There is a wind of change about to affect the training of all house
officers in the United States. The Accreditation Council of Graduate
Medical Education (ACGME) has promulgated a set of general competencies
for all U.S.-trained residents, with a major thrust focused on bioethics
and professionalism that will likely catch residency directors unaware.
The ACGME's General Competencies document globally addresses
many relationship-based ethical roles and responsibilities of house officers
in healthcare. Of note, this document contains a specific section on
professionalism. However, the entire document is woven with a sustained
thread of medical ethics throughout its other sections. The intent is to
imbue each physician with those skills, rules, and aspects of character
that will be a foundation for humane, ethical, professional conduct.
Professionalism does indeed go beyond ethical principles, accounting for
competency and commitment to excellence and, most of all, implying a virtue
ethics account of medical practice. The need to address the central place
of virtue ethics in house-staff education is apparent, and we now have the
right tool for the job—the ACGME General Competencies.