Dr. Lynne Kirk joined the ACGME staff in September 2019, following a 30-year career in internal medicine and geriatrics at UT Southwestern Medical Center. She was a Toni and Timothy P. Hartman Distinguished Teaching Professor in internal medicine and associate program director for internal medicine. She held several additional roles, including associate dean of graduate medical education and program director of the primary care track. Dr. Kirk served on the ACGME Board of Directors, as a member of the ACGME’s Clinical Learning Environment Review (CLER) Evaluation Committee, and as a member and Chair of the GME Committee for the Council on Medical Education of the American Medical Association. She is President-Emeritus of the American College of Physicians.
We recently asked Dr. Kirk to outline her goals as the ACGME’s first Chief Accreditation Officer.
How did you become interested in medicine, and then in academic medicine?
I grew up in rural Nebraska and my father was the large animal veterinarian for our county. I was frequently called upon to assist my dad in treating animals, some very large and not too cooperative. That spurred my interest in medicine. When I decided on a career in human medicine, I was hoping to remain immersed in medicine but avoid some of the dangers and challenges with having large patients (equine, bovine, and the like) who couldn’t understand and were uncooperative. I became an internist and ultimately a geriatrician.
Early in my career a mentor told me that as a physician caring for patients, I would have a significant impact on those patients for whom I cared. However, if I taught medicine in addition to caring for patients, I would also have some impact on the patients that all the learners I interacted with would care for throughout their careers. That was very compelling for me, and as I’ve matured, humbling, especially now that we know that the care our residents and fellows learn in graduate medical education likely affects their practice for their entire careers.
During my decades as an academic internist, I’ve had the good fortune to be an associate program director, a program director and a DIO [designated institutional official]. Over the past decade, I’ve been able to work with the wonderful professionals at the ACGME, first on the Review Committee for Internal Medicine, and more recently as a Director on the ACGME Board. I have found the most rewarding part of my career is watching altruistic and motivated young people enter medical school and, through medical school and residency, develop into amazing physicians who provide excellent care to their patients, create astounding new knowledge, and contribute significantly to the improvement of health care for the entire population of this country and world. These important outcomes align well with what the ACGME does.
As Chief Accreditation Officer, you are heading a new, restructured department in the ACGME. What do you feel is the main role of your department?
The most important outcome of the accreditation of graduate medical education is that all learners who receive graduate medical education in any of our programs become the best physicians they can be. This allows us as an organization to fulfill our commitment to the public—that any physician who provides their care has received the education necessary to manage all their patients’ health care needs with the highest quality.
What is your philosophy when it comes to accreditation, recognition, and site visits?
I see all the activities of the accreditation enterprise as being focused on achieving the outcomes I outlined previously in terms of optimal training and education for physicians and optimal care for the public. Accreditation and recognition, supported by the work of the Accreditation Field Representatives, are the processes we use to ensure that every program in every specialty is providing the education necessary to develop excellent physicians in their field.
What are your top priorities for the department?
We are a number of years into the “Next Accreditation System” and can learn from that experience about how it is working for each of the specialties. The data we are getting from the 10-Year Accreditation Site Visits can help inform us as to whether we have been accurate in identifying programs that are doing well and can innovate and those not performing as well as needed. And more importantly, to discover whether those not performing as well can improve. All of this information will be helpful as we think about designing “The Accreditation System After the Next Accreditation System” in a few years. Hopefully, by that time we’ll have access to additional outcomes data about performance of physicians after they complete residency to better inform our decisions about programs.
In the shorter term, many of the specialty-specific Program Requirements will undergo major revisions. As a Board member, I worked with the Internal Medicine 2035 group on developing the new Program Requirements for Graduate Medical Education in Internal Medicine. Hopefully we can use this experience and the expertise of the Committee and staff members of all the Review Committees to assist in developing the best processes for the other specialties to do this important work.