Residency

Changes to common program requirements finalized

Residency Program Insider, April 10, 2007

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The ACGME board of directors approved revisions to the common program requirements (CPR) at their February 2007 meeting, increasing consistency with the institutional requirements and research requirements for residents, among other changes. The new requirements will go into effect July 1, 2007.

The revised requirements have increased consistency with the common institutional requirements and have eliminated some unnecessary redundancies. There has been added language regarding protected educational time for the program director. While this change will help programs allow more time for education, it may also increase the financial burden on some departments.

The CPR now include the following requirements:

"The sponsoring institution and the program must ensure that the Program Director has sufficient protected time and financial support for his or her educational and administrative responsibilities to the program." (Section A, lines 12-14).

This requirement is good because program directors will be more likely to spend time teaching, but may cause some programs to have to stretch already thin budgets. This will be an especially tough adjustment for programs that did not already have stipulations that protected teaching time.

Another significant change is that program letters of agreement (PLA) must be reviewed every five years. The previous CPR language did not require a review within any length of time.

Note: The PLA is a written document that addresses GME responsibilities between an individual accredited program and an entity such as a clinic or hospital other than the sponsoring institution at which residents receive part of their training.

The CPR state that the PLA must

  • identify the faculty who will assume both educational and supervisory responsibilities for residents
  • specify their responsibilities for teaching, supervision, and formal evaluation of residents
  • specify the duration and content of the educational experience
  • state the policies and procedures that will govern resident education during the assignment

Additional language has also been added regarding the responsibilities of the program director, including requirements that he or she must:

  • evaluate program faculty and approve continued participation of program faculty based on evaluation (III.4.d.)
  • monitor resident supervision at all participating sites (III.4.e)
  • provide each resident with documented semiannual evaluation of performance with feedback (III.4.g)
  • implement policies and procedures consistent with the institutional and program requirements regarding duty hours and moonlighting and selection, evaluation, and promotion of residents, disciplinary action, and supervision of residents (III.4.j and III..4.l)
  • obtain review and approval of the sponsoring institution's GMEC/DIO before submitting certain information to the ACGME (III.4.n. 1-10)
  • obtain DIO review and co-signature on all program information forms, as well as any correspondence regarding program citations or requests for changes to the ACGME (III.4.o.1-2)

The change that most program administrators are buzzing about, however, is the revision to language about resident and faculty scholarship. In addition to now requiring competency-based goals and objectives for each assignment at each educational level (IV.A.2.), the revised CPR includes the following requirements for residents' scholarly activities (IV.B.1-3):

  • The curriculum must advance residents' knowledge of the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care.
  • Residents should participate in scholarly activity (as further specified by the specialty review committee)
  • The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities.

Although many programs already have some research requirement, some administrators are now implementing "research days," which will allow residents to show off poster presentations to their peers.Resident presentations may include research papers, posters, or case reviews to fulfill this requirement.In addition, program directors should keep an eye out for national venues that offer opportunities for residents to present research.

Note: To view the complete revised CPR, go to www.acgme.org.

All the best,

Kathryn M. Andolsek, MD, MPH,
Associate director for GME
Duke University Medical School
Durham, NC



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