| Commentary: training internists for practice focused on meeting patient needs. | |
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MedLine Citation:
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PMID: 18820515 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The author describes the evolution of practice within the broad specialty of internal medicine. This evolution is driven by scientific discovery, emergent patient needs, and market forces. Four ages describe the evolution: the age of the Oslerian diagnostic consultant, the age of the subspecialist, the age of the primary care internist, and the emerging age of focused general internal medicine practice. The author suggests that competence in practice-based learning and improvement linked with evaluation of practice performance throughout a career permits the professions to abandon the notion that valid learning for medical practice occurs only by completing a designated number of months of residency or fellowship training. By applying competency-based standards for specialty certification and maintaining its validity for current practice, boards can provide trainees and practitioners a tool for professional accountability for initial and continuous professional competence. The lifelong learning and evaluation process permits the timely recognition of proficiency acquired in practice. This process engages internists in ongoing guided reflection on measures of performance and provides evidence that they have incorporated new knowledge, technology, skills, and attitudes that align their practice with patient needs. As dialogue with internal medicine stakeholders and customers continues, the author describes how the training standards for certification might adapt to the evolving demands for the specialty practice and how the evaluation of continuous professional development through the maintenance of certification provides an instrument for identifying and recognizing proficiency in providing focused care within the broad discipline of internal medicine. |
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Authors:
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F Daniel Duffy |
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Publication Detail:
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Type: Comment; Journal Article |
Journal Detail:
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Title: Academic medicine : journal of the Association of American Medical Colleges Volume: 83 ISSN: 1938-808X ISO Abbreviation: Acad Med Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-09-29 Completed Date: 2008-10-24 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 8904605 Medline TA: Acad Med Country: United States |
Other Details:
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Languages: eng Pagination: 893-6 Citation Subset: AIM; IM |
Affiliation:
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University of Oklahoma College of Medicine's School of Community Medicine, Oklahoma City, Oklahoma, USA. dduffy@abim.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Attitude of Health Personnel Clinical Competence Education, Medical, Graduate Female Health Services Needs and Demand / organization & administration*, trends Humans Internal Medicine / education*, standards Internship and Residency / standards, trends Male Medicine / standards, trends Needs Assessment Physician's Practice Patterns / organization & administration*, standards, trends Physician's Role* Physician-Patient Relations Problem-Based Learning Specialization United States |
| Comments/Corrections | |
Comment On:
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Acad Med. 2008 Oct;83(10):910-5
[PMID:
18820519
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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