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Multisociety Task Force Recommendations of Competencies in Pulmonary and Critical Care Medicine

¹ Henry Ford Hospital, Indiana University School of Medicine, Indianapolis, Indiana; ² New York University School of Medicine, New York; ³ Departments of Medicine and Surgery, Duke University, Durham, North Carolina; ⁴ Division of Pulmonary and Critical Care, University of Washington, Seattle, Washington; ⁵ University of Pennsylvania, Philadelphia, Pennsylvania; ⁶ Mount Sinai School of Medicine, New York; ⁷ University of California at Davis, Davis, California; ⁸ Virginia Commonwealth University Health System Medical College of Virginia Physicians and Hospitals, Richmond, Virginia; ⁹ University of Pittsburgh, Pittsburgh, Pennsylvania; ¹⁰ North Shore University Hospital and Long Island Jewish Health System, Long Island, New York; ¹¹ Cooper University Hospital, Camden, New Jersey; ¹² University of California at San Francisco, San Francisco, California; ¹³ Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and ¹⁴ University of Vermont School of Medicine, Burlington, Vermont

Correspondence and requests for reprints should be addressed to John D. Buckley, M.D., M.P.H., Indiana University School of Medicine, Emerson Hall 317, 545 Barnhill Drive, Indianapolis, IN 46220. E-mail: johnbuck{at}iupui.edu

ABSTRACT

Rationale: Numerous accrediting organizations are calling for competency-based medical education that would help define specific specialties and serve as a foundation for ongoing assessment throughout a practitioner's career. Pulmonary Medicine and Critical Care Medicine are two distinct subspecialties, yet many individual physicians have expertise in both because of overlapping content. Establishing specific competencies for these subspecialties identifies educational goals for trainees and guides practitioners through their lifelong learning.

Objectives: To define specific competencies for graduates of fellowships in Pulmonary Medicine and Internal Medicine-based Critical Care.

Methods: A Task Force composed of representatives from key stakeholder societies convened to identify and define specific competencies for both disciplines. Beginning with a detailed list of existing competencies from diverse sources, the Task Force categorized each item into one of six core competency headings. Each individual item was reviewed by committee members individually, in group meetings, and conference calls. Nominal group methods were used for most items to retain the views and opinions of the minority perspective. Controversial items underwent additional whole group discussions with iterative modified-Delphi techniques. Consensus was ultimately determined by a simple majority vote.

Measurements and Main Results: The Task Force identified and defined 327 specific competencies for Internal Medicine-based Critical Care and 276 for Pulmonary Medicine, each with a designation as either: (1) relevant, but competency is not essential or (2) competency essential to the specialty.

Conclusions: Specific competencies in Pulmonary and Critical Care Medicine can be identified and defined using a multisociety collaborative approach. These recommendations serve as a starting point and set the stage for future modification to facilitate maximum quality of care as the specialties evolve.

Key Words: clinical competence fellowships and scholarships education • professional curriculum