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In June 2024, we propose that program directors and CCCs will attest that each graduating resident is competent to: Practice as personal physicians, providing first contact, comprehensive and continuity care, to include excellent doctor-patient relationships, excellent care of chronic disease and routine preventive care and effective practice management
Diagnose and manage acute illness and injury for people of all ages in the emergency department or hospital
Provide comprehensive care of children, including diagnosis and management of the acutely ill child and routine preventive care
Develop effective communication and constructive relationships with patients, clinical teams, and consultants
Model professionalism and be trustworthy for patients, peers, and communities
We will monitor progress and see further input, but for June 2025, we would extend attestation of assessment of competency by program directors and CCCs for each graduating resident to include competence in: Practice as personal physicians, to include care of women, the elderly, and patients at the end of life, with excellent rate of continuity and appropriate referrals
Provide care for low-risk patients who are pregnant, to include management of early pregnancy, medical problems during pregnancy, prenatal care, postpartum care and breastfeeding, with or without competence in labor and delivery
Diagnose and manage common mental health problems in people of all ages
Perform the procedures most frequently needed by patients in continuity and hospital practices
Model lifelong learning and engage in self reflection
In June 2026, with continuing monitoring of progress, we would extend attestation by the program directors and CCCs to include the following competencies for each graduating resident Practice as personal physicians, to include musculoskeletal health, appropriate medication use and coordination of care by helping patients navigate a complex health system
Provide preventive care that improves wellness, modifies risk factors for illness and injury, and detects illness in early, treatable, stages for people of all ages while supporting patients’ values and preferences
Assess priorities of care for individual patients across the continuum of care—in-office visits, emergency, hospital, and other settings, balancing the preferences of patients and medical priorities
Evaluate, diagnose, and manage patients with undifferentiated symptoms, chronic medical conditions, and multiple comorbidities
Effectively lead, manage, and participate in teams that provide care and improve outcomes for the diverse populations and communities they serve
ABFM = American Board of Family Medicine; CCC = Clinical Competency Committees.
Core Outcome Example Assessments Practice as personal physicians, providing first contact, comprehensive and continuity care, to include excellent doctor-patient relationships, excellent care of chronic disease, routine preventive care and effective practice management Feedback to residents on quality of care or preventive care
Efficiency of patient care assessments such as timeliness of seeing patients, completion of charting, and coding
Preceptor and behavioral health faculty assessments of effectiveness of doctor-patient relationship
◦ End of clinic shift cards
◦ Clinic field notes
Diagnose and manage acute illness and injury for people of all ages in the emergency department or hospital End of inpatient hospital rotation evaluation that includes:
◦ Efficiency and thoroughness of initial assessment and floor management
◦ Managing discharges and other transitions of care
◦ Effective collaboration with teammates, nurses, and other professionals
◦ Trustworthiness with team members and consultants
Use of multi-source feedback of all members of hospital teams
Provide comprehensive care of children, including diagnosis and management of the acutely ill child and routine preventive care Existing rotational assessments of pediatric inpatient, emergency department, and outpatient rotations that include:
◦ Recognition and management of emergencies
◦ Key procedures and communication with patients, families, and other professionals on the team
Precepting assessments in continuity clinic
Develop effective communication and constructive relationships with patients, clinical teams, and consultants Likely included in all rotational assessments
◦ Ideally develop way for CCC to monitor across rotations and settings so can request additional assessments as necessary
Assessments from special curricula in behavioral health
Model professionalism and be trustworthy for patients, peers, and communities Routine rotation assessments and reviews by faculty advisors or coaches should include a component of professionalism
Recommend asking specifically about trustworthiness from peers, faculty, and rotation leads in all rotation evaluations
CCC = Clinical Competency Committees.
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