Beall D. The Basic Requirements Institutions Must Provide Residents, Part 1. JAMA. 1999;282(1):98A. doi:10.1001/jama.282.1.98
Prepared by Ashish Bajaj, Department of Resident
and Fellow Services, American Medical Association.
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.
Residents should be given enough financial support so they can fulfill
the responsibilities of their educational programs.
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.
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.
Institutions should facilitate resident access to appropriate medical
services, confidential counseling, and psychological support services.
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
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