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Trainee Physician Milestone Ratings and Patient Complaints in Early Posttraining Practice
Misop Han1, Stanley J Hamstra2,3,4, Sean O Hogan3
1Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA Network Open
|April 11, 2023
Summary
Physicians with lower graduate medical education Milestone ratings in professionalism and communication skills face higher risks of patient complaints post-training. Early support for these trainees may improve patient care outcomes.
Area of Science:
- Medical Education
- Patient Safety
- Physician Performance
Background:
- Graduate medical education programs use Milestones for trainee evaluation since 2013.
- The association between low Milestones ratings and posttraining patient complaints is not well understood.
Purpose of the Study:
- To investigate the link between resident Milestone ratings and patient complaints received after training.
Main Methods:
- Retrospective cohort study of physicians completing ACGME-accredited programs (2015-2019).
- Collected Milestone ratings and national Patient Advocacy Reporting System (PARS) data.
- Analyzed data linking low professionalism and communication skills ratings to patient complaint scores.
Main Results:
- Physicians with the lowest Milestones ratings (0-2.5 and 3.0-3.5) showed a statistically significant increased likelihood of higher PARS scores.
- Specifically, 4.7% of physicians in the lowest Milestones group had high PARS scores, compared to 2.9% with proficient ratings.
Conclusions:
- Low Milestone ratings in professionalism and interpersonal/communication skills predict increased patient complaints in early practice.
- Trainees with lower ratings may require additional support during residency or early career stages to mitigate risks.
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