Demystifying the ACGME: Your guide to understanding the residency accreditation body

In the year prior to a scheduled RRC review, a trained professional site visitor visits each program and meets with peer-selected residents, the program director and other departmental and institutional faculty and administrators. The site visitor confirms the results of the resident survey and the information presented on the PIF and clarifies other relevant information about the program.

Two RRC members who do not have a conflict of interest with the program review this data. Their report includes a review of previous citations, a description of whether these have been adequately addressed and descriptions of new citations. Based on this detailed review, each reviewer also submits a recommendation for an accreditation decision. Each reviewer presents this report at the RRC full committee meeting. Any members who work in the same state or geographic vicinity of the training program being reviewed or who have another conflict of interest with the training program being reviewed are asked to leave the room for the entire discussion and vote.

Following full committee discussion of the residency program, the committee makes an accreditation decision by open vote. Decision options include continued accreditation vs. probation, number of residents allowed per year of training, determination of cycle length and defined areas of noncompliance (citations). Accreditation cycle lengths vary from one to five years, and adverse actions such as proposed probation or decrease in resident complement are very uncommon.

Based on the citations confirmed by the committee and the accreditation decision made by committee vote, the ACGME prepares a statement of action and letter of notification and sends them to the program director in a timely fashion. The committee may also request that an interim progress report be submitted by the program in order to follow up on specific areas of concern prior to the next formal review. Duty hours violations require immediate progress reports.

Importance to Otolaryngology

So what…who cares? Truly, we all should. Residents should be comforted to know that there is a committee of resident advocates who desire to improve the training experience of otolaryngology residents across the country. The ACGME RRC is the ideal body to protect residents from programs providing inadequate training or from potential abuses such as significant imbalances between service obligations and educational activities. Additionally, the ACGME provides on its website a substantial number of free resources and materials to assist educators in their development; the website also provides notable practices and other guidelines to help faculty further improve their residency training programs. Even for those no longer associated with an academic practice, the ACGME RRC provides the service of ensuring that the new partner joining the practice has completed a residency program that meets very high standards of excellence. Becuase the ACGME RRC guarantees the excellence that we have come to expect from residency training in otolaryngology, it is crucial for the future of our specialty.