GMEC Responsibilities
The GMEC must - establish and implement policies and procedures
regarding the quality of education and the work environment for the
residents in all ACGME-accredited programs.
- review annually and make recommendations to the
Sponsoring Institution on resident stipends, benefits, and funding for
resident positions to assure that these are reasonable and fair.
- establish and maintain appropriate oversight of and
liaison with program directors and assure that program directors
establish and maintain proper oversight of and liaison with appropriate
personnel of other institutions participating in the ACGME-accredited
programs of the Sponsoring Institution.
- establish and implement formal written policies and
procedures governing resident duty hours in compliance with the
Institutional and Program Requirements. The GMEC must assure that the
following requirements are met:
- Each ACGME-accredited program
must establish formal written policies governing resident duty hours
that are consistent with the Institutional and Program Requirements.
These formal policies must apply to all participating institutions used
by the residents and must address the following requirements:
- The educational goals of the
program and learning objectives of residents must not be compromised by
excessive reliance on residents to fulfill institutional service
obligations. Duty-hours and call schedules must be monitored by both
the Sponsoring Institution and programs and adjustments made as
necessary to address excessive service demands and/or resident fatigue.
Duty hours, however, must reflect the fact that responsibilities for
continuing patient care are not automatically discharged at specific
times. ACGME-accredited programs must ensure that residents are
provided appropriate backup support when patient care responsibilities
are especially difficult or prolonged; and,
- Resident duty hours and
on-call time periods must be in compliance with the Institutional and
Program Requirements. The structuring of duty hours and on-call
schedules must focus on the needs of the patient, continuity of care,
and the educational needs of the resident.
- The GMEC must develop and
implement procedures to regularly monitor resident duty hours for
compliance with the Sponsoring Institution's policies and the
Institutional and Program Requirements.
- The GMEC must develop and
implement written procedures to review and endorse requests from
programs prior to submission to an RRC for exceptions in the weekly
limit on duty hours up to 10 percent or up to a maximum of 88 hours. All
exceptions requested must be based on a sound educational rationale. The
procedures must outline the process for endorsing an exception in
compliance with the ACGME policies and procedures for duty-hour
exceptions. The procedures and their application, if the institution has
utilized them, will be assessed during the institutional review.
- assure that ACGME-accredited programs provide
appropriate supervision for all residents that is consistent with proper
patient care, the educational needs of residents, and the applicable
Program Requirements. Supervision of residents must address the
following:
- Residents must be supervised
by teaching staff in such a way that the residents assume progressively
increasing responsibility according to their level of education,
ability, and experience.
- On-call schedules for
teaching staff must be structured to ensure that supervision is readily
available to residents on duty.
- The teaching staff must
determine the level of responsibility accorded to each resident.
- assure that each program provides a curriculum and an
evaluation system to ensure that residents demonstrate achievement of the
six general competencies listed in Section III.E and as defined in each
set of Program Requirements.
- establish and implement formal written institutional
policies for the selection, evaluation, promotion, and dismissal of residents
in compliance with the Institutional and Program Requirements.
- regularly review all ACGME program accreditation
letters and monitor action plans for the correction of concerns and areas
of noncompliance.
- regularly review the Sponsoring Institution's Letter
of Report from the IRC and develop and monitor action plans for the
correction of concerns and areas of noncompliance.
- review and approve prior to submission to the ACGME
- all applications for ACGME
accreditation of new programs and subspecialties;
- changes in resident
complement;
- major changes in program
structure or length of training
- additions and deletions of
participating institutions used in a program;
- appointments of new program
directors;
- progress reports requested by
any Review Committee;
- responses to all proposed
adverse actions;
- requests for increases or any
change in resident duty hours
- rrequests for "inactive
status" or to reactivate a program;
- voluntary withdrawals of
ACGME-accredited programs;
- requests for an appeal of an
adverse action; and,
- appeal presentations to a
Board of Appeal or the ACGME.
- conduct internal reviews of all ACGME-accredited
programs including subspecialty programs to assess their compliance with
the Institutional Requirements and the Program Requirements of the ACGME
Residency Review Committees in accordance with the guidelines in Section
V.
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