Abstract
The course of study for young physicians for post-graduate training is an exciting and life-changing opportunity, one that is filled with the relentless optimism of intellectual discovery and personal growth and development. The American Council for Graduate Medical Education (ACGME) is a non-profit private council that evaluates and accredits internship, residency, and fellowship programs. The role of the ACGME is to oversee curriculums, training environments, and specialty evaluation standards to ensure satisfactory competency leading to board eligibility and certification in the respected field of study. The ACGME has the monumental task of guiding educational standards that are designed to both protect the public welfare and further educational programs. Many educational standards are objective, such as quantitative performance on examinations, involvement in research, and involvement in systems development and quality improvement. However, key clinical performance measures are based on prior training and experience. Over the last several years, studies examining rates of abuse and discrimination during post-graduate medical training in both the United States and Canadian studies, which have reported alarmingly high rates of 50%. With the increasing utility and availability of social media, such issues have become more transparent to the public. A plethora of studies has been conducted, examining physician biases towards patients, practice changes, insurance company regulations, and evolving healthcare systems. However, a significant amount of evaluation is merited when examining individual institutional cultures and the educational environments that harbor them. We wish to examine the role of ever-evolving specialty-specific ACGME-instituted educational milestones in Internal Medicine and Opthalmology in the context of potential cognitive biases and their implementation within post-graduate training programs.
Highlights
BackgroundWith the objective of examining the role of cognitive bias in the context of the American Council for Graduate Medical Education (ACGME)-defined specialty-specific educational milestones, a clinical definition must first be examined
We wish to examine the role of ever-evolving specialtyspecific ACGME-instituted educational milestones in Internal Medicine and Opthalmology in the context of potential cognitive biases and their implementation within post-graduate training programs
The ACGME milestones project ensures that trainees in Medical Oncology are aware of common adverse effects and contraindications to standard cytoreductive chemotherapy regimens such as with high dose methotrexate [8]
Summary
With the objective of examining the role of cognitive bias in the context of the American Council for Graduate Medical Education (ACGME)-defined specialty-specific educational milestones, a clinical definition must first be examined. An example is a large academic cancer center being mindful of the appropriate use of intravenous immunoglobulin (IVIg) in patients with hypogammaglobulinemia [17] Activity, such as quality improvement projects, are an integral part of any training program, and institutional cognitive biases may affect the ultimate outcome of such endeavors that affect patient outcomes and educational advancement [18,19,20]. Learners come from diverse cultural, emotional, and psychological backgrounds, which could subconsciously affect an evaluator's judgment By acknowledging both the institutional and cognitive limitations in creating more objective evaluation standards consistent with the ACGME-sponsored milestones, a more inclusive and fertile ground for education and mentorship could be established
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