AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 311
(A-05)
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Introduced by:
Resident and Fellow Section
Subject:
Protection Against Delayed Residency Program Closure
Referred to:
Reference Committee C
(Harry S. Jonas, MD, Chair)
Whereas, When a residency program announces impending closure, it may choose to delay
closure for an additional one year for administrative and/or educational reasons; and
Whereas, The impending closure may result in the loss of educational curriculum, reduction in
number of residents and collapse of program infrastructure; and
Whereas, These changes may adversely affect the resident workload and work environment
thereby violating Accreditation Council for Graduate Medical Education established standards;
and
Whereas, Many medical specialty boards require multi-year continuous care of patients in order
to become eligible for board certification and only those residents in a residency program
already closed or with evidence of “hardship” can transfer to a different residency program while
in the latter parts of training; and
Whereas, The American Board of Family Practice defines hardship “as a medical condition or
injury of an acute but temporary nature, or the existence of a threat to the integrity of the
resident’s family which impedes or prohibits the resident from making satisfactory progress
toward the completion of the requirements of the residency program”; and
Whereas, Impending closure of a residency program does not qualify as a “hardship” even if the
program infrastructure and educational quality of the residency program is disintegrating;
therefore be it
RESOLVED, That our American Medical Association encourage medical specialty boards to
add “delayed residency program closure” to its list of exceptions to the continuity of care board
certification eligibility guidelines, and expand the definition of “hardship” so that it permits
residents to transfer to another residency program for completion of board eligibility
requirements where a program announces delayed closure (New HOD Policy); and be it further
RESOLVED, That our AMA encourage each Residency Review Committee to perform a timely
emergency site visit to any residency program announcing delayed closure to ensure
compliance with Accreditation Council for Graduate Medical Education established accreditation
guidelines (New HOD Policy); and be it further
RESOLVED, That our AMA encourage each Residency Review Committee to closely monitor
any residency program in delayed program closure to ensure continued compliance with the
Accreditation Council for Graduate Medical education guidelines. (New HOD Policy)
Resolution: 311 (A-05)
Page 2
Fiscal Note: Staff cost estimated at less than $500 to implement.
Received: 5/11/05
RELEVANT AMA POLICY
H-310.943 Closing of Residency Programs
The AMA: (1) encourages the Accreditation Council for Graduate Medical Education (ACGME)
to address the problem of non-educational closing or downsizing of residency training programs;
(2) encourages the ACGME to develop guidelines for the institution to follow in such closings or
reductions that provide for adequate notification and out-placement service (such as resource
contacts, transfer assistance, and financial assistance); (3) reminds all institutions involved in
educating residents of their contractual responsibilities to the resident; (4) encourages the
ACGME and the various Residency Review Committees to reexamine requirements for "years
of continuous training" to determine the need for implementing waivers to accommodate
residents affected by non-educational closure or downsizing; (5) urges residency programs and
teaching hospitals be monitored by the applicable Residency Review Committees to ensure that
decreases in resident numbers do not place undo stress on remaining residents by affecting
work hours or working conditions, as specified in Residency Review Committee requirements;
and (6) urges institutions that initiate significant reductions in graduate medical education
programs (in excess of 20 percent of the trainee complement or in excess of 10 percent of
trainees for a given year), or that voluntarily close programs, be requested prior to or at the time
of the reduction to file a concise summary of its educational impact with the Accreditation
Council for Graduate Medical Education or the relevant Residency Review Committees. (Sub.
Res. 328, A-94; Appended by CME Rep. 11, A-98)