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Medical Specialty Boards Can Help Measure Graduate Medical Education Outcomes

Peterson, Lars E. MD, PhD; Carek, Peter MD; Holmboe, Eric S. MD; Puffer, James C. MD; Warm, Eric J. MD; Phillips, Robert L. MD, MSPH

doi: 10.1097/ACM.0000000000000250

U.S. graduate medical education (GME) training institutions are under increasing scrutiny to measure program outcomes as a demonstration of accountability for the sizeable funding they receive from the federal government. The Accreditation Council for Graduate Medical Education (ACGME) is a potential agent of measuring GME accountability but has no interaction with physicians after residency training is completed. American Board of Medical Specialty (ABMS) member boards interact with physicians throughout their careers through maintenance of certification (MOC) and are a potential source of valuable data on physician competency and quality of care, both of which could be used to measure GME accountability.

The authors propose that ABMS boards and the ACGME deepen their existing relationship to better assess residency training outcomes. ABMS boards have a wealth of data on physicians collected as a by-product of MOC and business operations. Further, many ABMS boards collect practice demographics and scope-of-practice information through MOC enrollment surveys or recertification examination questionnaires. These data are potentially valuable in helping residencies know what their graduates are doing in practice. Part 4 of MOC generally involves assessment of the quality of care delivered in practice, and ABMS boards could share these deidentified data with the ACGME and residency programs to provide direct feedback on the practice outcomes of graduates.

ABMS member boards and the ACGME should broaden their long-standing relationship to further develop shared roles and data-sharing mechanisms to better inform residencies and the public about GME training outcomes.

Dr. Peterson is research director, American Board of Family Medicine, and assistant professor of family and community medicine, University of Kentucky, Lexington, Kentucky.

Dr. Carek is professor and chair, Department of Family Medicine, University of Florida, Gainesville, Florida.

Dr. Holmboe is senior vice president for Milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. At the time this Commentary was written, he was chief medical officer, American Board of Internal Medicine, Philadelphia, Pennsylvania.

Dr. Puffer is president and chief executive officer, American Board of Family Medicine, Lexington, Kentucky.

Dr. Warm is professor, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio.

Dr. Phillips is vice president of research and policy, American Board of Family Medicine, Lexington, Kentucky.

Funding/Support: No external sources of funding.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Disclaimers: The views expressed represent the personal opinions of the authors and are not necessarily the views or policies of their respective institutions.

Correspondence should be addressed to Dr. Peterson, American Board of Family Medicine, 1648 McGrathiana Pkwy., Suite 550, Lexington, KY 40511-1247; telephone: (859) 269-5626; fax: (859) 335-7509; e-mail:

© 2014 by the Association of American Medical Colleges