Program directors should first and foremost consult and coordinate with their designated institutional officials (DIOs) and graduate medical education (GME) offices concerning the impact of extreme emergent situations (e.g., epidemics) on resident education and work environment in accordance with their institutional disaster policies. Note that these extreme emergent situations are localized to one sponsoring institution, a participating institution or another clinical setting. These situations differ from events characterized as “disasters” declared by the ACGME in accordance with ACGME Policies and Procedures, II.H.2., considered to be extraordinary disasters which impact an entire community or region for an extended period of time.

If an extreme emergent situation causes serious, extended disruption to resident assignments, educational infrastructure, or clinical operations that might affect the sponsoring institution’s or its programs’ ability to conduct resident education in substantial compliance with ACGME standards, DIOs should report these events to the Executive Director for the Institutional Review Committee (IRC), following the steps outlined in FAQ#19. This reporting will document the event in order to explain any significant variations in resident clinical experience, case volume, or educational assignments identified in future program or institutional accreditation reviews.

In considering action plans for residents during these local extreme emergent situations, DIOs and program directors should carefully consider their decisions from the perspective of resident education in light of current ACGME standards and the overriding commitment of all physicians to patient care during an emergency. See the IRC’s FAQ #18 and #19 for additional information.

For additional information, please contact Patricia M. Surdyk, PhD, Executive Director, Institutional Review Committee.