ACGME Accreditation Council for Graduate Medical Education

THE ACGME DEPARTMENT OF FIELD ACTIVITIES AND THE ACCREDITATION SITE VISIT (2008)

THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) 

The Accreditation Council for Graduate Medical Education (ACGME) is a private professional organization with the responsibility for ensuring the quality of approximately 8,400 accredited residency and fellowship programs in 121 specialty and subspecialty areas of medicine. Collectively, the programs are responsible for the education of more than 105,000 residents. This number of accredited programs and residents makes the ACGME one of the largest private accrediting agencies in the country, if not the world. 

The ACGME relies on a system of specialty experts to articulate the accreditation decisions governing the accredited programs. There are 27 committees known as Review Committees (RCs) that carry out the function of reviewing and deciding the status of the accredited programs. There is a Residency Review Committee for each of the major specialty areas with responsibility to accredit programs in the general specialty and related subspecialties, and one for Transitional Year programs. Members of these Committees are physicians trained in the particular discipline. Often, they are medical educators who have gained a reputation for expertise in residency education in their particular medical specialties. Joining a Review Committee is considered a prestigious appointment and offers an individual the opportunity to make a meaningful contribution to medical education. Compliance with the ACGME’s requirements for institutions that sponsor accredited residency education programs is assessed periodically by the Institutional Review Committee (IRC).  

The ACGME and Residency and Institutional Review Committees are committed fully to the task of improving the quality of resident education in the United States.

THE ACCREDITATION SITE VISIT AND ROLE OF THE FIELD STAFF
Of the 2,000 site visits done annually by the ACGME Department of Field Activities, the majority is conducted by Field Representatives and a small number (approximately 60) is done by Specialist Site Visitors. Field Representatives are employed by the ACGME, and are expected to be knowledgeable in the Program Requirements and on-site review of the medical specialty and subspecialty areas accredited by the ACGME. 

In the ACGME’s approach to accreditation, the site visitor is not the decision-maker regarding the quality of the educational program, but serves as a fact-finder who verifies and clarifies the information provided in the program information form (PIF). The PIF and the site visitor’s report form the basis of the Review Committee’s review and accreditation decision. The site visitor serves as “the eyes and ears of the Review Committee.” Prior to the site visit, the site visitor reviews both the "Institutional and Program Requirements" governing accredited residencies as well as the program information form the individual program has prepared. He/she conducts a series of interviews with program directors, faculty members, administrators, residents and other key personnel in order to verify that the self-study document is an accurate and complete reflection of the educational experience offered by the program to the residents being trained. 

Following the site visit, the Field Representative composes an objective report of the information that he/she collected during the interviews. This document is factual and non-judgmental and addresses omissions or discrepancies between the self-study document and the information collected during the site visit from the program director, faculty or residents. It is intended as an objective presentation of the information gathered during the visit, without a direct or indirect effort to sway the Review Committee for or against the program.

In 2008-2009, the field staff of the ACGME consists of 31 individuals, 19 of which are full-time equivalent representatives. A full-time field representative is expected to carry out approximately 125 site visits per year. Field representatives have MD or PhD degrees and extensive experience in medical education. The medical specialties represented by the group of physicians include family medicine, internal medicine, neurology, obstetrics and gynecology, ophthalmology, orthopaedic surgery, pediatrics, plastic surgery, preventive medicine, psychiatry and surgery. Among the PhD members of the staff the disciplines of education, sociology, psychology, health education, and public health are represented. A significant number of field representatives have been with the ACGME for 10 or more years. 

Field Staff participates in two formal professional development meetings per year, organized by the Department of Field Activities, and Field Representatives also are encouraged to attend Review Committee meetings for their professional development. Field Representatives provide input into program requirement and PIF revisions, present at sessions at the ACGME Annual Educational Conference, and represent the ACGME at selected other professional meetings to discuss the accreditation site visit.

The members of the field staff play a crucial role in the accreditation enterprise and take satisfaction in helping the Review Committees formulate fair and accurate judgments about the educational quality of the programs and institutions accredited by the ACGME.

Updated:  November 10, 2008