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Viewpoint |

Balancing Service and Education in Residency Training A Logical Fallacy

Teri L. Turner, MD, MPH, MEd1,2; Elaine Fielder, MD1; Mark A. Ward, MD1
[+] Author Affiliations
1Department of Pediatrics, Baylor College of Medicine, Houston, Texas
2Center for Research, Innovation, and Scholarship in Medical Education, Texas Children’s Hospital, Houston
JAMA Pediatr. 2016;170(2):101-102. doi:10.1001/jamapediatrics.2015.3816.
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This Viewpoint discusses strategies for optimizing education in the context of service in residency training.

The system of residency training in the United States has at its core a perpetual tension between service and education. Graduate medical education (GME) is financed through prospective payments to teaching hospitals, where house officers compose a significant portion of the health care workforce. Numerous changes have occurred during the past 20 years that have put increasing pressure on this delicate balance. Radical transformation in the structure and process of GME training, most notably duty hour limitations, has led to compression of work, coupled with increasing emphasis on patient safety and quality. Hospitals have simultaneously undergone equally radical changes resulting from economic forces that have intensified pressure on faculty to increase clinical productivity to generate revenue. As a result, less time is available for faculty to teach and for trainees to learn.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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