ACGME Internal Medicine Programs To Prepare for Requirement Changes


 Authors: Kristina Dean, Kelsey Hogan, & Joe Catanese, MHA   

ACGME has engaged in several specialty requirement revisions for the upcoming 2021 year, focusing on major specialties as well as selected areas in subspecialties. In this month’s News Alert, we will highlight the most important proposed changes for Internal Medicine (IM).

1. The Review Committee emphasized the need for including, in the IM program, faculty members with expertise in the analysis and interpretation of practice data, data management science & clinical decision support systems, and managing emerging health issues. This proposed change will affect IM programs that do not have any current faculty members with practice data management experience and emerging health issues management.

2. The required core faculty count breakdown based on resident positions changed. The required core faculty count commences at 30 resident positions instead of the previous minimum 60 resident positions.  Also, the number of required core faculty members increases based on increments of 10 instead of increments of 15.  This proposed change will affect programs with at least 30 residents enrolled in their IM program.

3. Program coordinator changed from 0.5 FTE to a 1.0 FTE requirement.  IM programs that do not currently assign program coordinators 1.0 FTE will have to allocate the salary support for the new requirement.

4. The IM program’s minimum required residents decreased from 15 to 9.

5. The Review Committee overhauled the required resident experiences.  Initially, the Review Committee required 1/3 clinical experiences in an outpatient setting, 1/3 clinical experiences in an inpatient setting, and emergency medicine could not be more than 2 weeks.  The proposed changes would specify more details about the curriculum breakdown as follows:

a. At least 10 months of clinical experiences in outpatient setting
b. At least 10 months of clinical experiences in the inpatient and critical care settings
c. Critical care experiences must be a minimum of 2 months and a maximum of 6 months and must not occur solely in the PGY-1 year
d. At least 6 months of individualized educational experiences to participate in opportunities relevant to their future practice or attain further skill/competency development

6. Residents must demonstrate a level of expertise in the knowledge of the broad spectrum of clinical disorders seen by an internist, including:

7. The Review Committee removed the majority of the patient census limits for residents.  The only remaining elements are as follows:

a. PGY-1 residents must not be assigned more than five new patients per admitting day.
b. PGY-2 residents must not be assigned more than 10 new patients per admitting day.

The Review Committee requests IM programs to proactively monitor the patient census and complexity of patient cases to ensure residents receive a comprehensive educational experience as well as to ensure residents’ well-being remains optimal.

8. The Review Committee stated that at least one non-physician core faculty member must participate in resident and programmatic evaluations.

The Comment Period for Internal Medicine closed on September 4, 2020.  Based on the submitted comments, the ACGME Review Committee may change some proposed changes.  At this time, an official effective date has not been released.  Until an effective date is in place, residency programs are not required to implement any of the proposed changes.  However, it is imperative to know the upcoming Internal Medicine requirement changes and to begin any necessary program transition planning to achieve the new requirements.  


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