The Requirements of Residency: Educational Administration and Internal Reviews FREE

The last 3 Resident Physician Forum columns explained the requirements set by the Accreditation Council for Graduate Medical Education (ACGME) regarding compensation, fringe benefits, contracts, work hours, supervision, and other aspects of the work environment that apply to all institutions that train resident physicians. In addition to these institutional requirements, each residency program must adhere to the program requirements set by its Residency Review Committee. This column presents some of the requirements regarding the educational oversight of programs. Next week's column will present the requirements regarding communication between residents and the institution's administration.

Every institution must provide an organized administrative system that oversees all residency programs. The institution must designate an official who oversees and administers these programs.

The institution must establish a graduate medical education committee (GMEC) that monitors and advises the institution on all aspects of residency education. The voting members of the committee must include program directors, other faculty members, other accountable institutional officials, and at least 1 peer-nominated resident. The committee must meet at least quarterly and keep minutes. The committee is responsible for the following:

The GMEC is also responsible for ensuring that a regular review of each of the institution's residency programs is conducted to assess compliance with the institutional and program requirements. The reviewers should include faculty, residents, and administrators who are selected from both within and outside the department in which the residency exists. External reviewers may also be called in if the GMEC so decides. The review must follow a written protocol approved by the GMEC. This review should appraise:

The internal review can use data from the institutional and program requirements, letters of accreditation from previous ACGME reviews, reports from previous internal reviews, and interviews with the program director, faculty, residents in the program, and individuals outside the program deemed appropriate by the committee. Finally, the review must be documented and the mechanisms to correct any identified deficiencies must be recorded.