Program Director Perspective on the ABFM Core Outcomes

In March 2023, the Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Family Medicine (RCFM) and American Board of Family Medicine (ABFM) jointly proposed 12 core competencies for family medicine residency training.¹ The ABFM subsequently announced in June 2023 that it will require family medicine program directors to sequentially attest their graduating residents are competent in 15 outcomes that are based on the 12 core competencies.² Both the RCFM and the ABFM engaged in dialogue with the community of family medicine program directors (PDs) to inform their defined competencies, outcomes, and schedule of attestations.^1,2 Defined outcomes help us as PDs develop a culture of assessment for residents (individual assessment) and also programs (programmatic assessment).³

The first 5 core outcomes in June 2024 to which we must attest a graduating resident are competent center continuity care, acute care, care of infants and children, communication, and professionalism.² To feel confident in their attestation, we can engage with our clinical competency committees (CCCs) to optimize assessment of individual residents within our programs. CCCs can identify the methods and areas in which they currently assess residents then align them to ACGME Milestones 2.0 for use during CCC reviews and to ABFM core outcomes. We can evaluate the list for gaps and create (or ask the CCC or faculty to create) assessments that align with core outcomes that are not currently being assessed well. In many cases, we can use existing resources (Table 1).^4,5,6

While attesting to outcomes requires us to focus on an individual resident, it also affords the opportunity to review our program, curriculum, and structure to ensure that we are providing residents with opportunities to reach their goals. The program evaluation committee (PEC) can review milestone data and outcomes in aggregate in order to craft changes to our programs that will assure residents can be successful.

We now have a more granular call out in the form of the outcomes to guide our program development. As PDs, we are required to provide oversight and professional development for our faculty and residents to understand the importance of these specifics, and we will need to inform our designated institutional officials and health systems of our needs to ensure our residents can be successful. The work done by STFM on the linkage of core outcomes to competencies and milestones gives us an initial start and we will need to set aside the time to understand where we are now and where we need to adapt.

On behalf of family medicine programs and faculty nationally, the RCFM and ABFM publicly committed to patients and communities that, upon completion of ACGME-accredited training, family medicine residents would be competent in defined outcomes.¹ In June 2024, PDs will attest to 5 core outcomes for each graduating resident, increasing to 10 core outcomes for each graduating resident in June 2025, and 15 core outcomes for each graduating resident in June 2026.² PDs can leverage their CCCs and PECs to ensure they have comprehensive data to support their public attestation of graduating residents’ competency.

• © 2024 Annals of Family Medicine, Inc.