Training Exceptional Doctors

reprinted from Issue 13, Fall 2011 of Frontiers of Medicine (PDF)

Talmadge E. King, Jr., MD

The practice of medicine is changing at a rapid pace, and the way we are preparing young physicians for the future is also changing. Exciting scientific discoveries mean that trainees need a working knowledge of an everexpanding range of fields that were not even on the map a generation or two ago. At the same time, the Accreditation Council for Graduate Medical Education (ACGME) - the accrediting body for the nation's medical residency programs - has limited the number of duty hours that residents can work per week, to help ensure they are appropriately rested to provide high-quality care for patients.

With more to learn in less time, a few alumni have recently asked me whether today's residents will be adequately prepared to practice medicine when they graduate. My emphatic reply is, "Yes!"

There are two reasons for my confident answer. First, UCSF Department of Medicine residents are truly among the country's best and brightest. Second, our residency program is a model of innovation. We are helping transform residency from a service model - in which residents provided an affordable labor source for hospitals and medical centers - into a learning model, in which residents are trained in a wide range of skills that they will continue to develop over their careers. As part of these efforts, we are moving beyond large lecture classes as the main mode of teaching, and are incorporating small group seminars and hands-on projects as ways to help residents transform information into knowledge.

We have become a leader in designing better ways to learn partly through our participation in the ACGME's Educational Innovation Project (EIP). As one of just a handful of top-notch residency programs in the country chosen to participate in the EIP, UCSF has received a measure of flexibility in how we meet accreditation standards. This has allowed us to test out creative ways of fostering learning while teaching residents the tools to improve the practice of medicine.

This issue of Frontiers of Medicine highlights several innovative approaches we are trying. We describe our use of an online tool called Practice Improvement Modules to improve how residents' outpatient clinics are run. In addition, we are showing how our "Writing for Change" class helps residents learn to advocate effectively for improvements in health care. Finally, we introduce a new section of Frontiers of Medicine, the "Quality & Safety Corner," that describes the outcome of our inaugural Quality and Safety Innovation Challenge. Collectively, these efforts build on the Department of Medicine's history of training exceptional doctors who not only provide outstanding care to patients, but become leaders in medicine.

In addition, this issue highlights the accomplishment of several alumni of our training programs. Three are newly honored members of the Council of Master Clinicians, and a fourth leads research and development at a global biopharmaceutical company. These former trainees have become leaders in their fields, and their efforts have helped develop disease management approaches and new treatments that have transformed the way we care for patients today.

I am certain that today's residents will make similarly significant contributions to medicine. My faculty colleagues and I are privileged to support trainees in becoming exceptional leaders and innovators. While these efforts require considerable investments of time and effort, they will bear a rich harvest. Thank you for all your support in helping us achieve our goals to improve medical education and patient care.


Talmadge E. King, Jr., MD
Chair, Department of Medicine
Julius R. Krevans Distinguished Professorship in Internal Medicine

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