ACGME Resident/Fellow Education and Training Considerations related to Coronavirus (COVID-19)

Since the publication of this article, the ACGME has created a section of its website dedicated to the ACGME’s response to this pandemic crisis. Visit this section for the most up-to-date guidance on ACGME activities during this time.

The ACGME’s guidance on COVID-19 associated with work hour requirements, resident/fellow rotations, time away from programs, and general guidance is provided below.

Information on ACGME Site Visits, Educational Activities, and Other Meetings can be found here.

Work Hour Requirements
The ACGME Common Program Requirements Section VI Work Hour Requirements will remain unchanged. Because safety of patients and residents/fellows is the ACGME’s highest priority, it is important that all residents and fellows receive adequate rest between clinical duties because violations of the work hours limitations have been associated with an increase in medical errors, which might lead to lapses in infection control. At a time when adherence to infection control procedures becomes an important safety issue, slips in this area could increase risks for both patients and residents/fellows.

At this time, the ACGME believes the current Institutional and Program Requirements are consistent with the needs for both patient and provider safety in the US. The ACGME will continue to monitor the status of the presence and impact of COVID-19 in the US and issue updates as warranted.

Rotations
Over the next several months there may be significant pressures on the health care system. The ACGME recognizes that patients must be cared for and that exigent circumstances may require residents/fellows to be redeployed to meet the needs of patients. Significant changes in resident/fellow education of more than four weeks in duration should be reported to the Executive Director of the applicable Review Committee.

Time Away from Required Rotations/Program
Residents’/fellows’ time away from required rotations, or the program, may affect their Board eligibility. The ABMS has issued a statement that addresses potential training disruptions. Check with the relevant Board regarding eligibility requirements and with specific questions about time away from required rotations/the program related to COVID-19.

Clinical and Educational Expectations
The ACGME provides the following guidance about the conduct of graduate medical education in the circumstances of the clinical care of patients potentially infected with COVID-19. The ACGME expects that residents and fellows be both aware of and able to appropriately respond to this viral disease. They must understand the expected type of patient care contact and the patient care they might need to provide in the context of their respective specialty/subspecialty educational programs.

The ACGME also expects Sponsoring Institutions and their hospital, medical center, and ambulatory care sites to provide residents, fellows, and faculty and other staff members with adequate resources, facilities, and training to properly recognize and care for these patients, including the need to take a complete travel and exposure history in patients presenting with signs and symptoms associated with COVID-19.

At the current time, there are very few physicians who have had experience treating patients with COVID-19 and who have expertise in managing the unique treatment and infection control protocols and procedures required. In this context the ACGME expects that:

• any resident, fellow, and faculty member providing care to patients potentially infected with COVID-19 will be fully trained in treatment and infection control protocols and procedures adopted by their local health care setting; and,
• any resident or fellow who provides care to patients will do so under the appropriate supervision for the clinical circumstance and the level of training of the resident/fellow. Faculty members are expected to have been trained in the treatment and infection control protocols and procedures adopted by their local health care settings. Sponsoring Institutions and programs should monitor the CDC website.

Resident/Fellows Health and Travel
Sponsoring Institutions and programs should be aware of resident/fellow travel history and plans. If plans include travel to high-risk areas, the individual should be informed about the risks of being unable to return and/or the possibility of being placed in quarantine.

Any requirements for quarantine should be guided by the applicable institution’s policies, local health departments, and CDC recommendations.

Email questions related to this guidance statement to ACGMECommunications@acgme.org.