1. McGaw’s Overview of the Next Accreditation System (NAS)

2. Goals of NAS Focused on continuous accreditation and improvement Increased emphasis on annually submitted data Enhanced oversight to ensure high quality education and a safe/effective learning environment RRCs to assess program performance each year: – To free good programs to innovate – To assist poor programs to improve – To reduce the burden of accreditation – To provide accountability for Outcomes to the Public

3. Basic Structure of NAS CLER visits Continuous RRC Oversight/Accreditation Close Sponsor (McGaw) Oversight Site Visits (Program or Institution) as needed Frequent Institutional Review Self Study

4. Milestones/Competencies Milestones Developmental steps: (1) Novice; (2) Advanced Beginner; (3) Competent; (4) Proficient; (5) Expert; and (6) Master Describe the path from Novice to Practitioner “Intuitively” known by experienced medical educators in each specialty Provide framework/language to describe progress Communicate shared understanding of expectations Set aspirational goals of excellence

5. Program Performance Indicators Under NAS (data reviewed by RRC) Annual ADS Update Program Changes – PDs/Core Faculty/Residents Program Characteristics – Structure and Resources Scholarly Activity (both trainees/faculty) Board Pass Rate – 3-5 year rolling averages Resident/Fellow Survey – Common and specialty elements Resident Clinical Experience – Case logs or other Faculty Survey – Core Faculty Semi-Annual Resident Evaluation and Feedback Milestone reporting

6. Example 2 year timeline

7. Revision of Program Requirements Program standards revised every ten (10) years and each standard will be categorized:  Core—Statements that define structure, resource, or process elements essential to every graduate medical educational program.  All programs must adhere

8. Revision of Program Requirements (Cont.’d)  Outcome--Statements that specify expected measurable or observable attributes (knowledge, abilities, skills, or attitudes) of residents/fellows at key stages of the graduate medical education.  All programs must adhere

9. Revision of Program Requirements (Cont.’d)  Detail—Statements that describe a specific structure, resource, or process, for achieving compliance with a Core Requirement. Programs in substantial compliance with the Outcome Requirements may utilize alternative/innovative approaches to meet core requirements.  Good programs may innovate

10. Program Rollouts Phase I Group – July 2013  Pediatrics  Internal Medicine  Diagnostic Medicine  Orthopaedic Surgery  Neurological Surgery  Urology Phase II Group – July 2014  The remaining specialties/RRCs begin using the Next Accreditation System

11. Core Teaching Faculty Select group of faculty educators Need to complete ACGME faculty survey (minimum completion requirements) Members need to have documented scholarly activities Core faculty data will be uploaded to ADS by programs

12. Current PD “To Do” List Finalize Core Teaching Faculty List and do faculty education Finalize and convene Clinical Competency Committee (CCC) Complete McGaw Annual Program Update Review drafts of milestones if available http://www.acgme-nas.org/milestones.html Review RRC Program and Common Guidelines http://www.acgme-nas.org/review-comment.html http://www.acgme-nas.org/ccpr.html

13. PD Ongoing Tracking Tasks Follow ACGME and ACGME-NAS websites closely Engage and follow specialty specific training organizations (association of training directors, etc.)