May 1999
Volume 63 |
Number 5
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RESIDENTS' REVIEW
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| Introduction to
the Residency Review Committee |
Janet D. Pearl, M.D.
For the past year, I have been privileged to serve as the first
resident on the Residency Review Committee (RRC) for anesthesiology.
The ASA Resident Component Governing Council thought it would
be worth summarizing some of the information I provided at the
ASA Annual Meeting regarding the Anesthesiology RRC.
Who Is on the RRC?
The RRC for anesthesiology is made up of a total of 10 people
representing the American Board of Anesthesiology (ABA), American
Medical Association (AMA) and the American Society of Anesthesiologists
(ASA). They are an esteemed group of anesthesiologists, often
program directors, from all over the country. What impressed me
the most about this group is its genuine interest in the welfare
and education of residents. The resident member of the RRC is
nominated by the ASA Resident Component and ultimately selected
by the ASA Board of Directors.
What Is the RRC?
The RRC is a subcommittee of the Accreditation Council on Graduate
Medical Education (ACGME). The RRC develops the rules by which
residency programs must abide in order to receive accreditation.
The RRC for anesthesiology makes the core anesthesiology residency
program requirements as well as program requirements for critical
care, pediatric anesthesiology and pain management. These requirements
include the qualifications and responsibilities of program chairs
and faculty, didactics to be covered, supervision requirements,
clinical requirements and case numbers. The quality of life for
residents is also covered, which includes no more than one in
three days on call, one day off per week, no anesthetics to be
delivered on the post-call day, etc. The program requirements
for anesthesiology are in the process of revision.
Another major function of the RRC is to review anesthesiology
core and subspecialty programs to determine whether requirements
are being met. Objective physicians who have been trained in performing
site visits are selected to survey a program. The visitor observes,
interviews and records the operations and opinions of the program
director, faculty, residents and other department chairs. He or
she also inspects the facilities, including the call rooms, library,
offices, etc.
Two anesthesiology RRC members review the survey information
and program director's reports. In cases when the RRC resident
representative is asked to review a program, he or she has an
equal vote and serves as an additional third reviewer. From these
sources, a fairly good picture is painted of a program. Even inconsistencies
from different reports tell a story. The RRC reviewers then document
concerns of the program or violations of regulations and make
recommendations with regard to accreditation status (full, with
warning, probation, withdrawal).
The RRC reviewers present their findings and opinions to the
group at the biannual RRC meetings. The written ABA board results
of residents in the program are noted. The RRC then takes a group
vote on the program's accreditation status, years until the next
survey and the number of residents for which that program may
be accredited. The number of residents is a function of the program
itself and is not influenced by perceived workforce needs.
What the RRC Is Not
The RRC is not equipped to handle an individual resident's complaint
against a program unless it is a noncompliance issue with a program
or institutional requirement.
If a resident has a complaint against a program for noncompliance
with a standard, he or she can write to the RRC but must be prepared
to sign his or her name. Confidentiality is maintained if possible.
The ACGME Web page provides a complete step-by-step procedure
for dealing with complaints. The ACGME Web site is at <www.acgme.org>.
If you are interested in more information about the RRC, contact
Stephen J. Kimatian, M.D., Chair, 1999 ASA Resident Component
Governing Council.
Janet D. Pearl, M.D., is a Fellow in
Pain Management, Brigham & Women's Hospital, Boston, Massachusetts.
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