Reactions to and endorsements of the new ACGME Common Program Requirements in Section VI from several organizations across the medical community are presented and linked below.
The American Board of Surgery (ABS) endorses the task force's revisions, which promote improved continuity of care for patients and greater individual responsibility and professionalism for residents, while also incorporating additional safeguards for patient safety and resident well-being.
Today the American College of Surgeons issued comments on the release of Revised Common Program Requirements, Section VI, the Learning and Working Environment by the Accreditation Council for Graduate Medical Education (ACGME).
We applaud the ACGME for the release of new Common Program Requirements that allow programs flexibility to schedule residents’ clinical and education work hours within the well-established maximums currently utilized in the U.S., while preserving the original intent of the 2003 guidelines on residents’ working conditions.
These new requirements take into consideration findings from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial. The FIRST Trial is the first-ever national multicenter randomized trial of resident duty hour policies. Findings released in February 2016 showed that flexible hours do not affect patient safety, reduce handoffs, and lead to greater resident satisfaction.
“This is an evidence-based revision that aims to improve both resident education and surgical patient safety,” said ACS Executive Director David B. Hoyt, MD, FACS. “When residents work flexible schedules, they’re not disrupted by the clock. Patient safety is less likely to be compromised if a resident does not have to leave during the middle of an operation because a shift is ending, or hand off a patient in the middle of active care to another provider.“
The Resident and Associate Society of the American College of Surgeons (RAS-ACS) also commends the ACGME for allowing flexibility in duty hours.
“These revisions are in line with scientific evidence that shows flexibility enhances the quality of surgical residents’ education without affecting patient safety. We think these program revisions contribute to an optimal training and education environment, which is crucial to our development as fully trained and competent surgeons,” said Nicolas Mouawad, MD, MPH, MBA, Chair of the Resident and Associate Society of the American College of Surgeons.
The American Osteopathic Association supports the ACGME’s revisions to Section VI of the Common Program Requirements. The new requirements reflect the philosophy that residency education must occur in a learning and working environment that fosters excellence and promotes safe and quality patient care.
The Association for Hospital Medical Education (AHME) applauds the meticulous approach taken by the Task Force to review the literature, invite input from within and outside the medical profession, and carefully weigh all this information in an effort to ensure the quality and safety of patient care now and in the future, and to do so in an environment that facilitates team-based care and fosters the well-being of caregivers.
The best way to assure patient safety, quality care, and the well-being of residents is through a comprehensive approach that puts programs into place to support an educational learning environment that manages fatigue, promotes well-being, provides quality supervision for trainees, assesses residents’ workloads, and ensures that information is effectively transferred by residents to other members of the patient care team. The newly released changes to the Common Program Requirements offer just such an approach.
The Council of Medical Specialty Societies (CMSS) and the Organization of Program Director Associations (OPDA) applaud the Accreditation Council for Graduate Medical Education (ACGME) on its release of revised Section VI of the Common Program requirements, focusing on the learning and working environment. These revised standards reinforce a culture of patient safety and physician well-being in residency training programs by strengthening the focus on patient-centered, team-based care.
The revised requirements return first-year residents to the same schedule as other residents and fellows, without changing the limitation on the total number of hours per week which first-year residents work. The standards require that programs and residents continue to adhere to the maximum limits averaged over four weeks:
CMSS supports the recognition in these revised Common Program requirements that graduate medical education must balance three critical goals:
CMSS has 43 member societies, which represent 790,000 U.S. physician members. CMSS focuses on two strategic priorities:
CMSS has endorsed the National Quality Strategy, including:
CMSS convenes the Organization of Program Director Associations (OPDA), with 28 organizations representing the specialties accredited by the Accreditation Council for Graduate Medical Education.
The Society of Neurological Surgeons appreciates the comprehensive analysis performed by the ACGME Task Force leading to the Revised Common Program Requirements for the Working and Learning Environment.