Updated: Supplemental Guidance Regarding the COVID-19 Pandemic, ACGME Accreditation, and Sponsoring Institution Emergency Categorization

The ACGME continues to maintain a process for the Emergency categorization of Sponsoring Institutions that face operational disruption resulting from the COVID-19 pandemic, and to issue guidance statements that address emerging pandemic-related accreditation issues. Based on its continued monitoring of the effects of the pandemic on graduate medical education, health care providers, and the public, the ACGME is providing the following supplemental guidance:

1. The ACGME continues to maintain its process for the Emergency categorization of Sponsoring Institutions as described on the ACGME website. In a modification to this process, the days of a Sponsoring Institution’s Emergency Category status will be counted cumulatively in each academic year (July 1-June 30). A Sponsoring Institution’s first request for Emergency categorization in a given academic year should be submitted to the ACGME using the Request Form for 1-30 Days.
   
   
2. All Sponsoring Institutions, in partnership with their programs, must ensure the safety of resident, fellow, and faculty member assignments that may include responsibilities for the care of patients with COVID-19. As stated in previous ACGME guidance [“ACGME Reaffirms Its Four Ongoing Requirement Priorities during COVID-19 Pandemic”], “any resident, fellow, and faculty member providing care to patients potentially infected with COVID-19 must be fully trained in treatment and infection control protocols and procedures adopted by their local health care setting (e.g., personal protective equipment [PPE]).” When setting priorities for vaccination against COVID-19, inclusion of residents/fellows and faculty members who serve as frontline caregivers is considered an essential part of this requirement.
   
   These obligations to ensure safety extend to the protection of faculty members, residents, and fellows who inform Sponsoring Institutions and programs of health conditions or impairments that are likely to be associated with a high risk of morbidity or mortality in the event of COVID-19 infection. Sponsoring Institutions and programs must ensure that faculty members, residents, and fellows with such health conditions or impairments are informed of safety measures associated with their patient care assignments. Per the ACGME Institutional Requirements, Sponsoring Institutions must have policies addressing leaves of absence and accommodations for disabilities. Sponsoring Institutions should consider requests for leaves of absence or for accommodations made by faculty members, residents, and fellows whose ability to participate in patient care assignments or other program activities is affected by health conditions (including COVID-19-related illness) or impairments. Reasonable accommodations should include arrangements that avoid risks to personal safety associated with residents’, fellows’, and faculty members’ health status (e.g., alternative rotations).
   
   
3. All programs must continue to assess residents and fellows in all six Core Competencies, and such assessments must form the basis for decisions regarding promotion to subsequent appointment levels or satisfaction of requirements for program completion. The ACGME has issued guidance [“Guidance Statement on Competency-Based Medical Education during COVID-19 Residency and Fellowship Disruptions”] for program directors, faculty members, and Clinical Competency Committees in completing the required assessments when educational components of the programs have been disrupted as a result of the COVID-19 pandemic. Programs should follow the principles of competency-based medical education, as described in the above-referenced guidance statement, to make determinations regarding the advancement, graduation, and Board eligibility of individual residents and fellows.