PC7. Competency-based, Time-variable Resident Education: A Programmatic Update

Abstract

PURPOSE: In 2018, the University of Pittsburgh Medical Center (UPMC) adopted a Competency-Based, Time-Variable (CBTV) model for plastic surgery training, the first of its kind in the United States. This educational model emphasizes performance and skill mastery, rather than time-based benchmarks, as the measure by which residents are deemed fit for graduation. METHODS: Starting in the PGY1 year, each resident is evaluated regularly via oral exam to assess knowledge of plastic surgery principles. Resident self-assessment of technical competency is directly compared to faculty assessment utilizing the Zwisch Rating Scale, a validated scoring system in rating resident autonomy. Our department has reorganized its rotation schedule to shift Chief-level rotations from the PGY6 year to the PGY5 year. RESULTS: UPMC matched its first CBTV resident class in 2018. Of this three-resident cohort, two residents (66%) were deemed competent for graduation after five clinical years of training. One resident elected to defer graduation until after six years of training due to fellowship application timing constraints. The other resident elected to pursue a year of research and subsequently graduate after five clinical years of training. Thus, all three residents will graduate after six years at UPMC, but with customized experiences based on their specific interests and educational needs. CONCLUSION: The CBTV model has increased the flexibility of our training program to accommodate individualized educational needs of each resident, allowing them variable rotation schedules to address surgical deficiencies as well as to further develop their clinical interests. This is a paradigm shift in surgical education.