The panel also prioritizes its recommendation to diversify training sites from traditional teaching hospitals to federally qualified and school-based health centers "and to expand content related to professionalism, population medicine, and team-based practice.”
A third key recommendation is for educational institutions to eliminate historic boundaries so that other health provider professions can learn with their physician colleagues. "This will require revising regulations that now prevent supervision across specialties or professions," the group says.
The panel also wants to require a period of "monitored independence" during GME to confirm each physician's readiness for independent practice. "Program directors and teaching faculty express widespread concern that residents are not given sufficient opportunity to act independently within the present teaching environment and are consequently less well prepared for practice," the statement says.
The report lists four trends that make a major shift in medical training necessary:
1. New approaches to physician practice are necessary to meet the needs of an aging population, as the number of people 65 and older will double by 2020. This population will live longer with more chronic, cognitive, and functional issues and will be more racially and culturally diverse.
2. Care continues to move outside the hospital to the home, clinics, and other community settings, and care providers are assuming new roles to meet these needs. The Affordable Care Act's directives will accelerate this trend, giving 32 million more people health coverage. This influx will require trainees to be "prepared to work in different organizations and sites of care, and in teams of health professionals."