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Resident Forum
September 16, 1998

AMA-RPS Delegate's Report, Part 1

Author Affiliations

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

JAMA. 1998;280(11):1021. doi:10.1001/jama.280.11.1021

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.

Implementing Independent House Staff Organizations

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.

House Staff Organizations in Institutional Requirements

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.

Collective Action and Patient Advocacy

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.

Clinical Supervision of Resident Physicians by Nonphysicians

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.

Policies for Maternity, Family, and Medical Necessity Leave for Residents and Employed Physicians

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.

Educational and Work Environment of Resident Physicians

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.

Inappropriate Use and Reporting of Scores

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.