Beall D. The Requirements of Residency: Educational Administration and Internal
Reviews. JAMA. 1999;282(4):308E. doi:10.1001/jama.282.4.308
Prepared by Ashish Bajaj, Department of Resident
and Fellow Services, American Medical Association.
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
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:
Creation and implementation of policies that affect all residency
programs regarding the quality of education and the work environment for the
residents in each program.
Appropriate oversight of, and liaison with, the directors of each
residency program. The GMEC must also help ensure that the program directors
communicate effectively with personnel at any other hospitals or training
sites to which the residents are assigned to serve.
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 educational objectives of each program and the adequacy of
available educational/financial resources to meet these objectives.
The effectiveness of each program in meeting its objectives.
The effectiveness in addressing citations from previous ACGME
letters of accreditation and previous internal reviews.
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.