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June Special HOD 2021 Meeting Reference Committee C Reference Committee C CME Report(s) 01* Council on Medical Education Sunset Review of 2011 House Policies 02* Licensure for International Medical Graduates Practicing in U.S. Institutions with Restricted Medical Licenses 03* Optimizing Match Outcomes 04* Expediting Entry of Qualified IMG Physicians to U.S. Medical Practice 05* Promising Practices Among Pathway Programs to Increase Diversity in Medicine Resolution(s) 301 Medical Education Debt Cancellation in the Face of a Physician Shortage During the COVID-19 Pandemic 302 Non-Physician Post-Graduate Medical Training 303 Improving the Standardization Process for Assessment of Podiatric Medical Students and Residents by Initiating a Process Enabling Them to Take the USMLE 304* Decreasing Financial Burdens on Residents and Fellows 305* Non-Physician Post-Graduate Medical Training 306* Establishing Minimum Standards for Parental Leave During Graduate Medical Education Training 307* Updating Current Wellness Policies and Improving Implementation 308* Rescind USMLE Step 2 CS and COMLEX Level 2 PE Examination Requirement for Medical Licensure 309* Supporting GME Program Child Care Residency Training 310* Unreasonable Fees Charged and Inaccuracies by the American Board of Internal Medicine 311* Student Loan Forgiveness 312* AMA Support for Increased Funding for the American Board of Preventive Medicine Residency Programs 313* Fatigue Mitigation Respite for Faculty and Residents 314* Standard Procedure for Accommodations in USMLE and NBME Exams 315* Representation of Dermatological Pathologies in Varying Skin Tones 316* Improving Support and Access for Medical Students with Disabilities * Contained in the Handbook Addendum REPORT OF THE COUNCIL ON MEDICAL EDUCATION CME Report 1-JUN-21 Subject: Council on Medical Education Sunset Review of 2011 House Policies Presented by: Liana Puscas, MD, MHS, Chair Referred to: Reference Committee C 1 Policy G-600.110, “Sunset Mechanism for AMA Policy,” calls for the decennial review of 2 American Medical Association policies to ensure that our AMA’s policy database is current, 3 coherent, and relevant. This policy reads as follows, laying out the parameters for review and 4 specifying the needed procedures: 5 6 1. As the House of Delegates adopts policies, a maximum ten-year time horizon shall exist. A 7 policy will typically sunset after ten years unless action is taken by the House of Delegates to 8 retain it. Any action of our AMA House that reaffirms or amends an existing policy position 9 shall reset the sunset “clock,” making the reaffirmed or amended policy viable for another 10 10 years. 11 12 2. In the implementation and ongoing operation of our AMA policy sunset mechanism, the 13 following procedures shall be followed: (a) Each year, the Speakers shall provide a list of 14 policies that are subject to review under the policy sunset mechanism; (b) Such policies shall be 15 assigned to the appropriate AMA councils for review; (c) Each AMA council that has been 16 asked to review policies shall develop and submit a report to the House of Delegates identifying 17 policies that are scheduled to sunset; (d) For each policy under review, the reviewing council 18 can recommend one of the following actions: (i) retain the policy; (ii) sunset the policy; (iii) 19 retain part of the policy; or (iv) reconcile the policy with more recent and like policy; (e) For 20 each recommendation that it makes to retain a policy in any fashion, the reviewing council shall 21 provide a succinct, but cogent justification (f) The Speakers shall determine the best way for the 22 House of Delegates to handle the sunset reports. 23 24 3. Nothing in this policy shall prohibit a report to the HOD or resolution to sunset a policy earlier 25 than its 10-year horizon if it is no longer relevant, has been superseded by a more current policy, 26 or has been accomplished. 27 28 4. The AMA councils and the House of Delegates should conform to the following guidelines for 29 sunset: (a) when a policy is no longer relevant or necessary; (b) when a policy or directive has 30 been accomplished; or (c) when the policy or directive is part of an established AMA practice 31 that is transparent to the House and codified elsewhere such as the AMA Bylaws or the AMA 32 House of Delegates Reference Manual: Procedures, Policies and Practices. 33 34 5. The most recent policy shall be deemed to supersede contradictory past AMA policies. 35 36 6. Sunset policies will be retained in the AMA historical archives. © 2021 American Medical Association. All rights reserved. CME Rep. 1-JUN-2021 -- page 2 of 20 1 RECOMMENDATION 2 3 The Council on Medical Education recommends that the House of Delegates policies listed in the 4 appendix to this report be acted upon in the manner indicated and the remainder of this report be 5 filed. (Directive to Take Action) Fiscal Note: $1,000. CME Rep. 1-JUN-2021 -- page 3 of 20 APPENDIX: RECOMMENDED ACTIONS Policy Title Texts Recommendation Number H-210.986 Physicians and Our AMA (1) encourages residency review Rescind; duplicative of Family Caregivers committees and residency program directors to H-210.980, “Physicians - A Model for consider physician needs for training in and Family Caregivers: Partnership evaluation of caregivers. Emphasis at both the Shared Responsibility,” undergraduate and graduate level is needed on which reads: “Our the development of the physician’s AMA: (1) specifically interpersonal skills to better facilitate encourages medical assessment and management of caregiver stress schools and residency and burden; programs to prepare (2) supports health policies that facilitate and physicians to assess and encourage home health care. Current regulatory manage caregiver stress and financing mechanisms favor and burden; (2) institutionalization, often penalizing families continues to support attempting to provide lower cost, higher health policies that quality-of-life care; facilitate and encourage (3) reaffirms support for reimbursement for health care in the home; physician time spent in education and (3) reaffirm support for counseling of caregivers and/or home care reimbursement for personnel involved in patient care; and physician time spent in (4) supports research that identifies the types of educating and education and support services that most counseling caregivers effectively enhance the activities and reduce the and/or home care burdens of caregivers. Further research is also personnel involved in needed on the role of physicians and others in patient care; (4) supporting the family caregiver. supports research that Citation: (CSA Rep. I, I-91; Reaffirmed: Sunset identifies the types of Report, I-01; Reaffirmed: CSAPH Rep. 1, A- education, support 11) services, and professional caregiver roles needed to enhance the activities and reduce the burdens of family caregivers, including caregivers of patients with dementia, addiction and other chronic mental disorders; and (5) (a) encourages partner organizations to develop resources to better prepare and support lay caregivers; and (b) will identify and disseminate resources to promote physician understanding of lay caregiver burnout and develop strategies to support lay caregivers and their patients.” CME Rep. 1-JUN-2021 -- page 4 of 20 D-295.322 Increasing Our AMA will continue to study medical Retain; remains Demographically school implementation of the Liaison relevant, especially due Diverse Committee on Medical Education (LCME) to increased attention to Representation in Standard IS-16 and share the results with the need for diversity in Liaison appropriate accreditation organizations and all medical education and Committee on state medical associations for action on practice. Medical demographic diversity. (Res. 313, A-09; Education Modified: CME Rep. 6, A-11) Accredited Medical Schools H-295.888 Progress in 1. Our AMA encourages: (A) research on ways Retain; remains Medical to reliably evaluate the personal qualities (such relevant, as the AMA’s Education: the as empathy, integrity, commitment to service) Accelerating Change in Medical School of applicants to medical school and support Medical Education Admission broad dissemination of the results. Medical initiative and other Process schools should be encouraged to give activities seek to significant weight to these qualities in the improve the selection admissions process; (B) premedical coursework process for medical in the humanities, behavioral sciences, and students (and change social sciences, as a way to ensure a broadly- the composition and educated applicant pool; and (C) dissemination diversity of the future of models that allow medical schools to meet physician workforce). their goals related to diversity in the context of existing legal requirements, for example through outreach to elementary schools, high schools, and colleges. 2. Our AMA: (A) will continue to work with the Association of American Medical Colleges (AAMC) and other relevant organizations to encourage improved assessment of personal qualities in the recruitment process for medical school applicants including types of information to be solicited in applications to medical school; (B) will work with the AAMC and other relevant organizations to explore the range of measures used to assess personal qualities among applicants, including those used by related fields; (C) encourages the development of innovative methodologies to assess personal qualities among medical school applicants; (D) will work with medical schools and other relevant stakeholder
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