• J Formos Med Assoc · Nov 2022

    Multicenter Study Observational Study

    Longitudinal assessment of milestone development among internal medicine residents in Taiwan.

    • Wang-Huei Sheng, Yi-Lwun Ho, Chang-Chyi Jenq, Chiao-Lin Chuang, Chiung-Yu Chen, Ming-Ju Tsai, Yi-Sun Yang, Ming-Shiang Wu, and Shan-Chwen Chang.
    • Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.
    • J Formos Med Assoc. 2022 Nov 1; 121 (11): 2281-2287.

    Background/PurposeThe Accreditation Council for Graduate Medical Education (ACGME) milestones have been implemented in residency training worldwide. We investigated the development of individual competency in first-year residents (R1) and second-year postgraduate students (PGY2) who received internal medicine training in Taiwan.MethodsA multicenter observational cohort study was conducted to evaluate the competency-based milestone evaluation designed by the Taiwan Society of Internal Medicine in 2019. The evaluation was based on the ACGME-accredited milestone ratings. Periodic evaluation of milestone achievements of R1 and PGY2, who entered the internal medicine residency training at six medical centers, was performed. Each resident was evaluated every 3 months.ResultsAmong the 98 R1 enrolled in 2019, substantial improvement in sub-competencies, including skill in performing procedures (Patient Care 4), clinical knowledge (Medical Knowledge 1), knowledge of diagnostic testing and procedures (Medical Knowledge 2), and identify impact the cost of health care and practices cost-effective care (Systems Based Practice 3) during the two years of training. Among the 107 R1 and 46 PGY2 enrolled in 2020, no significant difference in baseline milestone ratings was observed. However, the milestone assessments of R1 in 2020 showed improvement in nearly all sub-competencies compared with the stationary status of PGY2 in 2020.ConclusionWe demonstrate the application of ACGME-based accredited milestone ratings to target the educational goals of internal medicine residency training in Taiwan. Differences in milestone ratings between different PGY training systems exist. The long-term impact of performance among different PGY training systems requires further investigation.Copyright © 2022. Published by Elsevier B.V.

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