Comments: Defining the Scholarly and Scholarship Common Program Requirements

Why do we have program requirements? When looking at the essence of this question, one realizes that program requirements help us to identify the basic elements needed to train a competent physician. The Common Program Requirements mandate that the training program monitor resident performance, faculty development, graduate performance, and the process by which the program attempts to improve its approach to training. These requirements make sense. We teach to develop proficiencies in the core competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Proficiency in each of the core competencies is critical to becoming a good physician. The Common Program Requirements also direct resident participation in scholarly activity, with the specific requirements left to the determination of each Residency Review Committee, and mandate that at least some members of the faculty demonstrate scholarship as defined by peer-reviewed funding, publication of original research, publication or presentation of case reports, and participation in national committees or educational organizations. Although our program has been compliant with these resident and faculty requirements, I am not certain that either the resident scholarship or the faculty scholarship outlined in these requirements is necessary to train a great physician.

We should train physicians who apply a systematic approach to clinical uncertainty, but the production of scholarship that adds to the body of knowledge in a field of inquiry should not be mandated. Scholars can be good physicians, but scholarship alone does not make a competent physician. Knowledge, caring, and a desire for constant improvement are the core requirements for creating a good physician, someone you would send your family to see. When you go to a physician's office, you don't care how many articles he or she has published, you care if your physician wants to care for you in the best way. When you undergo a procedure, you don't look at how many grants the physician was awarded; you want a physician who is your advocate and proficient in what he or she is doing. We need physicians who are good people and do the best to care for their patients. This requirement necessitates that a good physician have an inquisitive and processing mind. Sometimes we get blinded by the need for academic recognition. Climbing in academia requires the documentation of scholarship, but this in itself does not make for a great professor. We need teachers and students who care the most about helping train great physicians and making a difference in our world.