Process ImprovementA1
Managing Dual-Track Systems: A Program Integration Roadmap (PIR) for ACGME and non-ACGME Programs and Institutions
1 Phoenix Children’s · 2 Phoenix Children’s; FULGME
- Article type
- Process Improvement
- Published
- November 2024
- DOI
10.70785/JJQQ5831- Access
- Peer reviewed, open access
Abstract
Challenges persist in merging ACGME and non-ACGME or non-standard training programs within GME institutions due to differing program characteristics, such as work hour monitoring, supervision, salary structure, and career advancement opportunities, along with accreditation requirements and timelines. Some non-standard training programs may also face restrictive covenants, prohibiting trainees from using the skills, knowledge, and possibly patients they gained during the program in the same geographical area to directly compete against the program or institution that trained them. In institutions where ACGME and non-ACGME programs co-exist, these fundamental differences can be challenging to navigate. Program leaders and administrators may have to apply different standards to each type of program, and trainees may notice inequity if training under different guidelines than their peers within the same institution. Ultimately, programs that operate in silos, rather than cohesively, have the potential to undermine the strength of the GME enterprise. Integration of ACGME and non-ACGME program operations within a single sponsoring institution has great benefits for GME, program leaders, administrators, and trainees. However, current models for seamless integration are lacking. Our goal is to present an adaptable “Program Integration Roadmap” (PIR) that promotes consistency and synergy between both program types, fostering a richer learning environment and enhanced trainee development, while retaining the unique qualities of each.
About this issue. Issue 1 predates FULGME’s ISSN and DOI registration. The published PDF carries neither. The issue and article DOIs shown here come from the FULGME DOI archive, which was compiled afterwards.
Introduction
Graduate Medical Education (GME) institutions often face the challenge of managing both ACGME-accredited and non-ACGME or non-standard training programs. These programs differ significantly in terms of work hour monitoring, supervision, salary structure, career advancement opportunities, and accreditation requirements. The coexistence of these programs within a single institution can lead to disparities and inefficiencies, potentially undermining the overall strength of the GME enterprise. This manuscript aims to address these challenges by introducing a Program Integration Roadmap (PIR) designed to harmonize the management of ACGME and non-ACGME programs, fostering a cohesive and equitable training environment.
Methods
To develop the Program Integration Roadmap (PIR), we conducted a comprehensive review of existing literature on GME program management and integration on strategies. Additionally, we surveyed program leaders and administrators from various institutions to gather insights on the challenges and best practices in managing dual-track systems. The PIR was then designed to address the identified gaps and promote a cohesive integration of ACGME and non-ACGME programs.
Results
The implementation of the PIR in several pilot institutions has shown promising results. Program leaders reported improved communication and collaboration between ACGME and non-ACGME programs, leading to a more cohesive training environment.
Trainees expressed greater satisfaction with the equity and consistency in their training experiences. Additionally, the integrated approach has enhanced the overall quality of GME by fostering a culture of continuous improvement and innovation.
Discussion
The integration of ACGME and non-ACGME programs within a single institution presents significant challenges but also offers substantial benefits. The PIR provides a structured approach to address these challenges and promote a unified GME experience. By standardizing policies, integrating curricula, fostering collaborative leadership, and promoting equity, the PIR enhances the quality of medical education and supports the professional development of all trainees.
Conclusion
The Program Integration Roadmap (PIR) offers a viable solution to the challenges of managing dual-track systems in GME institutions. By promoting consistency and synergy between ACGME and non-ACGME programs, the PIR fosters a richer learning environment and enhanced trainee development. The successful implementation of the PIR in pilot institutions demonstrates its potential to improve the overall quality of GME and support the professional growth of program leaders, administrators, and trainees.
References
- Accreditation Council for Graduate Medical Education. (n.d.). Non-standard training (NST) recognition. Retrieved June 26, 2023, from ACGME
- Accreditation Council for Graduate Medical Education. (n.d.). Common program requirements. Retrieved June 26, 2023, from ACGME
- Juern JS, Stahl DM, Weigelt JA. Analysis of Academic Medical Center Graduate Medical Education Websites for Policies Regarding Restrictive Covenants in Non-ACGME Fellowships. J Surg Educ. 2018 Jul-Aug;75(4):924-927. doi: 10.1016/j.jsurg.2017.10.008. Epub 2017 Nov 6. PMID: 2.
Conflict of interest. The author(s) declares no conflict of interest.
How to cite this article
Bailey A, Gohre B. Managing Dual-Track Systems: A Program Integration Roadmap (PIR) for ACGME and non-ACGME Programs and Institutions. FULGME. 2024;(1):A1. DOI: 10.70785/JJQQ5831
Article Information
- Journal
- FULGME: Forum for United Leaders in Graduate Medical Education
- Publisher
- Forum for United Leaders in Graduate Medical Education
- ISSN
- 3065-582x
- Issue
- 1, November 2024
- Article number
- A1
- Article DOI
- 10.70785/JJQQ5831
- Issue DOI
- 10.70785/SONR4755
- Journal DOI
- 10.70785/IHSN6820
- Access
- Peer reviewed, open access, free to read
- Contact
- info@fulgme.org