New ACGME Rules 2011 for Residents

[keep]

As you know new ACGME rules are coming for July 2011. Here is the link for that:
http://acgme-2010standards.org/pdf/Common_Program_Requirements_07012011.pdf

I am concerned about the following things that are going to effect Psychiatry reidency programs and residents for example:

1. PGY-1 resident will do only 16 hour shift. It is good for interns but it may increase their number calls and also they will not able to cover whole weekends unless their number is big.

2. PGY-1 residents will require direct or indirect supervision (through phone). Most of the places already have indirect supervision by an attending. ACGME is very vauge about it. It seems local GMEs will decide whether they will go for Direct supervions of PGY-1 resident through seniors residents or not. It is very likely that they will because it will not effect other programs like medicine, surgey, Peds, OB or FM because they always more than 1 resident including 1 Senior resident. Our program seems like pushing for direct physical of PGY-1 residents through seniors residents. It will substantially going to increase their calls. Most of residency prgrams have very fewer residents. Please share if you heard anything about that at your programs.

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[psychattending]

As you know new ACGME rules are coming for July 2011. Here is the link for that:
http://acgme-2010standards.org/pdf/Common_Program_Requirements_07012011.pdf

I am concerned about the following things that are going to effect Psychiatry reidency programs and residents for example:

1. PGY-1 resident will do only 16 hour shift. It is good for interns but it may increase their number calls and also they will not able to cover whole weekends unless their number is big.

2. PGY-1 residents will require direct or indirect supervision (through phone). Most of the places already have indirect supervision by an attending. ACGME is very vauge about it. It seems local GMEs will decide whether they will go for Direct supervions of PGY-1 resident through seniors residents or not. It is very likely that they will because it will not effect other programs like medicine, surgey, Peds, OB or FM because they always more than 1 resident including 1 Senior resident. Our program seems like pushing for direct physical of PGY-1 residents through seniors residents. It will substantially going to increase their calls. Most of residency prgrams have very fewer residents. Please share if you heard anything about that at your programs.

You are correct these new rules will have significant effects on training. At the program level we are all still trying to make it work. My impression is that the new rules will likely have a greater impact on programs with smaller number of residents.

With respects to direct and indirect supervision for PGY1s. The indirect must be from a supervising MD who is in house (the MD cannot be at another hospital or at home). This is for all aspects of care that a PGY1 provides, not just call. While not finalized, most of us are hopeful that the psych RRC (this is not a decision that local GMEs will make but will be made nationally by the psychiatry part of ACGME) will decide that PGY1s will need direct supervision initially only when doing an emergency ER evaluation. Some of us PDs believe that even this can be done safely with indirect supervision on site. However, I do not know if the psych RRC will go that far or not.