Resources for Reporting Concerns

Before submitting a report to the ACGME, it is recommended that individuals use reporting channels within their program or Sponsoring Institution to share feedback, raise concerns and seek resolutions. The following resources may be available at most, but not all, programs or Sponsoring Institutions. This list does not represent every resource that a program or Sponsoring Institution may have for reporting.

• Program Director
  • The program director has authority and accountability for the operation of a residency/fellowship program, including compliance with all applicable program requirements.

• Program Coordinator
  • The program coordinator is the lead administrative person who assists the program director in accreditation efforts, educational programming, and support of residents/fellows.

• Designated Institutional Official (DIO)
  • The designated institutional official (DIO) is the person charged with oversight of all ACGME-accredited programs at an ACGME-accredited Sponsoring Institution. The DIO can clarify institutional policies and procedures and may have information about other institutional resources available to residents and fellows. The DIO often works with (and may chair) the institution’s Graduate Medical Education Committee (GMEC), with involvement in selection of program directors.

• Institutional Coordinator
  • The institutional coordinator is the lead administrator who works with the DIO on efforts related to graduate medical education (GME) and accreditation, which may include support of residents/fellows and educational programming.

• Human Resources
  • The Human Resources (HR) office at the institution may be able to assist with questions about employment-related matters. Some of these may include vacation and sick leave policies, benefits, contracts, legal matters, salary disputes, and others. Because residents and fellows function as both employees and students, the graduate medical education (GME) office also has responsibilities in oversight of these matters.

• Program, Department, or Institutional Ombudsperson (for the hospital, health system, or university)
  • This role may not be available in every program or institution. If an ombudsperson or Ombuds Office is available in an institution, they may provide confidential, impartial, informal, and independent assistance to individuals and groups who are experiencing conflicts or who have complaints. Ombuds may provide information about policies, procedures, rules, and formal or administrative options for addressing concerns within an institution.

• Resident/Fellow Forum
  • Sponsoring Institutions with more than one program must ensure availability of an organization, council, town hall, or other platform that allows all residents/fellows from within and across the Sponsoring Institution’s ACGME-accredited programs to communicate and exchange information with other residents/fellows relevant to their ACGME-accredited programs and their learning and working environment.

• Senior or Chief Resident
  • The chief resident may be a good resource for guidance or advice on navigating internal systems or bringing widespread concerns to the attention of a program and/or institutional leadership.

• GMEC Representatives
  • A Sponsoring Institution must have a Graduate Medical Education Committee (GMEC) that includes multiple voting members, and which oversees the quality of the GME learning and working environment and educational experiences, as well as ACGME accreditation and recognition statuses.

• Patient Safety Reporting Systems
  • The Sponsoring Institution must ensure that residents/fellows have access to systems for reporting errors, adverse events, unsafe conditions, and near misses in a protected manner that is free from reprisal. Residents/fellows must have opportunities to contribute to root cause analysis or other similar risk-reduction processes.

• Employee Assistance Program (EAP)
  • An EAP is a voluntary, employer-funded work benefit that may offer confidential assessments, short-term counseling, and resource referrals. EAPs are designed to help employees and their household members manage personal or work-related challenges that may impact their well-being, health, or job performance. Inquire with the HR department or check employee policies to determine if the institution has an EAP.

Equal Employment Opportunity Commission (EEOC)
www.eeoc.gov

From the website’s overview page:

“The U.S. Equal Employment Opportunity Commission (EEOC) is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy, childbirth, or related conditions, transgender status, and sexual orientation), national origin, age (40 or older), disability or genetic information. The EEOC has the authority to investigate charges of discrimination against employers who are covered by the law.”

Report a Safety Event about a Health Care Organization – Joint Commission
www.jointcommission.org

The Joint Commission’s primary purpose is to improve health care quality and safety by accrediting and certifying more than 22,000 health care organizations in the US. It establishes standards of care, evaluates performance, and helps organizations identify and fix safety gaps to ensure patients receive safe, high-quality, and effective care.

The Joint Commission has a process to submit a safety concern or event regarding a Joint Commission-accredited or -certified organization. The Joint Commission does not evaluate the care of an individual, or whether that care was appropriate. Their evaluation focuses on processes that are required within their standards.

National Resident Matching Program (NRMP)
www.nrmp.org

The NRMP^®, which administers The Match^®, is an independent, non-profit organization whose responsibility is to place the nation’s medical school talent into clinical training programs.

The NRMP maintains Match policies for applicants, programs, medical schools, and institutions. Match policies are designed to ensure a fair and transparent matching process by outlining the rights and responsibilities of Match participants and the guidelines for participation they must follow.

International Medical Graduate (IMG) Certification –
Educational Commission for Foreign Medical Graduates (ECFMG)

www.ecfmg.org

The US-based ECFMG certifies IMGs for US GME programs. As the designated dean’s office for IMGs, the ECFMG assesses their readiness for ACGME-accredited residency and fellowship programs through its certification. This involves verifying medical school credentials, processing United States Medical Licensing Examination (USMLE) applications, and authenticating diplomas. ECFMG certification is required for IMGs to take USMLE Step 3, apply for US residency, and obtain a medical license. The organization also approves agencies like the World Federation for Medical Education for recognizing medical school accreditation.

The ECFMG offers a variety of programs for international physicians and other members of the international medical education and regulatory communities.

Patient Care Concerns

Anyone who is/was a patient or patient representative who wishes to report concerns about the care and/or services received should report directly to the medical facility. Hospitals have established patient complaint or grievance mechanisms and can direct individuals appropriately within the system. Patients may also contact state agencies with grievances.

The ACGME does not evaluate the care of an individual, or whether that care was appropriate.