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Academia and the Profession |

Competency-Based Education and Training in Internal Medicine

Steven E. Weinberger, MD; Anne G. Pereira, MD, MPH; William F. Iobst, MD; Alex J. Mechaber, MD; Michael S. Bronze, MD, the Alliance for Academic Internal Medicine Education Redesign Task Force II
[+] Article and Author Information

For members of the Alliance for Academic Internal Medicine Education Redesign Task Force II, see the Appendix.


From the American College of Physicians and American Board of Internal Medicine, Philadelphia, Pennsylvania; Hennepin County Medical Center, Minneapolis, Minnesota; University of Miami Miller School of Medicine, Miami, Florida; and University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.


Acknowledgment: The authors thank Mr. Charles Clayton and Dr. Lee Berkowitz for their leadership of the Alliance for Academic Internal Medicine Education Redesign Task Force II and their support and assistance with the work of the Competency Subcommittee.

Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1728.

Corresponding Author: Steven E. Weinberger, MD, American College of Physicians, 190 North Independence Mall West, Philadelphia, PA 19106; e-mail, sweinberger@acponline.org.

Current Author Addresses: Dr. Weinberger: American College of Physicians, 190 North Independence Mall West, Philadelphia, PA 19106.

Dr. Pereira: Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415.

Dr. Iobst: American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106.

Dr. Mechaber: University of Miami Miller School of Medicine, PO Box 016960 (R-129), Miami, FL 33101.

Dr. Bronze: Department of Medicine, University of Oklahoma Health Sciences Center, PO Box 26901, WP1140, Oklahoma City, OK 73190.

Author Contributions: Conception and design: S.E. Weinberger, A.G. Pereira, W.F. Iobst, A.J. Mechaber, M.S. Bronze.

Drafting of the article: S.E. Weinberger, A.G. Pereira, W.F. Iobst, M.S. Bronze.

Critical revision of the article for important intellectual content: S.E. Weinberger, A.G. Pereira, W.F. Iobst, A.J. Mechaber, M.S. Bronze.

Final approval of the article: S.E. Weinberger, A.G. Pereira, W.F. Iobst, A.J. Mechaber, M.S. Bronze.

Collection and assembly of data: A.G. Pereira, W.F. Iobst, M.S. Bronze.


Ann Intern Med. 2010;153(11):751-756. doi:10.7326/0003-4819-153-11-201012070-00009
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Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program.

Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

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