The ACGME, responsible for the accreditation of graduate medical training programs within the US, has identified six general competencies for residents. They are defined in ACGME's Outcome Project, a long-term initiative to increase emphasis on educational outcomes in the accreditation of residency programs.

The ACGME, like other academic and advisory organizations, has recognized that demands and expectations for high quality, cost-effective, patient-centered health care translate into new expertise and capabilities required of physicians. The curricular content of medical education needs to expand beyond the core clinical skills that are the traditional focus of training.

The ACGME's Outcome Project has developed, in conjunction with the American Board of Medical Specialties, an approach for cataloguing these competencies. The two categories of Systems-Based Practice and Practice-Based Learning and Improvement in particular incorporate elements of care management that complement the resident's clinical training. The related major focus of the Outcome Project is developing and implementing assessment tools for programs to use in evaluating learners.

The shift in emphasis from structure-and-process oriented education to focus on outcomes, coupled with a broader set of training goals, will occur over time - but it is happening now and will affect all accredited residency training programs in the U.S.

View a PowerPoint presentation by the ACGME about the Outcome Project.