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Resident Physician Forum
July 7, 1999

The Basic Requirements Institutions Must Provide Residents, Part 1

Author Affiliations

Prepared by Ashish Bajaj, Department of Resident and Fellow Services, American Medical Association.

JAMA. 1999;282(1):98A. doi:10.1001/jama.282.1.98

The Accreditation Council for Graduate Medical Education (ACGME) requires institutions that sponsor graduate medical education to provide a scholarly environment and to be committed to excellence in education and patient care. As part of this commitment, institutions must provide residents with enough resources and support needed to meet their training requirements. The following is an abbreviated checklist containing some of the institutional requirements that are of particular importance to residents.

Financial Support

Residents should be given enough financial support so they can fulfill the responsibilities of their educational programs.

Malpractice Insurance

Institutions must provide residents with professional liability coverage for the duration of training. This coverage must provide legal defense and protection against financial claims if a lawsuit is filed after the completion of training and if the alleged acts or omissions by the resident occurred within the scope of the educational program. The coverage should be consistent with the institution's coverage for other medical/professional practitioners.

Disability Insurance

If an institution has access to a disability insurance program, that institution must provide its residents with access to insurance for disabilities resulting from activities that are part of the educational program.

Counseling Services

Institutions should facilitate resident access to appropriate medical services, confidential counseling, and psychological support services.

Leave Policies

The institution must provide residents with a written policy regarding professional, parental, and sick leave and the effect such leaves of absence would have on the resident's ability to complete training. These policies must comply with applicable laws.


Institutions must provide residents with a written agreement or contract outlining the terms and conditions of their appointment to an educational program. The institutions also must ensure that program directors are meeting these terms. The contract must contain, or at least reference, information on the support and benefits listed above. It must also contain or reference the following: vacation policies, conditions under which living quarters and/or meals and/or laundry are to be provided, institutional policies covering sexual and other forms of harassment, grievance procedures, the resident's responsibilities, duration of appointment, and professional activities outside the educational program.

Future columns will discuss the work environment, grievance policies, and other requirements. Residents can obtain the complete institutional requirements and the program requirements for their specialties on the ACGME's Web site (http: //www.acgme.org). Residents should be aware that the requirements are written to allow for some variation among institutions.