One of these key principles of the proposed new educational model is competency-based training, in which progress through medical school and graduate medical education is assessed through demonstrated competencies. The seamless integration of undergraduate and graduate medical education called for in this pathway should reduce redundancies and create efficiencies in the system. This training structure has the potential to lead to a short-ened amount of time to training completion. Some have expressed concerns that acquiring such competencies and completing the clinical training necessary to produce quality physicians is impossible in a shorter period. However, the Commission is arguing for a different approach to medical education, one in which the focus should be on achieving competencies (outlined in the full report
2), not on meeting certain time requirements.
Currently, there are numerous medical schools with 3-year curricula, which means that some family physicians are already completing their medical training in less than the traditional 7 years. The Lake Erie College of Osteopathic Medicine, for example, recently reported preliminary results that students enrolled in its 3-year Primary Care Scholar Pathway demonstrated performance similar to that of 4-year track students on the Comprehensive Osteopathic Medical Licensing Examination-USA Level 1 and Level 2-Cognitive Evaluation.
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In addition, the Commission intends that physicians completing the new educational pathway would be prepared to deliver high-quality care in a community-based setting and to serve as the leader of an interdisciplinary health care team. To the extent that these physicians share the same competencies as family physicians, we would welcome conversations leading to that designation, but the Commission intentionally did not presume to make such an explicit specialty designation. The Commission further notes that graduates of this pathway may elect to pursue additional specialty training and should be very well prepared to do so. The full Commission report
2 acknowledges that there are numerous issues that need to be addressed, including accreditation, licensure, and funding stream. However, ultimately, the Commission believes the nation needs physicians with redefined competencies. If a physician demonstrates these new competencies—regardless of the length of training—does this make a lesser or superior physician? The Commission believes the latter.