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The ACGME introduced milestones in internal medicine, pediatrics, and surgery for assessing progress of residents toward the six identified competencies. [7] Milestones can be evaluated by numerous methods ranging from direct observation of clinical encounters to medical simulation .
This led to institutions framing their curricula around competency frameworks, such as the Accreditation Council for Graduate Medical Education (ACGME) in the USA, which defined core competencies for all medical specialties. [1] However, while CBME provided a structured approach, educators and policymakers noticed some limitations.
The American Board of Medical Specialties (ABMS) is a non-profit organization established in 1933 which represents 24 broad areas of specialty medicine.ABMS is the largest and most widely recognized physician-led specialty certification organization in the United States. [1]
That year, the Accreditation Council for Graduate Medical Education also included systems-based practice as one of its six core competency domains. [11] In 2001, the Health Resources and Services Administration funded an 18-medical-school consortium to launch several pilots related to systems-based education. [12]
The initial curriculum outline was presented in 2008 via the SCORE web portal and focused on the competencies of patient care and medical knowledge, however, the site expanded to the six physician competencies. [3] In 2010, the portal became a subscription-only product. By 2012, >95% of general surgery training programs subscribed to SCORE.
The core body of knowledge that defines an area of medical specialization is referred to as the core competencies for that specialty. Core competencies are developed through detailed review of the medical literature combined with review by recognized experts from established medical specialties, experts within the new area of specialization and experts from outside the medical profession.
The Accreditation Council for Graduate Medical Education has established Common Program Requirements and a shared competency framework [31] for all accredited residencies, although each specialty defines its own learning objectives and required experiences. Programs range from 3 years after medical school for internal medicine and pediatrics ...
The MOC program structure strives to address these concerns with a sound theoretical rationale via the six ACGME competencies framework and a respectable body of scientific evidence, and to address its relationship to patient outcomes, physician performance, validity of the assessment or educational methods utilized and learning or improvement ...