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Beall D. Residency Requirements Concerning Grievances and Educational Experiences. JAMA. 1999;282(5):496A. doi:10.1001/jama.282.5.496
Prepared by Ashish Bajaj, Department of Resident
and Fellow Services, American Medical Association.
The last 4 Resident Physician Forum columns have explained many of the
requirements set by the Accreditation Council for Graduate Medical Education
(ACGME) for all institutions that train resident physicians. The remaining
requirements are presented below. Next week's column will explain the procedures
that a resident must follow when filing a complaint with the ACGME against
The institution must ensure an educational environment in which residents
may raise and resolve issues without fear of intimidation or retaliation.
To achieve this, the institution must:
Provide an organizational system through which residents can communicate
and exchange information with the institution regarding the working environment
and education. This system could be a house staff organization, an ombudsperson,
or another forum. Residents must be able to raise concerns in a confidential
and protected manner.
Establish and implement fair institutional policies and procedures
regarding academic or other disciplinary actions taken against residents.
For actions that could result in a resident's dismissal or could significantly
threaten a resident's intended career development, the institution must establish
and implement fair policies and procedures for the adjudication of resident
Ensure that each residency program establishes and implements
formal written criteria for resident selection, evaluation, promotion, and
Ensure that each program establishes an appropriate work environment
and reasonable duty hours.
Give residents the opportunity to submit confidential written
evaluations of the faculty and the educational experiences to the program
director or to a designated institutional official at least annually.
Institutions must ensure that residents have the opportunity to:
Develop a personal program of learning to foster continued professional
growth with guidance from the teaching staff.
Participate in safe, effective, and compassionate patient care,
under supervision, commensurate with their level of advancement and responsibility.
Participate fully in the educational and scholarly activities
of their program and, as required, assume responsibility for teaching and
supervising other residents and students.
Participate, as appropriate, in institutional programs and medical
staff activities and on institutional committees and councils whose actions
affect residency education and/or patient care.
Review ethical, socioeconomic, medical/legal, and cost-containment
issues that affect GME and medical practice. The curriculum must also provide
an appropriate introduction to communication skills and research design, statistics,
and critical review of the literature necessary for acquiring skills for life-long
While residents are responsible for performing their duties to
their best ability, institutions are responsible for providing enough resources
and support so that residents can meet those responsibilities. The ACGME's
Institutional Requirements provide a list of the expected resources and support
necessary for high quality residency education. By understanding these requirements,
the quality of graduate medical education will be improved.
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