ACGMECore Competencies

New ACGME Duty Hours Standards

ACGME Site Visit Residency

Program July 26

EffectiveJuly 1, 2011

The Accreditation Council for Graduate Medical Education (ACGME) is a private, non-profit council that evaluates and

accredits medical residency programs in the US.

To accomplish this, the ACGME has established a set of standards for all programs, and specific standards by specialty. Accredited programs must demonstrate

compliance with these standards through contribution of program data on an ongoing basis, and at the time

of scheduled site visits.

Our department has eight accredited training programs:

The Core AP/CP Residency Program

Fellowship Programs:Blood Banking and Transfusion Medicine

CytopathologyDermatopathologyHematopathology

Molecular Genetic PathologyPediatric PathologySurgical Pathology

…and is currently pursuing two additional ACGME-accredited fellowships:Neuropathology

Forensic Pathology

1. Relationships between the sponsoring institution and participating sites

2. Qualifications and responsibilities of the Program Director and the Faculty

3. Resident selection, credentialing, and quota4. The Educational Program• Including the Six Core Competencies

5. Resident and Faculty evaluations6. Program evaluation7. Resident duty hours and the learning

environment

The ACGME Standards with which we must comply are organized as follows:

Patient Care

Medical Knowledge

Practice-based Learning and Improvement

Interpersonal and Communication Skills

Professionalism

Systems-based Practice

The ACGME Six Core Competencies are:

Residents must be able to provide patient care that is

compassionate, appropriate, and effective for the treatment of health

problems and the promotion of health.

Patient Care =

What you do

Medical Knowledge =

What You Know

Residents must demonstrate knowledge of established and

evolving biomedical, clinical, epidemiological and social/behavioral

sciences, as well as the application of this knowledge to patient care.

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence,

and to continuously improve patient care based on constant self-evaluation and life-long

learning.

Practice-based Learning and Improvement =

How You Get Better

Residents must demonstrate interpersonal and communication

skills that result in the effective exchange of information and

collaboration with patients, their families, and health professionals.

Interpersonal and Communication Skills =

How You Interact With Others

Residents must demonstrate a commitment to carrying out

professional responsibilities and an adherence to ethical

principles.

Professionalism =

How You Act

Residents must demonstrate an awareness of and responsiveness to the larger

context and system of health care, as well as the ability to call effectively on other

resources in the system to provide optimal health care.

Systems-based Practice =

How You Work Within the System

Why should you know about these six core competencies if you are not a residency or fellowship

program director?

The newly written curriculum, including all of the rotation goals and objectives are based on them.

Resident evaluation forms will ask you to comment on them.

Surveys of employers of recent pathology graduates indicate that many are deficient in skills related to those competencies other than Patient Care and Medical Knowledge.

An ACGME Site Visitor will expect the faculty to understand them.

Since 2003, the ACGME standards for residency programs have included caps on weekly duty hours and rules governing in-

house call and days off.

2011 updated Duty Hours standards have added further guidelines, some regarding

first year residents.

Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-

house call activities and all moonlighting.

PGY-1 residents are not permitted to moonlight.

Residents must be scheduled for a minimum of one day free of duty every week, averaged over four

weeks. At-home call cannot be assigned on these free days.

The following duty hours standards are significant to our residency program:

Duty periods of PGY-1 residents must not exceed 16 hours.

PGY-1 residents cannot take call, either in-house or at-home.

PGY-1 and intermediate level residents (PGY-2 for pathology) should have 10 hours and must have 8

hours between scheduled duty periods.

Residents in the final years of training (3rd and 4th years) may have fewer than 8 hours free when patient care needs dictate this need, but these circumstances must be closely monitored by the program director.

More duty hours standards that are significant to our residency program:

For which of these duty hours standards does our residency program have violations?

80 hour work week?

12 violations since 7/1/10

10 hr. rest between duty periods?

67 violations since 7/1/10

1st yr moonlighting? Change in policy

1st year taking call? Autopsy scheduling changes

80 hour work week?

12 violations since 7/1/10

10 hr. rest between duty periods?

67 violations since 7/1/10

These are happening in the services

with the highest clinical volumes.

ACGMECore Competencies

New ACGME Duty Hours Standards

You will be seeing and considering these as

part of resident education

More work to be done to address

these