Journal Notes: JGME’s Reimagining Residency Supplement: A Conversation with Drs. John Andrews and Arianne Baker
This month, the Journal of Graduate Medical Education (JGME) released its supplemental issue, Reimagining Residency: An American Medical Association Initiative to Transform GME. This special issue represents the work of several projects launched in 2019 as part of an American Medical Association (AMA) grant program to transform residency education. In partnering with the AMA, JGME is excited to publish several real-world applications that it hopes will benefit residents and fellows, program leaders, health care systems, and patients.
The seeds of this project were planted in 2013 when the AMA invested in a five-year initiative called “Accelerating Change in Medical Education,” designed to support innovation in undergraduate medical education (UME). Following the success of this program, the AMA directed its attention to innovation in graduate medical education (GME) with the Reimagining Residency initiative. AMA Vice President, Graduate Medical Education Innovations John Andrews, MD was hired in 2018 to oversee the development and implementation of this five-year, 20 million dollar effort, which included 11 ambitious projects aimed at improving the transition from UME to GME, better preparing residents for practice, and supporting well-being in the learning and working environment. Dr. Andrews said he has been particularly impressed by the focus and resilience of these innovative projects, especially as they were implemented during the COVID-19 pandemic. “I wouldn’t call it a surprise, but many of the projects ended up in places they did not anticipate at the outset,” he said. “The lesson is that successful innovation evolves and is responsive to the environment in which it takes place.”
Dr. Andrews said he also gained a deeper appreciation for the value of collaboration as the project teams worked together to amplify their work, confront common challenges, and support each other during difficult times. He noted that some of the projects had immediate impact, others took time for their ideas to take hold, and some are only now, at the conclusion of the initiative, seeing wider adoption of their work. “It’s a testament to persistence and to building relationships over time,” he said. He also observed that the innovations proposed have created an environment where even more new ideas are coming forward, illustrating that “innovation breeds innovation.”
JGME Associate Editor Arianne “Cuff” Baker, MD served as one of the supplement’s editors and has been most surprised by the range of projects, from single institutions to national specialty-wide collaborations, all of which share the goal of improving residency education. “My co-editors and I agreed that the ideas from these projects have real-world application and can be translated to new and different settings,” she recalled. “Even for the projects that worked out differently from the authors’ initial plans, there is something to learn.”
Dr. Baker said she also hopes readers will keep an open mind and consider how the different projects could spark a new idea or motivate change at their own institutions. She acknowledged that “reimagining residency” sounds like a gargantuan task and that readers may come with a preconceived notion of what this means. But the projects in the supplement represent different approaches to iterative change.
“While we aren't completely upending the structures of modern GME in the United States,” she noted, “there are plenty of opportunities to improve the experience of residency for residents, faculty [members], and patients.”
Dr. Andrews agreed, saying that while, “there is still a lot to do, I hope that readers will find messages in this work that are applicable to their local environments and that learning about Reimagining Residency inspires them to pursue their innovation ideas and continue to improve GME.”
As always, each article in the issue of the journal is open access and available without a subscription. Be sure you’re also listening to JGME’s podcast, Hot Topics in Med Ed. An upcoming episode in June will feature a conversation with Dr. Andrews, as well as a guest author and guest editor from the supplement. And finally, the JGME team appreciates ideas and feedback. Email jgme@acgme.org – the editors would love to hear from you!
Journal Notes blogger Kevin Gladish is a staff editor for the Journal of Graduate Medical Education. He’s been at the ACGME since 2016, and is also a performer, writer, and storyteller.