What are the specific six ACGME competencies?

After an extensive review and consultation process, the ACGME developed the six general competencies.^16-17 The process included a review of the existing literature and other documents (e.g., published curricula, reports, educational literature, surveys, and interviews); consultation with a representative cross section of the key external stakeholders (e.g. government, public and private foundations, corporate chief executives, presidents of universities, residency review committees, and focus groups of residents, program directors, practicing physicians, allied health personnel, and the public); and consensus building among experts in the field (e.g., “gathering input, drafting preliminary language, obtaining feedback, and preparing numerous revisions, and an extensive input and feedback process”). An ACGME Outcome Project Advisory Group was formed, composed of 11-members with expertise and national recognition in the development and implementation of models of accreditation and outcomes assessment. The project was funded by a grant from the Robert Wood Johnson Foundation. The Advisory Group reviewed an original list of 86 statements to reach the final six competencies.

The final six ACGME competencies are 1) Patient care; 2) Medical knowledge; 3) Practice-based learning and improvement; 4) Interpersonal and communication skills; 5) Professionalism; and 6) Systems-based practice. For ophthalmology, the American Board of Ophthalmology (ABO) includes competence in surgery as a “seventh” competency requirement (presented at the American Academy of Ophthalmology, Midyear Forum, Washington, D.C., April 2002 by Denis O’Day, MD). Table 3 summarizes the ACGME expectations for residents in each of the six competencies. ¹⁶

---

Table 3: Summary of the six ACGME competencies
1. Patient care:

• Provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and promotion of health.
• Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and families.
• Gather essential and accurate information about their patients.
• Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
• Develop and carry out patient management plans.
• Counsel and educate patients and their families.
• Use information technology to support patient care decisions and patient education.
• Perform competently all medical and invasive procedures considered essential for the area of practice.
• Provide health care services aimed at preventing health problems or maintaining health.
• Work with health care professionals, including those from other disciplines, to provide patient-focused care.

2. Medical knowledge

• Demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
• Demonstrate an investigatory and analytic thinking approach to clinical situations.
• Know and apply the basic and clinically supportive sciences which are appropriate to their discipline.

3. Practice-based learning and improvement

• Investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve patient care practices.
• Analyze practice experience and perform practice-based improvement activities using a systematic methodology.
• Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems.
• Obtain and use information about their own population of patients and the larger population from which their patients are drawn.
• Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
• Use information technology to manage information, access on-line medical information; and support their own education.
• Facilitate the learning of students and other health care professionals.

4. Interpersonal and communication skills

• Demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and professional associates.
• Investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve patient care practices.
• Create and sustain a therapeutic and ethically sound relationship with patients.
• Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning and writing skills.
• Work effectively with others as a member or leader of a health care tam or other professional group.

5. Professionalism

• Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
• Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development.
• Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices.
• Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities.

6. Systems-based practice

• Demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.
• Understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice.
• Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
• Practice cost-effective health care and resource allocation that does not compromise quality of care.
• Advocate for quality patient care and assist patients in dealing with system complexities.
• Know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance.

[PREVIOUS] [NEXT]