Special e-Communication - May 11, 2020

May 11, 2020

NEW! ACGME Announces Diversity and Inclusion Award for 2021


The ACGME is proud to announce the Diversity and Inclusion Award, a new award to support efforts to achieve diversity and inclusion in graduate medical education (GME).

The COVID-19 crisis has reinforced data showing that underrepresented minorities are the victims of systemic inequality. Eliminating disparities in health care requires a commitment from all-even, and especially, during times of crisis. This annual award will highlight the most innovative and exemplary initiatives that drive diversity in GME.

Read more about the award, including instructions for submitting a nomination

Nominations are due Friday, July 17, 2020 by 5:00 p.m. Central.

NEW! Policy Statement on Enforcing COVID-19 Prevailing Requirements

As always, during the COVID-19 pandemic the ACGME remains committed to the safety and well-being of the graduate medical education (GME) community, including residents, fellows, faculty members, and the patients they serve.

With this focus top of mind, the ACGME has updated its Procedures for Alleged Egregious Events to address how the organization will rapidly respond to alleged non-compliance with the four prevailing COVID-19 priority requirements. The new section outlines the process for invoking the policy and subsequent investigation of alleged egregious events related to COVID-19 and includes an added means of identifying institutions or programs by way of a public sanction. Institutions and programs that receive a public sanction will be required to notify current residents and fellows, as well as new applicants, including the reason for the sanction.

Read the Full Statement in the ACGME Newsroom

NEW! Coalition for Physician Accountability Publishes Recommendations for 2020-2021

The Coalition for Physician Accountability—a cross-organizational group of national medical education organizations, of which the ACGME is a member—released its recommendations, Medical Students in the Class of 2021: Moving Across Institutions for Post Graduate Training, covering three major issues that applicants and education programs are facing as they prepare for the 2020-2021 residency cycle during the COVID-19 pandemic.

Read about the Report in the ACGME Newsroom

NEW! Clarifications and Frequently Asked Questions

FAQs are being developed in response to questions and requests for clarification the ACGME has received as it has communicated its response to the current pandemic crisis. View the FAQs on the Frequently Asked Questions page in the COVID-19 section of the ACGME website.

ACGME Program/Institutional Requirements

Q: What needs to be in place for a program’s residents/fellows to work in another hospital if that hospital has never been used by the program for required rotations previously?
A: If some of a program’s residents/fellows are assigned to work in another hospital as described in the question, that hospital would become a new participating site for the program. Each participating site must have a faculty member appointed by the program director as the site director who is accountable for resident/fellow education at that site, in collaboration with the program director. The program must monitor the clinical learning and working environment in that hospital, including resident/fellow work hours, resident/fellow supervision, and provisions for resident/fellow safety. If this site becomes one that routinely provides an educational experience required for all residents/fellows for one month or longer in duration, the program director will have to designate that hospital as an additional participating site in the program’s Accreditation Data System (ADS) record.

See Participating sites and PLAs in the Common Program Requirements: I.B. Participating Sites to I.B.4.

Q: If, over the next one-to-two months, the majority of a program’s core faculty members (and therefore residents) will temporarily work at a hospital never previously used for a required rotation, must the program notify the Review Committee of the new (but temporary) additional site even if it will not become a permanent or required rotation site?
A: Yes, the Review Committee must be notified of the new site through ADS.

The resident experience described will presumably be temporary and used to meet the educational need created by the pandemic. However, if the experience will extend beyond one month and is required of residents, information regarding the new site must be added in ADS.

Common Program Requirement I.B.4. states, “The program director must submit any additions or deletions of participating sites routinely providing an educational experience, required for all residents, of one-month full time equivalent or more through the ACGME Accreditation Data System (ADS).” (Core) For required participating sites, the program must monitor the clinical and working environment (CPR I.B.3.) and identify a site director (CPR I.B.3.a)). For each participating site, the residents who rotate there must know their responsibilities for reporting patient safety events and the method for reporting those events. (CPR VI.A.1.a).(3).(a))

Q: Is a program letter of agreement (PLA) required if a program would like, on a temporary basis (until the pandemic abates), to send, for example, all of its PGY-2 and PGY-4  residents to a hospital that is a new site for the program and that is not owned and operated by the primary clinical site?
A: Yes, there must be a PLA in place for this required experience. Common Program Requirement I.B.2. states, “There must be a PLA between the program and each participating site that governs the relationship between the program and the participating site providing a required assignment.”

The purpose of a PLA is to ensure that residents/fellows are provided with an appropriate educational experience and to protect them from undue service requirements that do not enrich their education. They also ensure an understanding of common expectations, the nature of the experience, and the responsibilities of the participating site.

Q: If a newly designated participating site is owned and operated by the primary clinical site, does there need to be a PLA in place?
A: No, a PLA is not required for a newly designated participating site that is owned and operated by the primary clinical site.

Guidance for participating sites and PLAs is provided in the Program Directors’ Guide to the Common Program Requirements:

eBook version, pages 26-29

PDF version, pages 18-31

Q: Should programs delay their Program Evaluation Committee (PEC) meetings for this academic year based on the delayed release of ACGME Resident/Fellow and Faculty Survey results?
A: No. programs should not delay PEC meetings for this academic year based on not having survey data alone. Survey data is just one of the many elements the PEC reviews as part of the Annual Program Evaluation process.

The pandemic has resulted in significant changes to the clinical and didactic experiences for the 2019-2020 academic year. The PEC might consider concurrently evaluating the effectiveness of any pandemic-related changes made in resident/fellow assignments, the use of telemedicine (including telesupervision), didactics, and other educational activities. The information will help in understanding the ability of the program to adapt and apply necessary changes in the event of an extension or recurrence of the pandemic.

Given the close date of June 26, 2020, Survey reports will not be released until all responses are analyzed, which will be after the current academic year ends on June 30, 2020. As announced in the March 18, 2020 Letter to the Community, the Resident/Fellow and Faculty Surveys are still available but completion is not required for the remainder of this academic year. Surveys will remain available to scheduled Window 3 participants until the extended deadline of June 26, 2020, but participation is optional. For programs that completed reporting before March 15, 2020 (the closing date for Window 2), and those programs in Window 3 that choose to continue to participate, the ACGME will create program-specific reports. When a program has at least a 70 percent survey completion rate, results will be made available as in prior years.

Read more about the role of the PEC in Program Directors’ Guide to the Common Program Requirements:

Residency eBook version, pages 278-287

Residency PDF version, pages 268-277

Fellowship eBook version, pages 264-273

Fellowship PDF version, pages 258-267

Letters to the Specialty Communities

A page in the COVID-19 section of the ACGME website includes letters to the specialty communities from the ACGME Review Committees and their staff and leadership. No new letters have been added since the last e-Communication.

Read Letters to the Specialty Community