(Archived) Stage 1: "Business as Usual"
Institutions and programs operating in Stage 1 have no significant disruption of patient care and educational activities yet but are likely in the process of planning for increased clinical demands.
Such programs are governed by the Common and specialty-specific Program Requirements, with the following activities suspended:
- Site Visits (accreditation, recognition, and Clinical Learning Environment Review (CLER) Program)
- Self-Study
- ACGME Resident/Fellow and Faculty Surveys
Additionally, the ACGME’s requirements regarding telemedicine are in effect immediately.
Site Visits
The ACGME has suspended all site visits. Accredited programs that had site visits scheduled should have been notified of their cancellation. Institutions and programs will be notified with more information regarding the ACGME resuming site visits in the future.
Self-Study
All Self-Study activities, including the submission of the Self-Study Summary, are suspended until further notice. The suspension does not prohibit Self-Study activities. Programs may upload the Self-Study Summary if they want to. Email dfascheduling@acgme.org with any questions or issues uploading the Self-Study Summary, and be sure to include the program number in these communications. The ACGME will notify the GME community when the submission of Self-Study activities may resume.
ACGME Surveys
The annual Resident/Fellow and Faculty Surveys are suspended for all ACGME-accredited Sponsoring Institutions and programs until future notice to allow the GME community to prioritize patient care duties in line with COVID-19 responsibilities.
Surveys will remain available to scheduled participants and the survey closing date has been extended to May 15, 2020, but participation is optional. Currently, programs scheduled to complete the surveys and that choose to continue administering them can still remind survey takers using the reminder tool in the Accreditation Data System (ADS), but the ACGME will stop sending reminders.
For programs that have already reported, and those that choose to continue participating, we will work to create program-specific reports when there is a large enough response rate to protect the confidentiality of the participants.
Telemedicine
For all programs, the Common Program Requirements regarding use of telemedicine/telehealth are in effect ahead of the original July 1, 2020 effective date.
The definition of Direct Supervision as part of these new telemedicine requirements includes the following classification: “the supervising physician and/or patient is not physically present with the resident and the supervising physician is concurrently monitoring the patient care through appropriate telecommunication technology.”
Ultimately each specialty Review Committee will choose whether to continue to allow for this type of direct supervision with telemedicine in other situations. In no situation will a program be penalized retroactively for appropriate engagement of residents and fellows with appropriate supervision in the use of telemedicine during this crisis.
Those residents and fellows who are capable of providing this service (telemedicine) with indirect supervision available or immediately available are covered under the indirect supervision requirements.
Under the circumstances, where direct supervision is required in the context of provision of telemedicine/telehealth, new Common Program Requirement VI.A.2.c).(1).(b) permits faculty members to provide direct supervision through telecommunications technology.
Decisions regarding how this is implemented must be made at the program level and must be appropriate for the clinical setting and the needs of the individual patient, as well as the health and safety of the resident(s)/fellow(s) and faculty member(s) involved. In some situations, it may be appropriate for a resident/fellow to conduct a patient encounter remotely and then discuss the case with the supervising faculty member, also through remote means. In other situations, the program may determine that the resident/fellow and supervising faculty member should both participate in the patient encounter.
This type of program-level decision making is already in place for other clinical settings, and is addressed in Common Program Requirement VI.A.2.b.(1), which states that the program must demonstrate that the appropriate level of supervision is in place for all residents/fellows based on each resident’s/fellow’s level of education/training and ability, as well as patient complexity and acuity.