ACGME Common Program Requirements Revisions – Section VI
The ACGME Phase I Task Force will bring forth to the ACGME Board of Directors proposed requirements for approval and implementation. The public comment period was available through December 19, 2016. The new proposed Common Program Requirements bring about significant additions and changes in the subsections of patient safety, physician well-being, and clinical experience and education hours (formally known as duty hours).
After much work investigating the published literature on the impact of these areas and input from the medical education community and the public, the Task Force has emphasized that the Common Program Requirements represent that Medical Education is Professional Education.
As noted by Thomas Nasca, MD, Executive Director of the ACGME , “ The ACGME is placing greater emphasis on systems of and experiences in, team care, patient safety, quality of care, and physician well-being.” The goal is to support programs, residents, and faculty as they strive to provide excellent clinical care “while ensuring ethical humane resident education.”
Patient Safety and Quality Improvement
The proposed requirements articulate the need for a culture and clinical learning environment focused on resident education and faculty development in patient safety and quality improvement. The ACGME has proposed more specific expectations in the quality of care being delivered by residents and faculty. It is proposed that residents evaluate the specialty specific metrics and benchmark their patient’s data.
Supervision is not a one-size-fits-all approach, but rather, according to Dr. Nasca, “an emphasis on the expectation that an individual resident’s level of training and ability, as well as the patient’s complexity and acuity, must factor into decisions regarding supervision.”
Resident and Faculty Well–Being
Brought to the forefront is an awareness that evidence shows physicians are at an increased risk for burnout. The focus is on the programs to share a responsibility in the resident and faculty well-being. Patient care is at risk when a physician does not have the necessary support to manage these demands and the decisions that come along with it. The physician suffers in an overburdened system as does his/her patients.
Clinical Experience and Education Hours
The term “duty hours, duty periods” have been replaced for “clinical and educational work hours.” The change comes to ensure that the emphasis is on the responsibility to provide safe care to patients rather than a focus on duty to the clock or schedule. The training becomes about professionalism and not restrictive rules. The Task Force removed the requirement limiting PGY-1 residents to 16 hours of consecutive time on-task. Program directors have the flexibility to continue with their current configurations, but it will not be required. All the other previous “duty hour” requirements remain unchanged.
The ACGME Task Force looks at these new requirements as a way for Sponsoring Institutions and programs to embrace a team based interdisciplinary approach to patient care.
More information about these requirements can be found by accessing the GME office’s knowledge base at https://lsugme.atlassian.net/wiki.