession
AAMC has proposed EPAs for undergraduate
medical education – 13 EPAs
https://members.aamc.org/eweb/upload/Cor
e%20EPA%20Curriculum%20Dev%20Guide.pdf



Adopted ACGME competencies
Partnered in development of milestones for
each specialty
Future use of competencies in maintenance
of certification
AMA + AAMC
ACGME
(27 RC’s)
LCME
Medical School
Premedical
MCAT
AMCAS
AAMC
ACCME
Certification Continuing
+ MOC Medical
Education
Residency
+
Fellowship
USMLE
NBME
ABMS
(24 Boards)
International
Medical
Graduates
Medical
Practice
Licensure
+ MOL
FSMB
NRMP
ECFMG
70 Medical
Boards
Slide from 2010 Presentation at AAMC Annual Meeting by Deborah Powell.
Questions?