In this ever changing world in which we live in is the lyrics from a well known song, written by Paul McCartney. This accurately describes the medical education field today. It is becoming more of a challenge to keep up with all the changes and requirements that need to be met to keep our residency/fellowship programs in compliance with the ACGME Standards.
The rapid turn over of Administrators, Program Directors, Coordinators, and newly appointed Designated Institutional Officials (DIO) makes it even more challenging.
Many times the Institution and/or the DIO do not think about how their GME Program will measure up until they receive a letter from the ACGME informing them of an upcoming site visit. Unfortunately, if that is the first time the DIO has thought about an Institutional Review it is a little too late! Programs are required to have a mid-point internal review that should evaluate the Programs compliance with the Institutional, Common and Program Requirements. The reason for this is so the Institution and the Program Director knows what the Programs strengths and weaknesses are beforehand, and decide what can be done to correct any deficiencies prior to the Programs actual site visit from the ACGME.
Why then do Institutions wait until they receive the letter from the ACGME to start thinking about the Institutions compliance? Many times it is because the DIO has many other responsibilities and their attention is focused on putting out fires and handling daily problems. In addition, many Institutions have a DIO with little or no staff support. Therefore, problems completing the IRD or monitoring the Institutions compliance is only one of many responsibilities of the DIO.
The time has come when Institutions need to look at their GME Statement of Commitment and ask themselves; Do they really provide educational, financial and human resources to the overall GME Program? Is GME a priority? What would it cost the institution if they lost their GME programs?
I recommend that all Institutions have a mid-point internal or external review of their GME Program to evaluate their compliance with the ACGME Institutional Requirements. Why wait until you dont have the time to do something about an area of non-compliance?
If an Institution received a favorable Letter of Report for an Institutional Review with a 5 year accreditation period in 1999 or 2000 and the DIO hasnt looked at the Institutional Requirements since then, they are in for a rude awakening. The requirements have changed and so has the IRD. Not only have the requirements changed but there are very specific responsibilities listed for DIOs. Does your DIO know what is going on within each and every GME Program within the Institution? Does the CEO and the Board know the status of the GME Programs within the Institution? Do they know what it would cost if they lost all of the programs?
Have your DIOs been given the educational sessions needed to take on the responsibilities? Does your GMEC know the responsibilities of the Institution, the GMEC and the DIO? Does your President of the Board and your Institutional CEO know what is needed for a successful Institutional Review or what it means if your Institution receives an unfavorable?
If nothing else, I recommend you look at your most recent Letter of Report from the ACGME and review the Institutional Requirements and ask yourself Am I ready for the Institutional Review? Dont wait until the last minute to start working on your IRD. Give yourself at least one year to prepare your documentation and complete the IRD. If you need help, get it! This is one of the most important responsibilities of the DIO and one of the most critical documents you will complete. Be sure you understand and interpret the requirements appropriately.
From time to time everyone could use some professional assistance.
