ACGME & GMEC
The Accreditation Council for Graduate Medical Education (ACGME) is responsible for the accreditation of OHSU's 76 programs. On the ACGME Program Requirements page you will find the requirements and information specific to each program. The ACGME has developed a Virtual Handbook for program directors to assist them with obtaining information from its site. The Virtual Handbook links to sections of the ACGME website particularly relevant to the work of program directors.
The ACGME Accreditation Data System (ADS), or WebADS, is the ACGME's online reporting system. WebADS is also used for the preparation of the Common PIF, and in many cases, the Speciality PIF, as well the annual update, the resident survey and the upcoming Annual Program Report and faculty survey.
Program directors are provided with individual logins to WebADS and are responsible for verifying/updating critical accreditation program information annually (including case logs for some specialties) and for keeping resident records current. The ACGME sends annual reminders of update deadlines to program directors. After program directors have received GMEC approval for such changes, the WebADS system also serves as the place to submit formal requests to the ACGME regarding program changes such as increases in resident complement, changes in program structure, addition or deletion of affiliated sites, etc.
Next Accreditation System (NAS)
The ACGME is implementing the Next Accreditation System (NAS), an outcome-based system scheduled for initial implementation for the first seven early adopters (Diagnostic Radiology, Emergency Medicine, Internal Medicine, Neurological Surgery, Orthopaedics, Pediatrics and Urology) beginning July 2013. Under the new system, accreditation will be based on national benchmarks for physician competence within each specialty including the Core Competencies and clinical skills. For more information and answers to frequently asked questions about the NAS, visit ACGME's NAS FAQ page.
Clinical Learning Environment Review (CLER)
As a component of the NAS, the ACGME established the Clinical Learning Environment Review (CLER) site visits to assess the GME learning environment of each sponsoring institution and its participating sites. The goal of the CLER program is to move from a targeted focus on duty hours to a broader focus on the GME learning environment and how it can deliver high-quality physicians and higher quality, safer patient care. The CLER program will provide frequent on-site sampling of the learning environment that will:
- Permit lengthening the interval for standard ACGME site visits of individual programs if other parameters of program performance are at the expected level;
- Emphasize elements of "new" competencies demanded by the public which include:
1. Patient Safety
2. Quality Improvement
3. Transitions in Care
5. Duty Hours Oversight, Fatigue Management and Mitigation
- Provide the opportunity for sponsoring institutions to demonstrate leadership in patient safety, quality improvement, and reduction in health care disparities.
The Milestones are specialty specific benchmarks of skills and knowledge associated with each of the six general Core Competencies that residents are expected to demonstrate at intervals during their training. Milestones will provide data for the ACGME review committee and boards to use in assessing the quality of the residency program and the individual resident.
ACGME Core Competencies
As part of OHSU's continuing efforts to offer the most comprehensive resident education possible, GME is actively engaged in providing leadership and resources to integrate the ACGME competency educational model into all our residency programs' curricula. Although thoroughly describing this model concisely is difficult, it is in essence an attempt to focus our educational efforts on developing the most complete and well-rounded doctors.
The residency program must require its residents to obtain competence in these six areas to the level expected of a new practitioner. Programs must define the specific knowledge, skills, behaviors, and attitudes required and provide educational experiences as needed in order for their residents to demonstrate the following:
- Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
- Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
- Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
- Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
- Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
- Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.
Graduate Medical Education Committee (GMEC)
A Graduate Medical Education Committee (GMEC) is required by the ACGME. The GMEC is charged with establishing and implementing policies and procedures regarding the quality of education and the work environment for the residents in all programs. The committee's areas of responsibility include:
Communication with medical staff
Communication with program directors
Curriculum and evaluation
Experimentation and innovation
Management of institutional accreditation
Oversight of program accreditation
Oversight of program changes
Oversight of reductions and closures
Resident/fellow duty hours
Stipends and Benefits
Schedule of GMEC Meetings
The GMEC meets in the Mackenzie Hall Cafe Marquam Room on the fourth Thursday of each month (except in November and December, when the committee meets on the third Thursday) from 12:00 noon to1:00 PM. Lunch is provided.
It is required that program directors, residents elected by their peers, and various administrative persons serve as members of the GMEC. OHSU is pleased to have active membership from our community hospitals as well, including the VA, Legacy, Providence, and Kaiser.
View the 2012-2013 GMEC Members
Suggestions for agenda items are always welcome. Please call the GME office at 503-494-8652 or e-mail Sue Simmons to get a spot on an agenda. The agenda for each meeting is sent out via e-mail one week prior to the meeting.
Duty Hours Subcommittee: This subcommittee meets monthly to address reports of duty hours violations, implement policies regarding compliance reporting, and review compliance reports. Any reports of duty hours violations, as well as requests for agenda items, should be provided to the GME office at 503-494-8652.
GMEC Executive Committee: This small group serves as an adjunct to the GMEC. It helps to complete the copious amount of work the GMEC has and handles issues that are sensitive and more appropriate for a small group. The GMEC Executive Committee meets approximately one week after the GMEC meeting. Reports of its activities are provided at each GMEC meeting.
Items Requiring Review and Approval by the GMEC
Before the following are submitted to the ACGME, they must be reviewed and approved by the GMEC and signed by OHSU's Designated Institutional Official:
- All applications for ACGME accreditation of new programs and subspecialties
- Changes in resident/fellow 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 for any change in resident duty hours
- Requests for "inactive status" or for reactivation of a program
- Voluntary withdrawals of ACGME-accredited programs
- Requests for an appeal of an adverse action