ACGME Common Program Requirements
Introduction
Int.A. Residency is an essential dimension of the transformation of the medical student to the independent practitioner along the continuum of medical education. It is physically, emotionally, and intellectually demanding, and requires longitudinally-concentrated effort on the part of the resident.
The specialty education of physicians to practice independently is experiential, and necessarily occurs within the context of the health care delivery system. Developing the skills, knowledge, and attitudes leading to proficiency in all the domains of clinical competency requires the resident physician to assume personal responsibility for the care of individual patients. For the resident, the essential learning activity is interaction with patients under the guidance and supervision of faculty members who give value, context, and meaning to those interactions. As residents gain experience and demonstrate growth in their ability to care for patients, they assume roles that permit them to exercise those skills with greater independence. This concept--graded and progressive responsibility--is one of the core tenets of American graduate medical education. Supervision in the setting of graduate medical education has the goals of assuring the provision of safe and effective care to the individual patient; assuring each resident’s development of the skills, knowledge, and attitudes required to enter the unsupervised practice of medicine; and establishing a foundation for continued professional growth.
Int.B. Definition and Scope of the Specialty
Diagnostic radiology encompasses a variety of diagnostic and image guided therapeutic techniques, including all aspects of image-based diagnosis, (radiography, nuclear radiology, diagnostic ultrasound, magnetic resonance, computed tomography, interventional procedures, and molecular imaging). The residency program in diagnostic radiology shall offer a quality graduate medical educational experience in all of these associated disciplines.
Int.C. Duration and Scope of Education
Int.C.1. Resident education in diagnostic radiology must include five years of clinically oriented graduate medical education, of which four years must be in diagnostic radiology. (Core)*
Int.C.2. Diagnostic Radiology Residency
The residency program is four years of graduate medical education (including vacation and meeting time) in diagnostic radiology. Full time participation by the residents in clinical and didactic activities must occur at all levels of training, including the final year of residency. In the four
years, the maximum period of training in any one of the nine subspecialty areas shall be 16 months. The nine subspecialty areas of diagnostic radiology are neuroradiology, musculoskeletal radiology, vascular and interventional radiology, cardiothoracic radiology, breast radiology, abdominal radiology, pediatric radiology, ultrasonography (including obstetrical and vascular ultrasound), and nuclear radiology (including PET and nuclear cardiology). (Core)
Int.C.3. Residents entering diagnostic radiology training on July 1, 2010 or thereafter must be provided appropriate clinical rotations and formal instruction in all subspecialties of diagnostic radiology and in the core subjects pertaining to diagnostic radiology (e.g. medical physics, physiology of contrast media, etc.) before taking the American Board of Radiology (ABR) Core Examination (given after 36 months of diagnostic radiology training at the end of PGY-4). During the final year of diagnostic radiology training (PGY-5), these residents should be allowed, within program resources, to select and participate in rotations, including “general radiology,” that will reflect their desired areas of concentration as they enter practice. (Detail)
Int.C.4. Participation in on-call activities is essential for the development of radiologists, who are expected to practice independently upon completion of training, and should occur throughout the second, third and final years of diagnostic radiology residency. (Core)
Int.C.4.a) Program directors may exercise discretion in granting relief from call responsibilities for short periods before the oral board exam for residents entering diagnostic radiology training before July 1, 2010 and before the “Core” board exam for residents entering diagnostic radiology training on July 1, 2010 or thereafter. (Detail)
Int.C.5. The education in diagnostic radiology must occur in an environment that encourages the interchange of knowledge and experience among residents in the program and among residents in other major clinical specialties located in those institutions participating in the program. (Detail)
Int.A. Residency is an essential dimension of the transformation of the medical student to the independent practitioner along the continuum of medical education. It is physically, emotionally, and intellectually demanding, and requires longitudinally-concentrated effort on the part of the resident.
The specialty education of physicians to practice independently is experiential, and necessarily occurs within the context of the health care delivery system. Developing the skills, knowledge, and attitudes leading to proficiency in all the domains of clinical competency requires the resident physician to assume personal responsibility for the care of individual patients. For the resident, the essential learning activity is interaction with patients under the guidance and supervision of faculty members who give value, context, and meaning to those interactions. As residents gain experience and demonstrate growth in their ability to care for patients, they assume roles that permit them to exercise those skills with greater independence. This concept--graded and progressive responsibility--is one of the core tenets of American graduate medical education. Supervision in the setting of graduate medical education has the goals of assuring the provision of safe and effective care to the individual patient; assuring each resident’s development of the skills, knowledge, and attitudes required to enter the unsupervised practice of medicine; and establishing a foundation for continued professional growth.
Int.B. Definition and Scope of the Specialty
Diagnostic radiology encompasses a variety of diagnostic and image guided therapeutic techniques, including all aspects of image-based diagnosis, (radiography, nuclear radiology, diagnostic ultrasound, magnetic resonance, computed tomography, interventional procedures, and molecular imaging). The residency program in diagnostic radiology shall offer a quality graduate medical educational experience in all of these associated disciplines.
Int.C. Duration and Scope of Education
Int.C.1. Resident education in diagnostic radiology must include five years of clinically oriented graduate medical education, of which four years must be in diagnostic radiology. (Core)*
Int.C.2. Diagnostic Radiology Residency
The residency program is four years of graduate medical education (including vacation and meeting time) in diagnostic radiology. Full time participation by the residents in clinical and didactic activities must occur at all levels of training, including the final year of residency. In the four
years, the maximum period of training in any one of the nine subspecialty areas shall be 16 months. The nine subspecialty areas of diagnostic radiology are neuroradiology, musculoskeletal radiology, vascular and interventional radiology, cardiothoracic radiology, breast radiology, abdominal radiology, pediatric radiology, ultrasonography (including obstetrical and vascular ultrasound), and nuclear radiology (including PET and nuclear cardiology). (Core)
Int.C.3. Residents entering diagnostic radiology training on July 1, 2010 or thereafter must be provided appropriate clinical rotations and formal instruction in all subspecialties of diagnostic radiology and in the core subjects pertaining to diagnostic radiology (e.g. medical physics, physiology of contrast media, etc.) before taking the American Board of Radiology (ABR) Core Examination (given after 36 months of diagnostic radiology training at the end of PGY-4). During the final year of diagnostic radiology training (PGY-5), these residents should be allowed, within program resources, to select and participate in rotations, including “general radiology,” that will reflect their desired areas of concentration as they enter practice. (Detail)
Int.C.4. Participation in on-call activities is essential for the development of radiologists, who are expected to practice independently upon completion of training, and should occur throughout the second, third and final years of diagnostic radiology residency. (Core)
Int.C.4.a) Program directors may exercise discretion in granting relief from call responsibilities for short periods before the oral board exam for residents entering diagnostic radiology training before July 1, 2010 and before the “Core” board exam for residents entering diagnostic radiology training on July 1, 2010 or thereafter. (Detail)
Int.C.5. The education in diagnostic radiology must occur in an environment that encourages the interchange of knowledge and experience among residents in the program and among residents in other major clinical specialties located in those institutions participating in the program. (Detail)
- I.
- A.Sponsoring Institution
One sponsoring institution must assume ultimate responsibility for the program, as described in the Institutional Requirements, and this responsibility extends to resident assignments at all participating sites.(Core)
The sponsoring institution and the program must ensure that the program director has sufficient protected time and financial support for his or her educational and administrative responsibilities to the program. (Core)
I.
B. Participating Sites
I.B.
1.There must be a program letter of agreement (PLA) between the program and each participating site providing a required assignment. The PLA must be renewed at least every five years. (Core)
The PLA should:
- I.B.
- 1.a)identify the faculty who will assume both educational and supervisory responsibilities for residents;(Detail)
- I.B.1.b)specify their responsibilities for teaching, supervision, and formal evaluation of residents, as specified later in this document; (Detail)
- I.B.1.c)specify the duration and content of the educational experience; and, (Detail)
- I.B.1.d)state the policies and procedures that will govern resident education during the assignment. (Detail)
- I.B.
- 2.The program director must submit any additions or deletions of participating sites routinely providing an educational experience, required for all residents, of one month full time equivalent (FTE) or more through the Accreditation Council for Graduate Medical Education (ACGME) Accreditation Data System (ADS). (Core)
- I.B.
- 3.The program should be based at a primary hospital. A program using multiple sites must ensure the provision of a unified educational experience for the residents. Each participating site must offer significant educational opportunities to the overall program. Service responsibility alone at a participating site is not a suitable educational experience. (Core)
- I.B.
- 4.Programs should avoid affiliations with sites at such distances from the primary hospital as to make resident attendance at rounds and conferences impractical, unless there is a comparable educational experience at the site. (Detail)
There must be a single program director with authority and accountability for the operation of the program. The sponsoring institution’s GMEC must approve a change in program director. (Core)
The program director must submit this change to the ACGME via the ADS. (Core)
[As further specified by the Review Committee]
The program director should continue in his or her position for a length of
time adequate to maintain continuity of leadership and program stability. (Detail)
Qualifications of the program director must include:
requisite specialty expertise and documented educational and
administrative experience acceptable to the Review Committee; (Core)
current certification in the specialty by the American Board of _____, or specialty qualifications that are acceptable to the Review Committee; and, (Core)
current medical licensure and appropriate medical staff appointment. (Core)
The program director must administer and maintain an educational environment conducive to educating the residents in each of the ACGME competency areas. (Core)
The program director must:
- oversee and ensure the quality of didactic and clinical education in all sites that participate in the program; (Core)
- approve a local director at each participating site who is accountable for resident education; (Core)
- approve the selection of program faculty as appropriate; (Core) evaluate program faculty; (Core)
- approve the continued participation of program faculty based on evaluation; (Core)
- monitor resident supervision at all participating sites; (Core)
- prepare and submit all information required and requested by the ACGME. (Core) This includes but is not limited to the program application forms and annual program updates to the ADS, and ensure that the information submitted is accurate and complete. (Core)
- ensure compliance with grievance and due process procedures as set forth in the Institutional Requirements and implemented by the sponsoring institution; (Detail)
- provide verification of residency education for all residents, including those who leave the program prior to completion; (Detail)
- implement policies and procedures consistent with the institutional and program requirements for resident duty hours and the working environment, including moonlighting, (Core)
- and, to that end, must: distribute these policies and procedures to the residents and faculty; (Detail) ; monitor resident duty hours, according to sponsoring institutional policies, with a frequency sufficient to ensure compliance with ACGME requirements; (Core) ; adjust schedules as necessary to mitigate excessive service demands and/or fatigue; and, (Detail) if applicable, monitor the demands of at-home call and adjust schedules as necessary to mitigate excessive service demands and/or fatigue. (Detail)
- monitor the need for and ensure the provision of back up support systems when patient care responsibilities are unusually difficult or prolonged; (Detail)
- comply with the sponsoring institution’s written policies and procedures, including those specified in the Institutional Requirements, for selection, evaluation and promotion of residents, disciplinary action, and supervision of residents; (Detail)
- be familiar with and comply with ACGME and Review Committee policies and procedures as outlined in the ACGME Manual of Policies and Procedures; (Detail)
- obtain review and approval of the sponsoring institution’s GMEC/DIO before submitting information or requests to the ACGME, including: (Core) ; all applications for ACGME accreditation of new programs; (Detail) ; changes in resident complement; (Detail) ; major changes in program structure or length of training; (Detail) ; progress reports requested by the Review Committee; (Detail) ; requests for increases or any change to resident duty hours;(Detail) ; voluntary withdrawals of ACGME-accredited programs; (Detail) ; requests for appeal of an adverse action; and, (Detail) ; appeal presentations to a Board of Appeal or the ACGME. (Detail)
- obtain DIO review and co-signature on all program application forms, as well as any correspondence or document submitted to the ACGME that addresses: (Detail) ; program citations, and/or, (Detail)
request for changes in the program that would have ; significant impact, including financial, on the program or institution. (Detail)
At each participating site, there must be a sufficient number of faculty with documented qualifications to instruct and supervise all residents at that location. (Core)
The faculty must:
devote sufficient time to the educational program to fulfill their supervisory and teaching responsibilities; and to demonstrate a strong interest in the education of residents; and, (Core) administer and maintain an educational environment conducive to educating residents in each of the ACGME competency areas. (Core)
The physician faculty must have current certification in the specialty by the American Board of _____, or possess qualifications judged acceptable to the Review Committee. (Core)
The physician faculty must possess current medical licensure and appropriate medical staff appointment. (Core)
The nonphysician faculty must have appropriate qualifications in their field and hold appropriate institutional appointments. (Core)
The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. (Core)
The faculty must regularly participate in organized clinical discussions, rounds, journal clubs, and conferences. (Detail)
Some members of the faculty should also demonstrate scholarship by one or more of the following:
Faculty should encourage and support residents in scholarly activities. (Core)
The faculty must:
devote sufficient time to the educational program to fulfill their supervisory and teaching responsibilities; and to demonstrate a strong interest in the education of residents; and, (Core) administer and maintain an educational environment conducive to educating residents in each of the ACGME competency areas. (Core)
The physician faculty must have current certification in the specialty by the American Board of _____, or possess qualifications judged acceptable to the Review Committee. (Core)
The physician faculty must possess current medical licensure and appropriate medical staff appointment. (Core)
The nonphysician faculty must have appropriate qualifications in their field and hold appropriate institutional appointments. (Core)
The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. (Core)
The faculty must regularly participate in organized clinical discussions, rounds, journal clubs, and conferences. (Detail)
Some members of the faculty should also demonstrate scholarship by one or more of the following:
- peer-reviewed funding; (Detail)
- publication of original research or review articles in peer reviewed journals, or chapters in textbooks; (Detail)
- publication or presentation of case reports or clinical series at local, regional, or national professional and scientific society meetings; or, (Detail)
- participation in national committees or educational organizations. (Detail)
Faculty should encourage and support residents in scholarly activities. (Core)
The institution and the program must jointly ensure the availability of all necessary professional, technical, and clerical personnel for the effective administration of the program. (Core)
Resources
The institution and the program must jointly ensure the availability of adequate resources for resident education, as defined in the specialty program requirements. (Core)
Medical Information Access
Residents must have ready access to specialty-specific and other appropriate reference material in print or electronic format. Electronic medical literature databases with search capabilities should be available. (Detail)
Resources
The institution and the program must jointly ensure the availability of adequate resources for resident education, as defined in the specialty program requirements. (Core)
Medical Information Access
Residents must have ready access to specialty-specific and other appropriate reference material in print or electronic format. Electronic medical literature databases with search capabilities should be available. (Detail)