AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 845
(I-03)
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Introduced by:
International Medical Graduates Section
Subject:
Reporting of Duty Hour Violations by IMG Residents
Referred to:
Reference Committee K
(Ruth M. Covell, MD, Chair)
Whereas, At the 2003 Annual Meeting, our American Medical Association referred to the Board
of Trustees the directive to “conduct a 10-year survey to capture the attitudes and changes of
residents on duty hours after the new Accreditation Council for Graduate Medical Education
guidelines to determine the effect on working conditions for residents and fellows”; and
Whereas, The AMA International Medical Graduates Section shares the Resident and Fellow
Section’s concerns regarding enforcement, mechanisms and corrective actions for violations of
the guidelines; and
Whereas, The ACGME is currently tracking residents’ complaints and duty hours violations and
recognizes the potential for intimidation of residents that could prevent reporting; and
Whereas, IMG residents holding visas are potentially more susceptible to certain types of
intimidation, particularly because their visas may depend on their being in the program;
therefore be it
RESOLVED, That our American Medical Association work with all the parties involved to include
in resident work hours compliance evaluation the special vulnerability of IMG residents in
reporting duty hour violations, because of IMGs’ dependency on the residency program for their
visa (Directive to Take Action); and be it further
RESOLVED, That our AMA work with all parties involved to specifically address the vulnerability
of IMG residents in reporting duty hour violations, because of IMGs’ dependency on the
program for their visa, to facilitate accurate and anonymous reporting of violations. (Directive to
Take Action)
Fiscal Note: Staff cost estimated at less than $500 to implement.
Received: 12/6/03
Resolution: 845 (I-03)
Page 2
RELEVANT AMA POLICY
D-310.986 Accreditation Council for Graduate Medical Education Enforcement of Duty
Hour Standards
Our AMA will: (a) continue to work with the Accreditation Council for Graduate Medical
Education (ACGME) to further refine the standards for resident physician duty hours and to
collect additional evidence on the impact of the current standards with respect to preserving the
quality of resident physician education and eliminating fatigue and sleep deprivation;
(b) continue to strongly encourage the ACGME to vigorously enforce its accreditation standards
regarding resident physician duty hours;
(c) request that an annual report be provided to the Member Organizations of the ACGME
(AMA, American Association of Medical Colleges, American Board of Medical Specialties,
American Hospital Association, Council of Medical Specialty Societies) on the number of
programs by specialty that were not in compliance with resident physician duty hour standards
and the action taken by the ACGME;
(d) continue to monitor the enforcement of ACGME standards on resident physician duty hours
and report back to the House of Delegates as soon as possible, but no later than the 2004
Interim Meeting and regularly thereafter; and
(e) work with the ACGME to objectively evaluate the impact of the new standards for resident
work hours upon patient care and safety.
(2) The Council on Medical Education will continue to explore all possible approaches to the
enforcement of duty hours and the protection of residents who report duty hour violations and
report its findings to the ACGME Task Force on Duty Hours for its consideration. (CME Rep. 6,
A-03)