Have Accreditation Council for Graduate Medical Education initiatives improved the education of cardiology fellows? Recent Accreditation Council for Graduate Medical Education Initiatives Have Not Been Shown to Improve the Education of Cardiology Fellows

The “Best Lad Scheme” Before formal training programs in medicine, physician trainees learned at the feet of established physicians. Although formal training programs in internal medicine and surgery had been around for many years, the Flexner report in 1910 fundamentally changed how training was performed.1,2 Flexner described the mediocre quality of medical education at the turn of the century, noting the poor facilities, the profit motives, and the inadequate curricula. To reform medical education, he envisioned academically oriented hospitals where clinical observations drove research questions and advancements in patient care. Postgraduate trainees were indeed “residents”; they lived at the hospital, allowing the closest observation of their patients and a continuity of inpatient care that was unmatched. Indeed, in this setting, a night off duty was characterized, without a lack of sarcasm, as a lost opportunity to learn. Response by Kuvin p 537