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Verification of Graduate Medical Education Training

November 29, 2017 : With the Alliance as the convening organization, the Internal Medicine Education Advisory Board (IMEAB) has provided feedback to the American Hospital Association on the Verification of Graduate Medical Education Training (VGMET) form. Because IMEAB has found that program directors and credentialing organizations often have varying definitions of non-probationary remediation, these changes will enhance uniform interpretability. Given the permanence of data reported to state medical boards and potential credentialing-related barriers that may result, the recommendations seek to clarify conditions set forth in Section I.

  1. Add “If answering yes to any of the following questions in this section, comment in section II” to the instructions for section I.
  2. Replace “Conditions or restrictions beyond those generally associated with the training regimen at your facility” with “Performance-related extensions in training, curtailment of clinical privileges, or formal probation.”
  3. Remove or modify “Involuntary leave of absence” to avoid complicating licensure for events unrelated to clinical readiness.

In addition, IMEAB recommended adding a “frequently asked questions” document to improve comprehension for users.

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In an effort to improve and streamline the credentialing process, the Accreditation Council for Graduate Medical Education (ACGME), American Hospital Association (AHA), National Association of Medical Staff Services (NAMSS), and Organization of Program Directors Associations (OPDA) have collaborated to create a standardized “Verification of Graduate Medical Education Training” (VGMET). This group has also been working with the Federation of State Medical Boards (FSMB) to address the needs for licensure within the form and will continue that work.

APDIM formed a work group, led by Heather Laird-Fick, MD and David A. Wininger, MD, to address the need for a standardized, less subjective iteration of the verification of training form. The work group sought to provide clarity to AAIM members and develop change recommendations to the form. The Internal Medicine Education Advisory Board (IMEAB) accepted the work group’s recommendations and subsequently formed a working group to expand those efforts. A final version will be presented to the American Hospital Association as a form change request.

FAQ for Completing the Verification of Graduate Medical Education Training

Background: A standardized “Verification of Graduate Medical Education Training” (VGMET) form has been developed through collaboration of multiple accrediting bodies. This form will be completed once, either at the time of completion of training (2016 and future graduates) OR at the time of the first request for verification (for pre-2–16 graduates).

How do I respond to the question, “Was the trainee subject to any of the following during training? (i) Conditions or restrictions beyond those generally associated with the training regimen at your facility”.

The question could be re-phrased to:

  • Did the trainee experience any disciplinary actions, such as probation or revocation of clinical privileges because of performance problems?
  • Was the trainee required to extend training to successfully demonstrate competence (excluding any leaves of absence)?

A trainee may receive negative feedback, letters of concern, warnings, and reprimands. All of these communications reinforce expectations of the facility or program without necessarily instituting a disciplinary or adverse action. They are not necessarily “conditions or restrictions” on clinical privileges or on the standing within a program.

What are examples of conditions or restrictions generally associated with training?

The need for direct supervision for certain types of clinical care, including performance of procedures, until a trainee has been deemed competent to perform these with indirect supervision, is an example.

In addition, graduate medical education programs routinely utilize focused remediation and/or learning plans to ensure that trainees have attained competence. Not every trainee requires such intervention, yet it is still a part of the normal process of graduate medical education.

Similarly, some programs may temporarily restrict some clinical duties, such as operating room assignments, as part of a focused remediation for medical knowledge or other requirements to allow greater flexibility and time. If this is a routine policy rather than a disciplinary action, it would generally not be reported in this section.

On occasion clinical privileges are restricted as part of other institutional policies. For example, an institution may require that residents refrain from clinical care while ill and febrile, as part of an infection control measure or response to influenza epidemic.