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

ACGME RRC—this litany of letters means little to most otolaryngologists. However, whether you are a private practitioner or an academician, a resident in training or a program director, you should have a basic understanding of the work done by the Accreditation Council for Graduate Medical Education Residency Review Committee (ACGME RRC).

Background

The ACGME was founded in 1981 in an effort to establish an independent, non-governmental accreditation body for graduate medical education. The organizations involved in founding the ACGME include the American Board of Medical Specialties (ABMS), the American Hospital Association (AHA), the American Medical Association (AMA), the Association of American Medical Colleges (AAMC) and the Council of Medical Specialty Societies (CMSS). From the beginning, the ACGME’s purpose has been to “improve healthcare by assessing and advancing the quality of resident education through accreditation.” The ACGME wants its values of accountability, professionalism and excellence to be manifested by processes that are valid and reliable, open and transparent; actions that are respectful, collaborative, responsive and fair; and accreditation that is efficient, outcomes-based and innovative.

The ACGME currently has 28 Review Committees, including one for each of its 26 specialties, one Transitional Year Review Committee and one Institutional Review Committee. Each of these RRCs is composed of six to 15 volunteers from within that field. The otolaryngology RRC comprises 11 members: 10 voting members, including three each from the three nominating organizations, one resident member and one ex-officio (non-voting) member, who is the executive director of the American Board of Otolaryngology (ABOto). Selection of members to the RRC is by nomination from the AMA Council on Medical Education, the ABOto, and the American College of Surgeons. The group receives additional assistance from the non-voting executive director of the RRC, who is an educational professional and a permanent employee of the ACGME. A chair and vice chair of the committee are elected by the voting members and serve as the executive council of the committee, making administrative decisions in between major meetings. The full otolaryngology RRC meets twice yearly for full program reviews.

This group is charged with setting the standards for accreditation for otolaryngology training programs and ensuring that accredited programs adhere to those standards. In setting standards for the breadth of general otolaryngology training, the ACGME RRC, along with the ABOto, plays a large role in defining the scope of our specialty.

The ABOto defines the professional standards of training and knowledge in otolaryngology-head and neck surgery and certifies that individuals have met this standard. The ACGME RRC is to residency training programs what the ABOto is to individuals. The ABOto certifies individuals, while the ACGME RRC accredits otolaryngology residency training programs and, currently, two advanced training (fellowship) programs, neurotology and pediatric otolaryngology.

What We Do

How are accreditation decisions made? And what is involved in the review process? The ACGME RRC receives specific information from each program: residency case logs, resident surveys, a site visitor report and the Program Information Form (PIF) submitted by the program director. Residency case logs are entered by each resident and fellow into the ACGME data collection website. Residents also complete an annual survey designed to evaluate their program’s compliance with several ACGME requirements such as supervision, institutional support, teaching and observance of duty hour limits. Prior to an RRC review, each program director submits a PIF, which contains detailed information about the residency program curriculum, faculty and participating institution(s), along with a summary of resident duty hours, case log reviews and board exam passing rates.