Session Summary: In President’s Plenary, Dr. Weinstein Embraces Change and Challenges Assumptions in GME
In her first and thought-provoking President’s Plenary, ACGME President and Chief Executive Officer Debra Weinstein, MD challenged her audience to rethink their assumptions and consider new approaches in graduate medical education (GME). Her talk highlighted the need for continual innovation and the importance of community collaboration in advancing academic medicine and improving patient care.
Dr. Weinstein reflected on her early impressions during her first seven weeks on the job, as well as on the external contexts in which the ACGME and GME operate. She shared her initial priorities, as well as her vision for GME and the path to follow to achieve it.
Dr. Weinstein acknowledged that GME is functioning in an increasingly complex and polarized world, with the structure of institutions and medicine delivery consolidating and evolving in new ways. She suggested that a full-scale assessment of the state of GME is necessary.
“We need to recognize with humility that the way we’re doing things may not be the best way,” she said.
While the ACGME’s Mission and Vision are unwavering, the work of the organization may need to change to keep in step with an ever-evolving medical and health care landscape, and to ensure that today’s new physicians are prepared for the future.
“We have to think about where our organizational Mission and priorities overlap,” Dr. Weinstein said. “How can we avoid unnecessary redundancy or competition to focus our resources where they will make the most difference?”
Dr. Weinstein wants to move the ACGME, and GME in general, out of process-based metrics and into outcomes-based information, so that connections can be made between a singular requirement or a set of Requirements and resident/fellow performance both in a program and in practice upon program completion.
“I hope GME can be evidence-based,” she said.
Building on the “Strength of Community”
An essential part of enacting that vision involves soliciting feedback and input from the community. Dr. Weinstein said it is vital for the ACGME to gather and analyze data to determine what’s working and what’s not and then develop opportunities to try out new approaches. She also reminded the audience of the forthcoming revisions to the Common Program Requirements and Institutional Requirements, indicating that the opportunities to weigh in and shape how residency and fellowship accreditation are happening now. “This is really an ideal time for feedback about the big pictures [and] our strategies,” she said.
This inclusive approach ensures that a wide range of perspectives are considered in shaping the future of GME. It will require trust, communication, and flexibility, Dr. Weinstein said.
“I think we have strength of community,” she noted, adding, “We’ve got a common purpose we’re dedicated to, and we also have big differences amongst us, so I think we should talk to each other.” This acknowledgment of both unity and diversity within the community underscores the importance of dialogue and mutual understanding in addressing complex health care challenges.
Dr. Weinstein acknowledged that her approach may simultaneously provoke and inspire, and that it is certainly new. “I know this is provocative, but I’m just trying to get us to challenge our own assumptions,” she explained.
Dr. Weinstein highlighted the critical role that health care professionals play and the ongoing need for their contributions. “Health care desperately needs us. We’ve been doing a lot, and there’s a lot more to do,” she said. “We have to step up and continue to do that now.”
Dr. Weinstein's emphasis on community, dialogue, and continual improvement is a powerful reminder that progress and advancement in academic medicine is a collective effort. By challenging assumptions and being open to new ideas, the GME community can drive meaningful changes to enhance the quality of resident/fellow education, which will translate into enhanced care and better outcomes for patients.
This call to action is particularly relevant in the context of the rapid advancements in medical technology and the evolving needs of patients. “Working in GME is a way to see the good you do in the world,” she said.