Ask the expert: How will the ACGME's new Common Program Requirements affect the medical staff?

The proposed Common Program Requirements spell out several new standards. The following are some of the most significant changes that may affect the operations of medical staffs in academic medical centers:

• Shift lengths for first-year residents are limited to 16 hours per day. Other non-first-year residents may be scheduled for 24 hours of duty and may stay up to an additional four hours in order to perform handoffs, but they may not participate in continuity clinic. 
• Three levels of supervision would be defined: direct supervision, indirect supervision, and oversight. First-year residents must be supervised either directly or indirectly with direct supervision available.
• Programs must create schedules to minimize handoffs. Institutions and programs must monitor handoffs and ensure residents’ competency in handoffs.
• Internal and external moonlighting would be included in the 80-hour workweek limit. Moonlighting is not allowed for first-year residents.
• Programs must educate residents and faculty on fitness of duty. Faculty and residents must show management of their time before, during, and after clinical assignments.
   

This week’s question and answer are from “ACGME’s new standards focus on more than just duty hours” in the August issue of Residency Program Alert (Subscription required)