The Accreditation Council for Graduate Medical Education (ACGME) has embarked on a comprehensive survey of the graduate medical education community concerning the elements contained in the Institute of Medicine (IOM) report1. This includes a national survey of program directors, faculty, and residents (which was in its fourth week at the time of writing) and will include requests from organizations (such as the Orthopaedic Trauma Association [OTA]) whose members are involved in the education of residents and fellows, the next generation of physician caregivers in the United States. The OTA has anticipated our request for positions regarding this report.
We do not intend merely to respond to the IOM report. The ACGME has called for formal positions from over 100 organizations, and their response has been requested by May 1. This information, coupled with an in-depth review of the medical literature on patient safety and resident duty hours, will be used to inform the Council of Review Committee Chairs and the ACGME Board of Directors in their deliberations regarding the review and potential revision of ACGME duty- hour standards. These actions are in keeping with the promise made to the profession in 2003, to review and revise as appropriate our resident duty-hour standards and key elements of the learning environment.
Among our goals in this comprehensive review are to recognize that different specialties require different training and that specialty-specific aspects of training must be taken into account in the design of duty-hour standards. These standards must provide for patient safety, both now and when our residents enter clinical practice in the future. They must also provide the setting for the inculcation of the practical dimensions of altruism and effacement of self-interest that are at the core of the physician-patient relationship, regardless of specialty.
This review will be coupled with new approaches to assure both the public and the profession of compliance with the standards that are set by the profession. The ACGME remains committed to professional self-regulation and believes that, with appropriate standard-setting, excellence in compliance will be achieved.
The ACGME thanks the Orthopaedic Trauma Association for providing their position on the IOM report, and we appreciate their commitment to the enhancement of the quality of patient care through the education of the next generation of physicians. 