ACGME Program Requirements for Graduate Medical Education in Complex General Surgical Oncology ACGME-approved focused revision: February 3, 2020; effective July 1, 2020 Contents Introduction .............................................................................................................................. 3 Int.A. Preamble ................................................................................................................ 3 Int.B. Definition of Subspecialty ..................................................................................... 4 Int.C. Length of Educational Program ............................................................................ 4 I. Oversight ............................................................................................................................ 4 I.A. Sponsoring Institution............................................................................................ 4 I.B. Participating Sites .................................................................................................. 4 I.C. Recruitment ............................................................................................................. 6 I.D. Resources ............................................................................................................... 6 I.E. Other Learners and Other Care Providers ............................................................ 8 II. Personnel ............................................................................................................................ 8 II.A. Program Director .................................................................................................... 8 II.B. Faculty ....................................................................................................................12 II.C. Program Coordinator ............................................................................................16 II.D. Other Program Personnel .....................................................................................17 III. Fellow Appointments ........................................................................................................17 III.A. Eligibility Criteria ...................................................................................................17 III.B. Number of Fellows .................................................................................................18 III.C. Fellow Transfers ....................................................................................................18 IV. Educational Program ........................................................................................................18 IV.A. Curriculum Components .......................................................................................18 IV.B. ACGME Competencies ..........................................................................................19 IV.C. Curriculum Organization and Fellow Experiences ..............................................23 IV.D. Scholarship ............................................................................................................25 V. Evaluation ..........................................................................................................................27 V.A. Fellow Evaluation ..................................................................................................27 V.B. Faculty Evaluation .................................................................................................31 V.C. Program Evaluation and Improvement ................................................................32 VI. The Learning and Working Environment .........................................................................35 VI.A. Patient Safety, Quality Improvement, Supervision, and Accountability ............36 VI.B. Professionalism .....................................................................................................41 VI.C. Well-Being ..............................................................................................................43 VI.D. Fatigue Mitigation ..................................................................................................46 VI.E. Clinical Responsibilities, Teamwork, and Transitions of Care ...........................47 VI.F. Clinical Experience and Education.......................................................................49 Complex General Surgical Oncology Tracked Changes Copy ©2020 Accreditation Council for Graduate Medical Education (ACGME) Page 2 of 55 1 ACGME Program Requirements for Graduate Medical Education 2 in Complex General Surgical Oncology 3 4 Common Program Requirements (Fellowship) are in BOLD 5 6 Where applicable, text in italics describes the underlying philosophy of the requirements in that 7 section. These philosophic statements are not program requirements and are therefore not 8 citable. 9 Background and Intent: These fellowship requirements reflect the fact that these learners have already completed the first phase of graduate medical education. Thus, the Common Program Requirements (Fellowship) are intended to explain the differences. 10 The “Subspecialty Background and Intent” text in the boxes below provide detail regarding the intention behind specific requirements, as well as guidance on how to implement the requirements in a way that supports excellence in residency education. Programs will note that the Surgery Subspecialty FAQs companion document has been integrated into this document and, where appropriate, guidance is given on additional Review Committee resource information. 11 12 Introduction 13 14 Int.A. Fellowship is advanced graduate medical education beyond a core 15 residency program for physicians who desire to enter more specialized 16 practice. Fellowship-trained physicians serve the public by providing 17 subspecialty care, which may also include core medical care, acting as a 18 community resource for expertise in their field, creating and integrating 19 new knowledge into practice, and educating future generations of 20 physicians. Graduate medical education values the strength that a diverse 21 group of physicians brings to medical care. 22 23 Fellows who have completed residency are able to practice independently 24 in their core specialty. The prior medical experience and expertise of 25 fellows distinguish them from physicians entering into residency training. 26 The fellow’s care of patients within the subspecialty is undertaken with 27 appropriate faculty supervision and conditional independence. Faculty 28 members serve as role models of excellence, compassion, 29 professionalism, and scholarship. The fellow develops deep medical 30 knowledge, patient care skills, and expertise applicable to their focused 31 area of practice. Fellowship is an intensive program of subspecialty clinical 32 and didactic education that focuses on the multidisciplinary care of 33 patients. Fellowship education is often physically, emotionally, and 34 intellectually demanding, and occurs in a variety of clinical learning 35 environments committed to graduate medical education and the well-being 36 of patients, residents, fellows, faculty members, students, and all members 37 of the health care team. 38 39 In addition to clinical education, many fellowship programs advance 40 fellows’ skills as physician-scientists. While the ability to create new 41 knowledge within medicine is not exclusive to fellowship-educated Complex General Surgical Oncology Tracked Changes Copy ©2020 Accreditation Council for Graduate Medical Education (ACGME) Page 3 of 55 42 physicians, the fellowship experience expands a physician’s abilities to 43 pursue hypothesis-driven scientific inquiry that results in contributions to 44 the medical literature and patient care. Beyond the clinical subspecialty 45 expertise achieved, fellows develop mentored relationships built on an 46 infrastructure that promotes collaborative research. 47 48 Int.B. Definition of Subspecialty 49 50 A surgical oncologist is a well-qualified surgeon who has obtained additional 51 education and experience in the multidisciplinary approach to the prevention, 52 diagnosis, treatment, and rehabilitation of cancer patients, and who devotes a 53 major portion of his or her professional practice to these activities and to cancer 54 research. Surgical oncologists interact with other oncologic disciplines and 55 provide leadership to the surgical, medical, and lay communities in matters 56 pertaining to cancer. 57 58 Int.C. Length of Educational Program 59 60 The educational program in complex general surgical oncology must be at least 61 24 months in length. (Core)* 62 63 I. Oversight 64 65 I.A. Sponsoring Institution 66 67 The Sponsoring Institution is the organization or entity that assumes the 68 ultimate financial and academic responsibility for a program of graduate 69 medical education consistent with the ACGME Institutional Requirements. 70 71 When the Sponsoring Institution is not a rotation site for the program, the 72 most commonly utilized site of clinical activity for the program is the 73 primary clinical site. 74 Background and Intent: Participating sites will reflect the health care needs of the community and the educational needs of the fellows. A wide variety of organizations may provide a robust educational experience and, thus, Sponsoring Institutions and participating sites may encompass inpatient and outpatient settings including, but not limited to