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The Residency Review Committee for Internal Medicine (RRC-IM) posted the newly approved accreditation requirements for internal medicine fellowship programs on its website Wednesday, November 10, 2004. The requirements will be effective for programs reviewed after July 1, 2005.
The Alliance for Academic Internal Medicine (AAIM) commented substantially on the draft requirements (comment letters are available on the AAIM website). Highlights in the final requirements include:
- Elimination of the requirement that an institution sponsor at least three fellowship programs to be able sponsor any (geriatric medicine and sports medicine programs were previously exempted).
- Addition of a “suggested” requirement that the sponsoring institution provide 25 percent to 50 percent of the fellowship program directors salary.
- Inclusion of required education and evaluation around the Accreditation Council for Graduate Medical Education (ACGME), including the development and implementation of at least one ongoing performance improvement project.
- Clarification of required research activities by faculty and fellows, including that “at least one faculty member must be active in the scholarship of discovery…as evidenced by peer-reviewed funding or by publication of original research in a peer-reviewed journal.”
- Redefinition of required ambulatory experiences to allow all fellowships to provide ambulatory continuity experiences in either the same clinic throughout training or in different clinics in six-month blocks.
The new document includes three tiers of requirements with which programs must demonstrate substantial compliance. According to the ACGME glossary:
“Must”: “Terms used to indicate that something is required, mandatory, or done without fail. These terms indicate absolute requirements.”
“Should”: “A term used to designate requirements that are so important that their absence must be justified. The accreditation status of a program or institution is at risk if it is not in compliance with a ‘should.’”
“Suggested”: “A term, along with its companion ‘strongly suggested,’ used to indicate that something is distinctly urged rather than required. An institution or a program will not be cited for failing to do something that is suggested or strongly suggested.” This term replaces “desirable.”
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