New Initiatives Aim to Improve Residency Application, Program Evaluation

To address some of these issues, OPDO introduced a standard letter of recommendation during the 2012–2013 application season, and it was used by an estimated 20 to 30 percent of all applicants. While the old format of the letters was “subjective and written in a style that is often flowery and uses superlatives,” this new standardized format “is an objective measurement of qualities in candidates,” said Dr. Zacharek.

The standardized letter uses a five-point scale to measure a candidate’s qualifications, specifically:

• Patient care;
• Medical knowledge;
• Professionalism;
• Interpersonal and communications skills;
• Procedural skills;
• Research;
• Initiative and drive;
• Commitment to the field of otolaryngology–head and neck surgery;
• Commitment to academic medicine; and
• Match potential.

It also asks for up to 10 lines of written commentary meant to address the candidate’s unique qualities that are not already covered elsewhere in the application.

OPDO is still evaluating how the new recommendation form was used, said Dr. Messner. “We are creating a survey to all program directors and chairs to see how useful it was, and to see how it can be improved,” she said.

“The public and others are demanding medical training that is outcome based and not just based on the duration of training.”

—Sugki S. Choi, MD

The Next Accreditation System

Beginning July 1, 2014, all otolaryngology residency programs in the United States will be evaluated by a new process known as the Next Accreditation System (NAS), which will replace the current residency review process. The goals set by the ACGME for the NAS are to accredit programs based on outcome measures rather than process measures that constitute the current system. The NAS will reduce the burden of accreditation by eliminating the Program Information Form (PIF) that took so long for a program to complete.

The roots of the NAS date back to 1998, when the ACGME established the Outcome Project, which served as a precursor. The Outcome Project helped determine core competencies for all residents and then made those competencies goals for residents to master. By 2009, the ACGME was working with dozens of medical specialty organizations and fully reviewing the changing health care landscape to help residents stay current and well trained.

“I think the impetus behind NAS is the public demand for a more accountable use of the GME dollars and medical education based on the competency outcomes,” said Sukgi S. Choi, MD, chair of the otolaryngology residency review committee and director of the voice clinic in the otolaryngology department at the Children’s National Medical Center in Washington, DC. “The public and others are demanding medical training that is outcome based and not just based on the duration of training.”