Comments: authors' response to letters regarding "defining the scholarly and scholarship common program requirements".

We are pleased we received a number of responses to our recent editorial on “Defining the Scholarly and Scholarship Common Program Requirements,”1 over 20 and counting. As a group, these letters continue to demonstrate the differing perspectives on whether and how the common program requirements for residency education should address the topic of scholarly activity (application of a systematic approach to a question or project in a domain as defined by Glassick et al2), or scholarship (a scholarly approach that additionally is aimed at advancing knowledge in the field as judged by peer review3). There seems to be support for the concept that residents and faculty should demonstrate a scholarly approach to questions and projects and that programs should cultivate a culture or environment of inquiry. However, readers disagreed on whether residents and faculty should be required to advance their scholarly approach by producing scholarship. These varying opinions are reflected in the responses received. Seehusen and Ledford4 argue that “successful scholarship breeds successful physicians,” and suggest residents should have a scholarship requirement and that their work should be focused on the scholarship of discovery. In contrast, Hong5 voiced uncertainty about the role that either resident or faculty scholarship has in the aim of training great physicians, stating that “scholarship alone does not make a competent physician.” Both Hong5 and Fringer6 highlight the importance of ensuring that trainees are prepared to apply a scholarly approach to clinical problems but opine against a widespread mandate for scholarship. In addition, Fringer6 illustrates the logistical challenges such an interpretation of the requirement would pose to program directors. Presently, we advocate that the common program requirements remain focused on the expectation of a scholarly activity as there is currently insufficient evidence to support or not support a requirement for scholarship as a residency training requirement. Given that each program must refer to their specialty's residency review committee (RRC) requirements for specific guidance, over time, we anticipate that the Next Accreditation System will produce data for scholarly activity across the range of accredited programs. The systematic analysis of this data will then allow us to make informed decisions about the relative value of scholarly activity and scholarship on residents' learning and professional development.