Reid S. AMA-RPS Delegate's Report, Part 1. JAMA. 1998;280(11):1021. doi:10.1001/jama.280.11.1021
Prepared by Ashish Bajaj, Department of Resident Physician Services,
American Medical Association.
In order to address many resolutions of interest to resident and fellow
physicians, the delegate and alternate delegate from the Resident Physicians
Section (RPS) to the American Medical Association (AMA) House of Delegates
(HOD) attended the RPS Annual Meeting and the AMA HOD Annual Meeting on June
11 through 18. Due to the work of all the residents who stayed to give testimony,
the section continues to have an effective and well-respected voice in the
HOD. The following is a summary of some of the resolutions and reports that
were addressed regarding residency training issues.
This RPS resolution instructs the AMA to develop and implement a nationwide
program offering support materials and on-site assistance to residents seeking
to form independent house staff organizations. This is the most recent action
in an area that has been the RPS's primary focus for the past year. House
staff organizations may help residents collectively bargain with their training
institutions on patient care and residency workplace issues. The RPS has begun
to implement this resolution.
This RPS resolution directs the AMA's representatives to the Accreditation
Council for Graduate Medical Education (ACGME) to continue to work to amend
the ACGME's institutional requirements so that institutions would be forbidden
from interfering with residents who develop house staff organizations that
could collectively negotiate with their training institution.
This report from the Council of Ethical and Judicial Affairs discusses
the ethical implications of collective action on the part of physicians and
provides guidelines for physicians who are considering collective action.
Its core statement is that collective actions should not be conducted in a
manner that could jeopardize the health and interests of patients. It also
recommends that residents and fellows take full advantage of the tools of
collective action to press for needed reforms.
This RPS resolution requests that AMA policy state clearly that attending
physicians are responsible for patient care and resident education. It also
asks the ACGME to incorporate the spirit of the resolution into its institutional
requirements. The HOD felt that there were many facets to this resolution
and voted to refer it to the Board of Trustees.
A report from the AMA's Council on Medical Education (CME) provides
guidelines for residency programs and program directors regarding residents
who need to take an extended leave from their training program. The report
also instructs the AMA to work with the ACGME and other relevant organizations
to implement the guidelines in this report.
Another report from the CME recommends: ensuring that residency programs
and the ACGME properly address issues related to the environment of training;
continuing to collect and disseminate data and information on the resident
work environment; monitoring residency programs to ensure that the educational
process is not adversely affected by decreases in residency numbers; ensuring
that institutions support residents in their efforts to negotiate about work
environment concerns; and advocating that residency programs file educational
impact statements with the ACGME and with appropriate Residency Review Committees
if the programs downsize or close.
This RPS resolution instructs the AMA to reaffirm current policy, which
states that residency programs should not use scores from the US medical licensing
examination to rank or screen applicants. It also called on the AMA to advocate
this position to the National Board of Medical Examiners.