ACGME and SI2025: The Journey Begins.

Abstract

Consistent with its mission of improving the health of the American public through excellence in educating the next generation of physicians, the Accreditation Council for Graduate Medical Education (ACGME) has worked over the last 18 months to develop an exciting new vision for the future of Sponsoring Institutions known as SI2025. Chaired by Lawrence Opas, MD, and Mr. John Duval, the Task Force listened to more than 1000 experienced thought leaders and produced a roadmap that encompassed more than 50 key observations about the future of health care, graduate medical education (GME), and Sponsoring Institution oversight.1 The Task Force's work encompasses a journey over the next decade to ensure high-quality residency and fellowship education.At every instance, the Task Force was able to reflect on the ACGME future scenario-based planning outcomes, seen through the lens of 8 domains.1,2 They included the best possible understanding of the future needs of health and health care, the mechanisms of delivery of care, and the institutions and systems that will deliver it, while attempting to understand the ongoing evolution of the role of physicians and other health care professional team members. The Task Force charted a course for the evolution of the current GME models to a futuristic model of sustained innovation and excellence. Seen in terms of the “social contract of medicine,” the 4 recommendations contained in this roadmap are designed to improve the health of individuals and populations through the development of a knowledgeable, skilled, and caring physician workforce.The Task Force brought forward 4 core recommendations, including the alignment of ACGME Institutional Requirements with the Phase I and Phase II Task Force changes to the Common Program Requirements. The Task Force also called for the creation of an innovative program recognizing and sharing the best practices from the Sponsoring Institutions that advance to defined levels of sustained performance excellence. In addition, the document emphasizes partnerships among multiple organizations to develop a new data-driven mechanism that will provide feedback on Sponsoring Institution performance by monitoring key GME factors, but also health care outcomes related to the quality of care provided by the Sponsoring Institutions and its clinical affiliates, and, potentially, the quality and safety performance of graduates in their practice after graduation.The SI2025 effort is based on, and has benefited from, broader strategic planning work by the ACGME. It successfully builds on the core principles of GME, and aligns in a unique fashion the accreditation requirements of the Sponsoring Institutions with those of residency and fellowship program, facilitating efficiency and effectiveness on multiple levels, while at the same time promoting innovation and excellence.The recommendations in SI2025 are particularly relevant at this time, given the constant evolution of expectations of the profession and the increasing demand on faculty's and learners' valuable time, and on institutional resources. These recommendations will require hard work, and may take as many as 8 years to implement and mature. The initial implementation—revising the Institutional Requirements to align them with the new Common Program Requirements—will be key to the early success of SI2025, and will serve as a foundation for later phases. This enhancement and alignment of institutional accreditation requirements should provide the initial directions on our roadmap.We owe a great deal of gratitude to those who led and staffed the Task Force, and to the broad group of GME stakeholders who participated in this process. Collectively, they built on decades of experience and dedication to GME, giving their very best effort to help imagine the role of our Sponsoring Institutions long into the future. With the release of this critical report, the real journey begins!