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Resident Forum
January 21, 1998

Resident Physicians Section Adopts Resolutions on Graduate Medical EducationResident Physicians Section Adopts Resolutions on Graduate Medical Education

Author Affiliations

Prepared by Ashish Bajaj, Department of Resident Physicians Services, American Medical Association

JAMA. 1998;279(3):248G. doi:10.1001/jama.279.3.248
Resident Physicians Section Adopts Resolutions on Graduate Medical Education

At the American Medical Association's Interim Meeting in December, the Resident Physicians Section (RPS) considered 10 resolutions and 9 reports dealing with graduate medical education, public health issues, and RPS procedures. The RPS adopted the following resolutions and reports pertaining to graduate medical education. The remaining adopted resolutions and reports will be published in next week's Resident Forum.

National Committee to Evaluate Medical School Closings called for the AMA to address the concern about the possible oversupply of physicians by working with appropriate agencies to develop recommendations regarding the number of graduates of US medical schools. The resolution acknowledged that most of the recommendations regarding the physician workforce have focused on the number of resident physicians and not on the number of students in medical schools.

Clinical Supervision of Resident Physicians by Nonphysicians called for the AMA to amend current policy to include the following language regarding the supervision of resident physicians: It is a cardinal principle that responsibility for the treatment of each patient and the education of housestaff lies with the staff physician to whom the patient is assigned and who supervises all care rendered by residents. The resolution also called on the AMA to ask the Accreditation Council for Graduate Medical Education (ACGME) to incorporate this language.

Effective Communication With HCFA asked the AMA-RPS Governing Council to meet with the staff at the Health Care Financing Administration (HCFA) to discuss the Medicare guidelines governing reimbursement of teaching physicians for supervising residents and to report back to the Assembly.

Impact of HCFA Medicare Regulations on Residency Training calls on the AMA-RPS Governing Council to continue to monitor the issue of Medicare, Medicaid, and private payor reimbursement of teaching physicians for supervising residents. This report stemmed from the concern that Medicaid and private insurance companies would use Medicare standards regarding reimbursement even though Medicare and private payors do not help fund graduate medical education. The report acknowledged the work that the AMA-RPS has done on this issue and asked the AMA-RPS Governing Council to continue to collect information and anecdotes from residents on the regulations regarding reimbursement of teaching physicians for supervising residents, and to continue to report back to the Assembly as appropriate.

Reallocation of Residency Positions and Preservation of Work Hour Reform called for the AMA-RPS to ask the AMA's Council on Medical Education's Task Force on Emotional and Physical Support of Undergraduate and Graduate Education to work with other interested entities to coordinate and secure funding for a longitudinal study of the effects of downsizing on residency work hours.

Evaluations and Consultations for Use in Grievance Procedures asked that the AMA-RPS ask the AMA's Council on Ethical and Judicial Affairs (CEJA) to develop guidelines for residency programs regarding the procedures by which a residency program can terminate or dismiss a resident. They also asked that the AMA-RPS publicize current CEJA Opinions that relate to residency termination hearings.

Inappropriate Use and Reporting of USMLE Scores calls for the AMA to advocate to the National Board of Medical Examiners (NBME) that scores for the US Medical Licensure Examination be used only in accordance with the following AMA policy: (a) Students receive "pass/fail" scores as soon as they are available. (A student who fails the examination may request numerical scores immediately.) (b) The NBME will report numerical scores to the state licensing authorities upon request by the applicant for licensure. At this time, the applicant may request a copy of his/her numerical scores. (c) The NBME will report scores for each student in pass/fail format to the medical school. The school also receives a frequency distribution of numerical scores for the aggregate of its students.