title: Developments and innovations in resident and fellowship education: review article.
abstract: BACKGROUND
  Medical trainee education has drastically changed over the past 30 years significantly since the inception of the Accreditation Council for Graduate Medical Education (ACGME) in 1981. With an emphasis on patient safety, regulations and oversight from the ACGME have drastically changed the way many programs function with respect to trainee responsibilities, duty hours, and resident supervision.
  
  
  OBJECTIVE
  The purpose of this review is to summarize significant changes and innovations implemented by the ACGME and their proposed effects on trainee education. While there is an emphasis on musculoskeletal radiology fellowship training, the majority of the regulations and guidelines are applicable to all training programs.
  
  
  METHODS
  Articles, commentaries, and policies focusing on ACGME requirements were reviewed, with a focus on musculoskeletal radiology.
  
  
  RESULTS
  Changes in ACGME policies have resulted in significant structural modifications in how training programs are designed, specifically with respect to curriculum standardization, measuring outcomes of trainee performance, and integration of residents and fellows into hospital-based quality improvement and patient safety initiatives.
  
  
  CONCLUSIONS
  With an eye to continued training program advancement and improvement, the goal of universal oversight and standardization in medical training remains to produce forward-thinking physicians with an emphasis on lifelong learning, patient care, and quality improvement.
authors.affiliation: Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th St, New York, NY 10021 USA ; Weill Cornell Medical College, New York, NY 10035 USA.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Sofka
keywords: ACGME; medical education; resident