Program Documents:

Article Outline

• ACGME Requirements
  • Curriculum
  • Supervisory Lines of Responsibility
  • Resident Recruitment
• ABR Policy on Transferring Residents
• APDR Policy Statement on Administrative Time for Program Directors
• Departmental Policies
• Institutional Policies
• References
• Copyright

Every organization has documents outlining its policies and guidelines. These documents serve as a means for the organization to function efficiently. This article addresses the policy and guidelines documents, classified according to various mandating bodies, that apply to radiology residency training programs. The policies and guidelines instituted by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Radiology (ABR), and the Association of Program Directors in Radiology (APDR) are general and apply to all programs. Guidelines that originate from local sponsoring institutions and residency programs vary in number and content to meet the individual needs of the institution and program. Therefore, this article includes examples but not a comprehensive list of institutional and program-specific policies.

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ACGME Requirements 

Curriculum 

The ACGME requirements specify that the program director is responsible for the “preparation of a written statement outlining the curriculum and educational goals and objectives of the program with respect to knowledge, skills, and other attributes of residents at each level of training and for each major rotation or other program assignment, and [that] this statement must be distributed to residents and members of the teaching faculty and be readily available for review” (1). Templates for curriculum development in the 10 specialty areas are available on the APDR Web site (2).

Supervisory Lines of Responsibility 

The ACGME requires “supervision of residents through explicit written descriptions of supervisory lines of responsibility for the care of patients; such guidelines must be communicated to all members of the program faculty; residents must be provided with prompt, reliable systems for communication and interaction with supervisory physicians” (1). The document in effect at the University of Wisconsin, Madison, is shown in Figure 1.

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• Figure 1. 

  Policy on supervision of residents, from the University of Wisconsin Hospital and Clinics (approved by the Education Committee, Department of Radiology, December 1999). CT = computed tomography, GI = gastrointestinal, and GU = genitourinary.

The ACGME guidelines also state that “duty hours and night and weekend call for residents must reflect the concept of responsibility for adequate patient care; however, residents must not be required regularly to perform excessively difficult or prolonged duties; it is recommended that residents should be allowed to spend at least 1 full day out of 7 away from the hospital and should be assigned on-call duty in the hospital no more than, on average, every third night; it is the responsibility of the program director to monitor resident assignments to ensure adherence to this recommendation” (1). During an external review of the program, the reviewer may ask to see resident call schedules to determine compliance with the duty hours requirement and may question residents specifically about their schedules.

Resident Recruitment 

The ACGME institutional requirements state that the sponsoring institution's graduate medical education committee must ensure “that each residency program establishes and implements formal written criteria and processes for the selection, evaluation, promotion, and dismissal of residents in compliance with the Institutional and Program Requirements for the specialties and subspecialties of the ACGME [residency review committees]” (3). The resident recruitment policy in effect at the University of Wisconsin is shown in Figure 2.

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• Figure 2. 

  Resident recruitment policy at the University of Wisconsin Hospital and Clinics (approved by the Education Committee, Department of Radiology, January 28, 2000). USMLE = United States Medical Licensing Examination.

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ABR Policy on Transferring Residents 

The ABR Board of Trustees announced a policy change for transferring residents, effective January 1, 2001 (letter to radiology program directors from Paul M. Capp, MD, executive director of the ABR, April 5, 2000):

If a transfer to another program is necessary or desired, that transfer must have verification from the initial program director that the resident has successfully completed the training in their institution, with a listing of the specific rotations. This training must be accepted by the new program director. If a program director states that a resident has not successfully completed training in their program, that statement must have the signatures of two other faculty members from the same program supporting the unsatisfactory completion of the previous program.

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APDR Policy Statement on Administrative Time for Program Directors 

The membership of the APDR approved the following policy statement on March 26, 1998: “The Association of Program Directors in Radiology recommends that the Residency Directors be granted a minimum of one day per week of ‘protected’ time for fulfillment of Directors' responsibilities. This allocated time shall be separate from clinical and academic time” (4).

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Departmental Policies 

Local policies are based on the needs of the individual program. Examples include policies on resident expense reimbursement, vacation, meeting and interview time, parental leave, moonlighting, call distribution and responsibilities, rotations outside of the regularly scheduled curriculum and parent institution, conference attendance, and appropriate work attire. These written policy documents should be developed, approved, and reviewed regularly by a committee of the teaching faculty with resident representation. The department's education committee should meet on a regular basis and should review all program policies annually.

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Institutional Policies 

Sponsoring institutions are required by the ACGME to provide each resident a contract that includes specific information. Most sponsoring institutions have an appointment information document that is sent to residents with their contract and addresses the following: resident's responsibilities, moonlighting, appointments, promotion, stipends, ethical or religious considerations, licensure, pretraining health assessment, annual tuberculosis testing, cardiopulmonary resuscitation training, dress code, caregiver background check, leave policies (family and medical, personal, bereavement, and military), vacation time and holidays, insurance (liability, disability, health, life, and accidental death and dismemberment), tax-sheltered annuity or deferred compensation programs, parking, on-call meals, counseling and support services, physician impairment, sexual harassment policies, and procedures for discipline and dismissal and for house staff grievances and appeals. This appointment information document should be developed, approved, and reviewed annually by the institution's graduate medical education committee. Individual programs must conform to these institutional policies.

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References 

References
1. ACGME program requirements for residency education in diagnostic radiology. Available at: www.acgme.org/req_nie/420pr701.asp. Accessed August 21, 2001
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2. APDR guidelines for residency curriculum. Available at: www.apdr.org/directors/curiculum.htm. Accessed September 28, 2002
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3. ACGME institutional requirements. Available at: www.acgme.org/IRC/Ircpr702.asp. Accessed September 11, 2001
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4. APDR recommendation of protected administration time for residency directors. Available at: www.apdr.org/directors.htm. Accessed May 27, 2002
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