SINK OR SWIM? Exploring Across Specialties and Certification Models for Easing the Transition to the First Year of Practice

Description: The first year of practice in any specialty is stressful. The transition to independent practice requires adaptation to a new level of personal accountability as structured supervision is withdrawn based on an expectation of readiness for practice.

In this session, we will examine the transition to practice by highlighting three approaches: the traditional model of full, immediate independence; the consecutive case-book method; and the recently described “sheltered independence” at the residency training institution.

Assumption of full, immediate independence is the default model for most specialties. The new specialist shoulders the challenges of transition, counting on having been fully prepared by their training program and the certification process.

In the sheltered independence model, the physician assumes the full duties (and full independence) of a specialist in the home institution where they have just finished their training. This allows the transition to occur in a familiar context with a deep social support network.

The consecutive case-book model has the newly graduated specialist collect documentation (e.g. operative reports) for their cases over a defined period as part of certification. This provides a window into unsupervised practice in the local context.

Representatives with experience in these models will describe the models. At least half of the session will be devoted to large group discussion of the wider implications.

Citations and Literature References (if none, write n/a): 1. Sheltered independence: Promotion in Place: A Model for Piloting Competency-based Time-variable GME -- AMA Reimagining Residency Grant
2. Case-Book

Method: https://www.abplasticsurgery.org/candidates/oral-examination/oral-examination-process-requirements/ American Board of Plastic Surgery Oral Examination Requirements.
3. Full, immediate independence: https://www.abim.org/certification/for-newly-certified-physicians/ As an example, the ABIM policies for newly certified physicians.