美国的医学教育过去与未来幻灯片.pptVIP

All residency programs conform to the specification of the ACGME This conformation is not mandatory for the existence of the residency; however residencies that are not ACGME-approved do no receive funding from the Federal Government for educating the residents via Medicare Parts A B U.S. RESIDENCY PROGRAMS ACGME Accreditation Council for Graduate Medical Education (ACGME) The governing body of medical education 7,800 U.S. Residency programs in 118 specialties and subspecialties 24 member boards of the American Board of Medical Specialties (ABMS) 26 specialty-specific Residency Review Committee’s (RRCs) ACGME Established in 1981 out of a consensus need in the medical community for an independent accrediting organization for graduate medical education programs Its forerunner was the Liason Committee for Graduate Medical Education ACGME ACCREDITATION A voluntary process Residency programs must be ACGME-accredited in order to receive graduate medical education funds from the federal Center for Medicare and Medicaid Services Residents must graduate from ACGME-accredited programs to be eligible to take their board certification examinations. Many states require completion of an ACGME-accredited residency program for physician licensure DUTY HOURS In the past, the long hours worked by medical residents were described as “a necessary component of resident education and a public symbol of a profession that requires hard work and dedication.” Philbert I, et al. JAMA 2002;288:1112-1114 THE 80 HOUR WORK WEEK During the 1990’s, concerns from the community began to arise regarding the overworking of residents It was during this time that reform in residency work hours began to arise THE 80 HOUR WORK WEEK The new standards became effective on in July 2003 Required at least 10 hour rest period between duty periods Continuous duty limited to 24 hours An added period of up to 6 hours for continuity and transfer of care and didactic activities Landrigan CP, Rothschild JM, Cronin