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. 2019 Feb;11(1):85-91.
doi: 10.4300/JGME-D-18-00730.1.

Aligning Strategic Interests in an Academic Medical Center: A Framework for Evaluating GME Expansion Requests

Kalli Varaklis, Mark G Parker, Jordan S Peck, Robert G Bing-You

Aligning Strategic Interests in an Academic Medical Center: A Framework for Evaluating GME Expansion Requests

Kalli Varaklis et al. J Grad Med Educ. 2019 Feb.

Abstract

Background: In 2017, the Maine Medical Center Graduate Medical Education Committee received an unprecedented number of requests (n = 18) to start new graduate medical education (GME) programs or expand existing programs. There was no process by which multiple programs could be prioritized to compete for scarce GME resources.

Objective: We developed a framework to strategically assess and prioritize GME program expansion requests to yield the greatest benefits for patients, learners, and the institution as well as to meet regional and societal priorities.

Methods: A systems engineering methodology called tradespace exploration was applied to a 6-step process to identify relevant categories and metrics. Programs' final scores were peer evaluated, and prioritization recommendations were made. Correlation analysis was used to evaluate the relevance of each category to final scores. Stakeholder feedback was solicited for process refinement.

Results: Five categories relevant to GME expansion were identified: institutional priorities, health care system priorities, regional and societal needs, program quality, and financial considerations. All categories, except program quality, correlated well with final scores (R 2 range 0.413-0.662). Three of 18 requested programs were recommended for funding. A stakeholder survey revealed that almost half of respondents (48%, 14 of 29) agreed that the process was unbiased and inclusive. Focus group feedback noted that the process had been rigorous and deliberate, although communication could have been improved.

Conclusions: Applying a systems engineering approach to develop institution-specific metrics for assessing GME expansion requests provided a reproducible framework, allowing consideration of institutional, health care system, and regional societal needs, as well as program quality and funding considerations.

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Conflict of interest statement

Conflict of interest: The authors declare they have no competing interests.

Figures

Figure 1
Figure 1
Process Flowsheet Describing the 6-Step Process
Figure 2
Figure 2
Regression Analysis Graph Comparing Sum of Institutional, System-Wide, Regional, and Societal Priorities
See this image and copyright information in PMC

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