ACGME Program Requirements for Graduate Medical Education in Internal Medicine Summary and Impact of Focused Requirement Revisions

Transcription

1 ACGME Program Requirements for Graduate Medical Education in Internal Medicine Summary and Impact of Focused Requirement Revisions Requirement: II.A.3.b), II.B.1.b).(1).(a), II.B.3.b).(1), II.B.4.c), II.B.5.a).(2) [Qualifications of the program director must include] current certification in the specialty for which they are the program director by the American Board of Internal Medicine (ABIM) or by the American Osteopathic Board of Internal Medicine (AOBIM), or specialty qualifications that are acceptable to the Review Committee; (Core) [The Subspecialty Education Coordinator must be]: currently certified in the subspecialty by the ABIM or AOBIM (Core) [The physician faculty must] have current certification in the specialty by the American Board of Internal Medicine or the American Osteopathic Board of Internal Medicine, or possess qualifications judged acceptable to the Review Committee. (Core) There must be a minimum number of ABIM- or AOBIM-certified core faculty members who are ABIM-certified based on program size the number of approved resident positions [Qualifications of the associate program directors are as follows:] must hold current certification from the ABIM or AOBIM in either internal medicine or a subspecialty. These program requirements are revised to make it explicit that AOBIM certification is acceptable to meet the qualification requirements for program director, subspecialty education coordinator, physician faculty member, internist core faculty member, and associate program director. This will not affect resident/fellow education, patient safety, and/or patient care quality Accreditation Council for Graduate Medical Education (ACGME) Page 1 of 7

2 II.B.4.c. The sponsoring institution and participating sites must provide support for There must be a minimum number of ABIM- or AOBIM-certified core faculty members based on program size the number of approved resident positions, as follows: according to the following faculty to resident ratio: (Core) This requirement is moved to the new Core Faculty section of the Common Program Requirements to make explicit that the Review Committee will continue to require a minimum (based on the approved number of residents) number of internist core faculty members. As this has been a longstanding specialty-specific program requirement, this will not affect resident/fellow education, patient safety, and/or patient care quality Accreditation Council for Graduate Medical Education (ACGME) Page 2 of 7

3 II.C.1.a) Program coordinator support must increase relative to the size of the program. (Core) This requirement was added to make it more explicit that 50% FTE is the minimum required support for a program coordinator larger programs will require more support Accreditation Council for Graduate Medical Education (ACGME) Page 3 of 7

4 IV.C.1.a)-b) (a) Assignment of rotations must be structured to minimize the frequency of rotational transitions, and rotations must be of sufficient length to provide a quality educational experience, defined by continuity of patient care, ongoing supervision, longitudinal relationships with faculty members, and meaningful assessment and feedback. (Core) (b) Clinical experiences should be structured to facilitate learning in a manner that allows the residents to function as part of an effective interprofessional team that works together towards the shared goals of patient safety and quality improvement. (Core) The requirements reflect the need for programs to consider the impact of frequent rotational transitions, such as occurs when fellows are scheduled for a series of short rotations, and the resulting disruption in supervisory continuity, on patient care and fellow education. They are also intended to address the impact of assigning supervising faculty members for very brief assignments. The intent of the requirements is to ensure that programs consider the impact of frequent rotational changes and the accompanying lack of supervisory continuity on patient care. This new requirement prioritizes patient safety and education in curriculum planning. The requirements are intended to minimize the frequency of rotational transitions and emphasize the importance of supervisory continuity. It is expected that this will have a positive impact on continuity of patient care Accreditation Council for Graduate Medical Education (ACGME) Page 4 of 7

5 IV.C.3. Residency training is primarily an educational experience in patient-centered care. The educational efforts of faculty and residents should enhance the quality of patient care, and the education of the residents. At least 1/3 of the residency training must occur in the ambulatory setting and at least 1/3 must occur in the inpatient setting. (Detail)(Core) Changing the categorization of this requirement from Detail to Core is correcting an error made by the Committee during the original categorization. The Committee has determined that there is no acceptable training model for internal medicine residents that would comprise less than 12 months of inpatient care or less than 12 months of outpatient care. This is an existing requirement that programs already comply with, so it will not affect resident/fellow education, patient safety, and/or patient care quality Accreditation Council for Graduate Medical Education (ACGME) Page 5 of 7

6 IV.C.3.k) Experience must include an assignment in at least four weeks dedicated to geriatric medicine. (Core) This revision clarifies that the geriatric medicine experience must be dedicated to geriatric medicine (i.e., it cannot be pieced together from geriatric patients who happen to be on other services) and must comprise at least four weeks. This had been previously clarified through an FAQ. As the Committee had already been directing programs to the FAQ when citing inadequate experience in geriatric medicine, this should not affect resident/fellow education, patient safety, and/or patient care quality Accreditation Council for Graduate Medical Education (ACGME) Page 6 of 7

7 Section V.A.1. All of the specialty-specific, formative-evaluation, subcompetency program requirements have been deleted. The Committee feels that the Common Program Requirements sufficiently describe the expectations for resident formative evaluations and feedback. The additional specialty-specific requirements are process-oriented, overly prescriptive, and almost exclusively categorized as Detail. They predate the Milestones, and they are often redundant with the Common Program Requirements. This will not affect resident/fellow education, patient safety, and/or patient care quality Accreditation Council for Graduate Medical Education (ACGME) Page 7 of 7