As COVID-19 continues to surge nationally, the Accreditation Council for Graduate Medical Education (ACGME) continues to provide and revise its guidance to sponsoring institutions and their graduate medical education (GME) programs to address pandemic-related disruptions to programs and accreditation.

ACGME monitors the effects of the pandemic on GME operations, health care providers and the public, and examines its process of emergency categorization for sponsoring institutions that face operational disruption resulting from the COVID-19 pandemic.  Bricker’s July 1, 2020, publication reviews prior responses from ACGME. ACGME has recently provided the following updated guidance:

1. The ACGME continues to maintain and modify its process for emergency categorization in order to honor requests for additional terms and days of continued classification status, with the goal being that a sponsoring institution’s emergency category status will be counted cumulatively in each academic year (July 1–June 30). If a sponsoring institution’s GME program operations are disrupted for more than 90 days in an academic year due to substantial pandemic-related events, the designated institutional official (DIO) may request that ACGME apply its extraordinary circumstances policy. If determined that the sponsoring institution’s ability to support resident education has been significantly altered and the extraordinary circumstances policy is invoked, the sponsoring institution will be expected to submit plans and timelines specifying revisions to its GME programs to comply with all applicable common and specialty-and subspecialty-specific program requirements; or, temporary or permanent arrangements for residents/fellows to transfer to other ACGME-accredited programs in which they can continue their education.

2. All sponsoring institutions and their programs must continue to ensure the safety of resident, fellow and faculty member assignments when responsibilities include care of patients with COVID-19 and provide training for such treatment with appropriate infection control protocols and procedures. This includes sponsoring institutions and programs also providing safety measures for faculty members, residents and fellows with known health conditions or impairments and maintaining policies on leaves of absence and accommodations for participation in patient care assignments or other program activities.

3. Despite pandemic challenges, ACGME continues to require all programs to assess individual residents and fellows across the six core competencies in order to make determinations regarding advancement, graduation and Board eligibility. To that end, the ACGME has issued guidance and provided new tools to assess clinical performance based on ACGME milestones for program directors, faculty members and Clinical Competency Committees to complete required assessments when educational components of the programs have been disrupted by the pandemic.

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