Grappling with the evaluation of clinical competencies: a view from the Residency Review Committee for Urology.

We sought to highlight the perspective of the Residency Review Committee for Urology regarding the current changes in residency program accreditation. Although the pedagogic underpinnings of the shift of the American Committee for Graduate Medical Education to outcomes-based accreditation appear solid, several concerns were raised by the Residency Review Committee for Urology: the paucity of effective evaluation tools, the likely increased expense of these measures, and the lack of evidence that these changes will ultimately improve the training of residents. As a result, the Committee plans to continue cautiously (but optimistically) in the process of incorporating the teaching and evaluation of the clinical competencies in the program requirements.