A Historical Perspective on Resident Evaluation, the Accreditation Council for Graduate Medical Education Outcome Project and Accreditation Council for Graduate Medical Education Duty Hour Requirement

Abstract

The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project, endorsed at the 1999 ACGME annual meeting, was intended to shift the focus of residency program requirements and accreditation from process-oriented assessment to an assessment of outcomes. The Outcome Project established six general competencies, each of which is supported by more specific competencies. We compared contemporary resident evaluation based on the Outcome Project to faculty evaluation of a surgical resident at Mayo Clinic that was completed in 1917. The contemporary faculty assessment of resident performance was remarkably similar to the evaluation form and criteria used in 1917. All six general competencies, and nearly all of the more specific items listed under each general competency, were included in the 1917 evaluation. Duty hour data as a component of the 1917 resident evaluation included the number of hours per week spent in "practical work," "medical library," and "research work." The remarkable similarities between the qualities assessed in the 1917 evaluation and the assessment of contemporary ACGME competencies suggest that a common set of desirable physician characteristics and behaviors can be identified and measured.