Evaluating Residency Competency and Its Impact on Antibiotic Prescribing Practices Among Early-Career Primary Care Physicians
By
Jesse Burk-Rafel
Hannah Park
MacIntosh Cornwell
Eric S. Holmboe
Kenji Yamazaki
Sally A. Santen
Yoon Soo Park
John S. Andrews
Sean O. Hogan
Judee Richardson
September 17, 2026
Clinical Scorecard: Evaluating Residency Competency and Its Impact on Antibiotic Prescribing Practices Among Early-Career Primary Care Physicians
At a Glance
Category Detail
Condition Antibiotic prescribing practices Key Mechanisms Residency training and competency assessments influence prescribing behavior. Target Population Early-career primary care physicians (PCPs) in the US. Care Setting Outpatient primary care settings.
Key Highlights
Physicians show significant variation in outpatient antibiotic prescribing patterns. Older adults are particularly vulnerable to antibiotic-related complications. Residency training may imprint enduring practice patterns in antibiotic prescribing. ACGME Milestone competency ratings are linked to early-career prescribing behaviors. Inappropriate antibiotic prescribing may reflect failures in medical knowledge and communication skills. Guideline-Based Recommendations
Diagnosis
Assess antibiotic prescribing appropriateness based on clinical guidelines. Management
Implement antibiotic stewardship programs targeting high-prescribing physicians. Monitoring & Follow-up
Evaluate prescribing patterns using Medicare claims data. Risks
Consider the risk of unnecessary antibiotic prescriptions in older adults. Patient & Prescribing Data
Older adults receiving outpatient antibiotics.
Up to 15% of antibiotics prescribed to older adults may be unnecessary.
Clinical Best Practices
Utilize ACGME competency ratings to inform residency training improvements. Encourage communication skills development during residency to enhance prescribing practices. Monitor and evaluate antibiotic prescribing patterns regularly. Related Resources & Content
