In Reply to Templeton et al

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Dr. Templeton and her colleagues from the Kansas State Board of Healing Arts have described their deliberative process including discussions and input from the public, academic medicine, community physicians, the state medical society, and hospital associations to increase the requirement for graduate medical education training to a minimum of 36 months for full licensure to practice medicine in Kansas. Their work occurred coincident with the publication of two articles by, respectively, Dr. Freeman and myself calling for a review of the minimum requirements needed for full licensure in all states. Dr. Templeton and colleagues state that concerns over readiness for practice led to the creation of the board’s taskforce and, in turn, the taskforce’s recommendations.
Medical boards in all states should take similar steps to determine if their current minimal training requirements are commensurate with maintaining the safety of the public. These same medical boards should also continue to review the work being done to understand the components of competency-based education. Medical schools and graduate medical education programs are beginning to redesign curricula to be flexible and to continually assess each learner’s knowledge, skills, professionalism, and teamwork such that all learners must achieve particular milestones and demonstrate specific core entrustable professional activities before advancing to the next level of training.1
Medical licensing requirements to protect the safety of the public should keep step with modern requirements to assess minimum competency. These requirements should not be locked in 50-year-old standards. I applaud Dr. Templeton and her colleagues for their work in reviewing and updating the standards in Kansas. I encourage them—and others—to measure, review, and reassess their actions on a regular basis.
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