National accrediting body revises GME program standards

Task force co-chaired by Dr. Kim Burchiel of OHSU

March 14, 2017

The Accreditation Council for Graduate Medical Education (ACGME) on March 10 released a final set of revisions to the professional standards all accredited U.S. residency and fellowship programs follow in preparing today's physicians for a lifetime of practice.

The new requirements, effective July 1, 2017, reinforce a culture of patient safety and physician well-being in residency training programs by strengthening the focus on patient-centered, team-based care. OHSU's model of wellness and counseling has been looked to as an example for the nation's GME programs now tasked with incorporating these standards. Since 2004, the OHSU Resident and Faculty Wellness Program has provided free, comprehensive, and easily accessible counseling services to residents, fellows and primary school faculty. Utilization of this program has increased steadily over the past 10 years.

"The American public deserves to know that starting on Day One physicians in practice already have the real-world experience they need to ensure high quality patient care," stated Thomas J. Nasca, M.D., M.A.C.P., chief executive officer of the ACGME and vice-chair of the Task Force, in a memo announcing the approved requirements. "Residents also have the right to develop such experience under appropriate supervision to manage the lifetime of demands and stress that come with the privilege of patient trust."

The revised requirements return first-year residents to the same schedule as other residents and fellows, re-establishing the commitment to team-based care and seamless continuity of care while also ensuring professionalism, empathy and the commitment of first-year residents to their patients. The cap for first-year residents will return to 24 hours, a cap that has been in place nationwide for all other residents and fellows, plus up to four hours to manage necessary care transitions. The revised standards do not change the total number of hours per week which first-year residents work (see right for a list of the changes).

"The 2017 revision includes a much-needed new section devoted to making the promotion of resident well-being a responsibility of both residency programs and the institutions that sponsor them," said Kim Burchiel, M.D., professor of neurological surgery, OHSU School of Medicine and co-chair of the Task Force. "In many ways, this puts the ACGME at the forefront of combating physician burnout during residency training and, later, independent practice."


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