AHCJ pushes for more data on residency programs

Charles Ornstein

About Charles Ornstein

Charles Ornstein is a senior reporter with ProPublica in New York. The Pulitzer Prize-winning writer is a member and past president of the Association of Health Care Journalists' board of directors and a member of its Right to Know Committee.

The Association of Health Care Journalists has called upon the accreditor of physician residency programs to be more transparent with its data so the public can be better informed about the quality of graduate medical education programs in their communities.

In a letter sent last week to the Accreditation Council for Graduate Medical Education, AHCJ praised the group for having a website that includes accreditation decisions for institutions and their individual training programs.

Karl Stark

Karl Stark

But it called on ACGME to publish additional information, echoing a similar call by an Institute of Medicine panel for greater transparency in graduate medical education.

“We believe ACGME can play an even greater leadership role by providing additional information or advocating for its release,” said the letter, signed by AHCJ president Karl Stark. “Doing so would be in keeping with the new Institute of Medicine report, which called for ‘transparency and accountability of GME programs.’”

Specifically, AHCJ asked ACGME to release two sets of information:

  • The reasons why individual programs and institutions have favorable or less-than-favorable accreditation status. This could entail general descriptions, such as, on the positive side, “high pass rates on board exams,” or, on the negative side, “violations of resident work hours” or “inadequate supervision.”
  • The percentage of residents who pass their board exams, as well as the threshold set by each ACGME residency review committee for what constitutes an acceptable program pass rate. (Small residency programs could aggregate the information over more than one year.)

“We understand and respect that the accreditation process is intended chiefly to improve quality, but we also believe that the public – taxpayers who support the program, prospective students, and the institutions’ own patients and staff – can benefit from understanding the strengths and weaknesses of residency programs,” Stark wrote.

The letter was sent to ACGME’s chief executive officer, as well as to three public members of its board of directors.

3 thoughts on “AHCJ pushes for more data on residency programs

  1. Robert Bowman

    The quality of local hospitals, local clinics, local residency programs, local physicians, or local nurse practitioners can certainly be posted and reported, but this may not aid in understanding or in improvements in health.

    In fact, these postings of “outcomes” may result in more harm than good at the current time of such poor awareness and understanding. Even major journals continue to damage rural hospitals and clinics serving the underserved.

    Resident work hour limitations should have been understood as limited for improving quality in teaching hospitals, but we failed to understand this because we fail to understand that health outcomes are about a lifetime of past, present, and future experiences and interactions with minimal impact from health care providers.

    Our “advanced” nation is decades away from understanding that health and health outcomes are mostly about individual patient and local factors. As Deming noted, quality is in the matrix of relationships involving income, local insurance coverage, local access to clinicians, local property value, and a number of social determinant and patient situations that shape outcomes for the individuals receiving care.

    If articles help shut down local programs or facilities associated with presumed “poor quality,” local quality could get worse instead of better. Declines in local access, jobs, economics, income, and social determinants could result. The factors that help determine health outcomes will be sent into decline.

    Major journals may publish studies that still have far too many limitations. Hopefully journalists or ethnographers will do better.

  2. Eileen Beal

    There is increasing acceptance/use of hiring-based NURSE residency programs.

    While they are 180 degrees different from/than medical residencies, they are, in many ways, patterned after them.

    So…my question is: How will this new interest in medical residences (which, as opposed to nursing residencies, doctors must participate in) impact nurse residencies…or will it?

    Eileen Beal, Cle, OH

  3. Pingback: AHCJ disappointed with ACGME’s response on transparency | Association of Health Care Journalists

Comments are closed.