Common Program Requirements

The Learning and Working Environment (Duty Hours)

Background

The ACGME continually monitors the published research regarding patient safety, supervision, resident and fellow education, and competency development as it relates to working hours, to ensure that the Common Program Requirements reflect the best available evidence.

By conducting a thorough review of the Common Program Requirements in conjunction with the graduate medical education community and other key stakeholders, the ACGME intends to meet both the responsibility of the profession to educate and train the next generation of physicians, and to ensure the safety of patients and residents and fellows involved in the educational process. If any changes or modifications to the accreditation requirements are proposed, the ACGME invites comments during a 45-day public comment period.

Flexibility Within a Maximum

Beginning in the fall of 2015, the ACGME undertook a full review of the Common Program Requirements as part of a scheduled five-year review. The review will be completed in two phases. Phase 1, which focused exclusively on Section VI, The Learning and Working Environment, began with assembly of a Task Force of expert physicians. The Task Force reviewed preliminary comments from the public of interest on the existing requirements, as well as formal position statements from member and constituent organizations and others with standing in the discussion, including impact analyses, recommendations, and supporting evidence. After consideration of this information as well as research, a draft revision was posted for a 60-day period of review and comment by the public. Comments received during that 60-day period were compiled and considered by the Task Force before preparation of a final proposed revision to Section VI of the Common Program Requirements for consideration for approval by the ACGME Board of Directors at its February 2017 meeting. The approved requirements go into effect July 1, 2017.

At the heart of the new requirements is the philosophy that residency/fellowship education must occur in a learning and working environment that fosters excellence in the safety and quality of care delivered to patients today and in the future. The important corollary is that physician well-being is crucial to their ability to deliver the safest, best possible care to patients. To that end, the changes to the Common Program Requirements are written to:

  • place greater emphasis on patient safety and quality improvement;
  • more comprehensively address physician well-being;
  • strengthen expectations around team-based care; and,
  • streamline resident clinical and educational work hours to be consistent across the country in a framework that is supported by testimony from educators.

Common Program Requirements Phase 1 Task Force Members

  • Kim Burchiel, MD, Co-Chair
    Neurological Surgery

  • Rowen K. Zetterman, MD, Co-Chair
    Gastroenterology – Internal Medicine

  • Thomas J. Nasca, MD, MACP, Vice Chair
    Chief Executive Officer, ACGME

  • James A. Arrighi, MD
    Internal Medicine

  • Stanley W. Ashley, MD
    General Surgery

  • Jessica L. Bienstock, MD
    Obstetrics and Gynecology

  • Peter J. Carek, MD
    Family Medicine

  • Ricardo Correa, MD
    Resident Member
    Endocrinology

  • David A. Forstein, DO
    Obstetrics and Gynecology

  • Robert Gaiser, MD
    Anesthesiology

  • Jeffrey P. Gold, MD
    Thoracic Surgery

  • George A. Keepers, MD
    Psychiatry

  • Benjamin C. Kennedy, MD
    Resident Member
    Neurological Surgery

  • Lynne M. Kirk, MD
    Internal Medicine

  • Anai Kothari, MD
    Resident Member
    General Surgery

  • Lorrie A. Langdale, MD
    General Surgery, Critical Care

  • Kenneth M. Ludmerer, MD
    Internal Medicine

  • Philip Shayne, MD
    Emergency Medicine

  • Steven C. Stain, MD
    General Surgery

  • Suzanne K. Woods, MD
    Pediatric Surgery

  • Claudia Wyatt-Johnson
    Public Member

Prior Letters to the Graduate Medical Education Community