ACGME mandates that residents develop competencies in six areas to the level expected of a new practitioner. To accomplish this, residency programs must define the specific knowledge, skills, and attitudes that are necessary, and provide educational experiences as required in order for their residents to demonstrate competency in each of the following areas:

• Patient care
• Medical knowledge
• Practice-based learning and improvement
• Interpersonal and communication skills
• Professionalism
• Systems-based practice

Two of these competencies are new to most programs.

• Systems-based Practice: Residents must demonstrate their knowledge of the environmental context and health care systems within which they function. The scope of systems-based practice includes
  
  
  • familiarity with financing structures, the organization and capacities of provider entities and delivery systems;
  • tools and techniques for controlling costs and allocating resources;
  • systems for improving the quality of care; and
  • the roles and contributions of other professionals in caring for individual patients and populations.
  
  Residents must use their knowledge of system resources to provide care that is of optimal value.
  
  
• Practice-based Learning and Improvement: Residents must know and apply scientific methods and analytic tools to improve their patient care practices. They must be able to:
  
  
  • locate and appraise scientific evidence and clinical studies related to their patients' health problems;
  • apply information about the panels and populations from which their patients are drawn;
    
  • use information technology including online resources; and
  • analyze practice experience in order to perform systematic improvement activities.
  
  Quality improvement, evidence-based medicine, and informatics are among the content areas that fall within this competency.