Abstract
BackgroundSocial accountability in medical education has been defined as an obligation to direct education, research, and service activities toward the most important health concerns of communities, regions, and nations. Drawing from the results of a summit of international experts on postgraduate medical education and accreditation, we highlight the importance of local contexts in meeting societal aims and present different approaches to ensuring societal input into medical education systems around the globe.Main textWe describe four priorities for social responsiveness that postgraduate medical education needs to address in local and regional contexts: (1) optimizing the size, specialty mix, and geographic distribution of the physician workforce; (2) ensuring graduates’ competence in meeting societal goals for health care, population health, and sustainability; (3) promoting a diverse physician workforce and equitable access to graduate medical education; and (4) ensuring a safe and supportive learning environment that promotes the professional development of physicians along with safe and effective patient care in settings where trainees participate in care. We relate these priorities to the values proposed by the World Health Organization for social accountability: relevance, quality, cost-effectiveness, and equity; discuss accreditation as a lever for change; and describe existing and evolving efforts to make postgraduate medical education socially responsive.ConclusionAchieving social responsiveness in a competency-based postgraduate medical education system requires accrediting organizations to ensure that learning emphasizes relevant competencies in postgraduate curricula and educational experiences, and that graduates possess desired attributes. At the same time, institutions sponsoring graduate medical education need to provide safe and effective patient care, along with a supportive learning and working environment.
Highlights
We describe four priorities for social responsiveness that postgraduate medical education needs to address in local and regional contexts: (1) optimizing the size, specialty mix, and geographic distribution of the physician workforce; (2) ensuring graduates’ competence in meeting societal goals for health care, population health, and sustainability; (3) promoting a diverse physician workforce and equitable access to graduate medical education; and (4) ensuring a safe and supportive learning environment that promotes the professional development of physicians along with safe and effective patient care in settings where trainees participate in care
Achieving social responsiveness in a competency-based postgraduate medical education system requires accrediting organizations to ensure that learning emphasizes relevant competencies in postgraduate curricula and educational experiences, and that graduates possess desired attributes
Social responsiveness in postgraduate medical education In contrast to earlier commentators who have discussed social accountability expectations for medical schools, we focus on physician education after medical school and describe four priorities for social responsiveness in the postgraduate medical education system
Summary
Social responsiveness in postgraduate medical education In contrast to earlier commentators who have discussed social accountability expectations for medical schools, we focus on physician education after medical school and describe four priorities for social responsiveness in the postgraduate medical education system. Accreditation: Standards requiring programs to set and meet aims relevant to the needs of the communities they serve; approaches to highlight and address health disparities and promote health equity [11] Institution and program: Initiatives to teach, rolemodel, and assess physician competencies important to patient advocacy [12, 13]; measures to address health disparities [14, 15], social determinants of health [16], and system-level factors that create barriers to health and health care for some members of society. The promotion of social accountability through accreditation will need to be sensitive to the fact that accredited programs and sponsoring institutions are complex adaptive systems [37] influenced by the environments in which they operate This constrains their ability to meet the range of potentially competing demands that arise from oversight organizations and the varying interests and foci within the medical education community. Addressing societal needs and expectations in postgraduate medical education is an area for additional work, including research on effective approaches and outreach to stakeholders, exploring successes and challenges, and gathering and disseminating information on effective practices for adoption or adaptation
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