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Tectonic Shifts Are Needed in Graduate Medical Education to Ensure Today’s Trainees Are Prepared to Practice as Tomorrow’s Physicians

Phillips, Robert L. Jr MD, MSPH; Bitton, Asaf MD, MPH

doi: 10.1097/ACM.0000000000000477
Responses to the 2014 Question of the Year

Dr. Phillips is vice president for research and policy, American Board of Family Medicine, Lexington, Kentucky. He is also professor of family medicine, Georgetown University School of Medicine, Washington, DC, and clinical professor of family and population health, Virginia Commonwealth University School of Medicine, Richmond, Virginia.

Dr. Bitton is assistant professor of medicine, Division of General Medicine, Brigham and Women’s Hospital, and assistant professor of health care policy, Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

Other disclosures: Dr. Phillips has received funding from the Josiah Macy Jr. Foundation to support research on graduate medical education outcomes and accountability; he has also received support from Title VII funding (Health Resources and Services Administration). In addition, he has received funding from the Commonwealth Fund (for patient-centered medical home/Medicaid evaluation), the U.S. Agency for Healthcare Research and Quality (quality/safety research and electronic health record–related research), and the Fulbright Scholar Program as a Specialist to the Netherlands. Dr. Bitton is a core faculty member of the Harvard Medical School Center for Primary Care, and associate program director at Ariadne Labs, a joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard School of Public Health. Dr. Bitton has received funding for work on primary care redesign, team-based care, and patient-centered medical home research from the Commonwealth Fund, the Controlled Risk Insurance Company Risk Management Foundation, the Center for Integration of Medicine and Innovative Technology, the National Institute for Health Care Management Foundation, the National Cancer Institute, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and the Gates Foundation.

Dr. Phillips is an advisor to a Macy Foundation-supported study on GME outcomes, and he is a former vice chair of the Council on Graduate Medical Education. Dr. Bitton serves on the Practice Assessment Committee of the American Board of Internal Medicine and is a member of the Executive Council of the Association of Chiefs and Leaders in General Internal Medicine. He also serves as a senior advisor to the Comprehensive Primary Care Initiative at the Center for Medicare and Medicaid Innovation (CMMI).

Ethical approval: Reported as not applicable.

Disclaimer: The ideas expressed in this article are solely those of the authors and do not represent official positions of CMMI or any other organization for which they work or advise.

Correspondence should be addressed to Dr. Phillips, American Board of Family Medicine, 1133 Connecticut Ave. NW, Suite 1100, Washington, DC 20036; telephone: (859) 269-5626 ext. 1253; e-mail:

© 2014 by the Association of American Medical Colleges