Not since 1910, when Abraham Flexner established a set of standards and an
accreditation process for schools of medicine in the United
States1, has the
foundation of American medical education been so shaken as it has by the 2001
Accreditation Council for Graduate Medical Education (ACGME) Outcome Project.
Predicated on imperatives derived from a public call for regulation and
accountability in support of patient safety and an evolving appreciation of
the education process and the optimal learning environment, the ACGME
instituted standards and limitations for the work hours of residents
participating in accredited
protest largely from the sector of surgical specialists during the period of
preparation and review, these restrictions were approved in February 2003 and
became effective on July 1, 2003.