Medical hierarchy of residents working and training in most hospitals
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Medical education is education related to the practice of being a medical practitioner; either the initial training to become a physician (i.e., medical school and internship), or additional training thereafter (e.g., residency, fellowship and continuing medical education). Medical education and training varies considerably across the world. Various teaching methodologies have been utilised in medical education, which is an active area of educational research. Medical education is also the subject-didactic academic field of educating medical doctors at all levels, including entry-level, post-graduate, and continuing medical education. Medical education applies theories of pedagogy specifically in the context of medical education. Specific requirements such as entrustable professional activities must be met before moving on in stages of medical education.
Entry-level medical education programs are tertiary-level courses undertaken at a medical school. Depending on jurisdiction and university, these may be either undergraduate-entry (most of Europe, Asia, South America and Oceania), or graduate-entry programs (mainly Australia, Philippines and North America). Some jurisdictions and universities provide both undergraduate entry programs and graduate entry programs (Australia, South Korea). In general, initial training is taken at medical school. Traditionally initial medical education is divided between preclinical and clinical studies. The former consists of the basic sciences such as anatomy, physiology, biochemistry, pharmacology, pathology. The latter consists of teaching in the various areas of clinical medicine such as internal medicine, pediatrics, obstetrics and gynecology, psychiatry, general practice and surgery.
The Association of American Medical Colleges (AAMC) has recommended 13 Entrustable Professional Activities (EPAs) that medical students should be expected to accomplish prior to beginning a residency program. EPAs are based on the integrated core competencies developed over the course of medical school training. Each EPA lists it's key feature, associated competencies, and observed behaviors required for completion of that activity. The students progress through levels of understanding and capability, developing with decreasing need for direct supervision. Eventually students should be able to perform each activity independently, only requiring assistance in situations of unique or uncommon complexity.
Further training in a particular field of medicine may be undertaken. In the U.S., further specialized training, completed after residency is referred to as "fellowship". In some jurisdictions, this is commenced immediately following completion of entry-level training, while other jurisdictions require junior doctors to undertake generalist (unstreamed) training for a number of years before commencing specialization.
Each residency and fellowship program is accredited by the Accreditation Council for Graduate Medical Education (ACGME), a non-profit organization led by physicians with the goal of enhancing educational standards among physicians. The ACGME oversees all MD and DO residency programs in the United States. As of 2019, there were approximately 11,700 ACGME accredited residencies and fellowship programs in 181 specialties and subspecialties.
Research areas into online medical education include practical applications, including simulated patients and virtual medical records (see also: telehealth). When compared to no intervention, simulation in medical education training is associated with positive effects on knowledge, skills, and behaviors and moderate effects for patient outcomes. However, data is inconsistent on the effectiveness of asynchronous online learning when compared to traditional in-person lectures. Furthermore, studies utilizing modern visualization technology (i.e. virtual and augmented reality) have shown great promise as means to supplement lesson content in physiological and anatomical education.
Regards
Rutherford
Managing Editor
Journal of Pharmacy Practice and Education