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Sowing the Seeds 2008–2009 Annual Report

Contents Message from the CEO

Year in Review

Message from the Chair

ACGME Board of Directors

Review Committees

2008–2009 Review Committee Members

ACGME Staff

Statistical Highlights

2008 Financial Report

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© 2010 Accreditation Council for Graduate Medical Education

Design: Arc Group Ltd

Interior photography: All photos by Paul Berg except pages 14–15 Pages 14–15, courtesy of Gaylord Texan

MissionWe improve health care by assessing and advancing the quality of resident physicians’ education through exemplary accreditation.

VisionWe imagine a world characterized by:• astructuredapproachtoevaluatingthecompetencyofallresidentsandfellows;• motivatedphysicianrolemodelsleadingallGMEprograms;• high-quality,supervised,humanisticclinicaleducationalexperience,withcustomized formativefeedback;

• residentsandfellowsachievingspecialty-specificproficiencypriortograduation;and• residentsandfellowspreparedtobecomeVirtuousPhysicianswhoplacetheneeds andwell-beingofpatientsfirst.

Values• HonestyandIntegrity• ExcellenceandInnovation• AccountabilityandTransparency• FairnessandEquity• StewardshipandService• EngagementofStakeholders

Strategic Priorities• Fosterinnovationandimprovementinthelearningenvironment• Increasetheaccreditationemphasisoneducationaloutcomes• Increaseefficiencyandreduceburdeninaccreditation• Improvecommunicationandcollaborationwithkeyexternalstakeholders

Core Staff Values • CustomerFocus• Integrity/Ethics• ResultsFocus• Teamwork

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Message from the CEO

ACGME Sows Seeds for the Future with NewJournal,ACGME-I,MilestonesProjectThispastyearhas,indeed,beenayearofpreparationforthefutureattheAccreditationCouncilfor Graduate Medical Education (ACGME). Our nearly 350 volunteers and 160 staff have “planted the seeds” of success and growth in support of our mission of improvement of patient care through excellenceingraduatemedicaleducation.UndertheseasonedleadershipofChairSusanH.Day,MD,andtheBoardofDirectorsoftheACGME,wehaveundertakenanumberofinitiativesthatprepare us for the future. Among the many important “seeds” planted and germinating in 2009 are the Journal of Graduate Medical Education (JGME),ACGME-International(ACGME-I),theMilestonesProject,andResidentDutyHourStandardReview.

ACGME began JGME infulfillmentofitscommitmenttotheeducationalcommunitytosupportinnovationingraduatemedicaleducation(GME).ItwasfoundedtosupportcreationanddisseminationofnewknowledgeinGME.ThefirstjournalwhosepurposeissolelythepublicationofresearchinGME-relatedtopicsacrossallspecialties,JGME published its inaugural issue in September 2009. TheresponseoftheGMEacademiccommunityhasbeenpositiveandenthusiasticwithexcellentresearchsubmissionssufficientforthenextthreeissuesalreadyinthepipeline!

Theworldisgetting“flatterandsmaller”eachday.ManyaroundtheworldlooktotheUnitedStatesforleadershipinmedicaleducationandtotheACGMEforvalidationofexcellenceinGME,placing a responsibility on the ACGME for dissemination of our model to those who seek and can achievesuchvalidation.Inresponsetoboththerecognitionofourresponsibilitytoeducatorsandpatientsbeyondourborders,aswellaswithintheUnitedStates,theACGMEBoardapprovedapilotprogramofinternationalaccreditationinSingaporeandthecreationofACGMEInternational,LLC.WorkingwiththeMinistryofHealthofSingapore,ACGME-Iisassistingtheeducatorsofthatcountryinthedevelopment,andultimatelytheaccreditation,ofprogramsusingACGME-Istandardswhicharesimilar,butnotidentical,tothoseusedintheUnitedStates.Entirelyself-funded,ACGME-Iwill permit the testing of the feasibility of international accreditation and lay the groundwork for moreextensiveinternationalrelationshipsforaccreditation,aswellasopportunitiesforpredictablyhigh-qualityinternationalexperiencesforAmericanresidentswithinACGME-accreditedprograms.

TheMilestonesProjectisunderwayinthreedisciplines:internalmedicine,generalsurgery, andpediatrics.TeamsrepresentingtheAmericanBoardofMedicalSpecialtiescertifying board,thecollegeoracademy,theprogramdirectors,andtheACGMEReviewCommitteearedefiningthespecificsofthecompetenciesineachdisciplineandthetrajectoryormilestones fortraineesinachievementofproficiencyorbeyondinthosecompetenciesandrecommendingtoolsfortheirevaluation.ThiswillprovidetheReviewCommitteesandtheACGMEwiththe tools necessary to move to “the next accreditation system” and realize the promise of the OutcomesProject.

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Finally,theACGMEhaskeptitspromisetothecommunitytorevisitresidentdutyhourstandardsafterfiveyears.A16-membertaskforce,composedofReviewCommitteechairs,residents,membersoftheBoardofDirectors,andonepublicdirector,hasbeenreceivingdatafromtheprofession,sleepscientists,clinicians,educators,andthepublic.Weanticipatedraftstandards tobeproposedbymid-2010.Morethan140medicalorganizationsand20expertshavetestifiedbeforethetaskforce.Thistestimony,alongwiththeInstituteofMedicinereportandthreeexternalreviewsofvariousdimensionsofthemedicalliterature,hasprovidedrelevantinformationandrecommendations.Ourgoalistoimprovebotheducationandpatientsafetyaswereaffirmtheroleof the ACGME in monitoring this aspect of residency training and enhance the public trust.

Asalways,theworkoftheACGMEisdonebyadedicatedstaff,workingwithexemplaryvolunteerleaders chosen from America’s medical educators. We are grateful for their abilities and willingness to serve the public and the profession as we strive to improve patient care through excellence in graduate medical education.

Sincerely,

ThomasJ.Nasca,MD,MACP Chief Executive Officer Accreditation Council for Graduate Medical Education

“Our nearly 350 volunteers and 160 staff have ‘planted the seeds’ of success and growth in support of our mission of improvement of patient care through excellence in graduate medical education.”

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Year in Review

Duringacademicyear2008–2009,theACGMEdevelopedthefirstpeer-reviewedjournaldedicatedsolelytotheeducation of medical residents and fellows and the learning environmentsinwhichittakesplace.ThequarterlyJournal of Graduate Medical Education (JGME) debuted in September 2009aftermorethanayearofplanning.Nearly11,000programdirectors,designatedinstitutionalofficials,andmembers of the ACGME Review Committees and Board of Directors receive JGME free of charge as part of their participation in the accreditation process.

TheSeptember2009inauguralissueincludesseveralscholarlyarticlesonsystems-basedpractice,assessmentofcompetence,residentmilestones,andrelatedmatters.Thesecondissue,publishedinDecember2009,focusesondutyhours,professionalism,residentburnout,andsimulation.Bothissuesare available to the public as open access issues at www.jgme.org/loi/jgme.Thewebsitealsofeaturesinformationonsubscriptions for individuals and institutions.

Journal Oversight Committee Sets Vision and Business Plan for New Journal

TheJournalOversightCommitteewasformedinthefallof2008 to oversee planning and publication of the ACGME’s newpeer-reviewedpublication,theJournal of Graduate Medical Education.Themissionofthisjournalistocontributeinameaningful way to the knowledge about graduate medical education and the environment in which residents and fellows learn and participate in care.

TheJournalOversightCommitteeoversawtheconversion of ACGME Bulletinintoaquarterly,peer-reviewedjournal.Itset a vision for the Journal,developedabusinessplan,andinstituted systems to promote editorial independence and a processforresolvingeditorialconflict.

Sowing the Seeds

September 2009

In this Issue

Sharpening the Focus on Systems-Based Practice

Developmental Milestones for Internal Medicine and Pediatric Residency Training

Assessing Intern Core Competencies

Systems-Based Practice Defined

Surgical Skills Training Using Simulation and Computer-Enhanced Visual Learning

Development of the Objective Structured System-Interaction Examination

A 4-Week Experiential Quality Improvement Curriculum

Teaching Error Disclosure to Residents: Curricular Innovation and Pilot Study

Residents Learn to Improve Care Using the ACGME Core Competencies and Institute of Medicine Aims for Improvement

Assessing the Patient Safety Culture of Internal Medicine House Staff

Achieving the AAAs of Ambulatory Care: Aptitude, Appeal, and Appreciation

International Medical Outreach: Benefits for US Education and Practice

The official journal of Accreditation Council for Graduate Medical Education ISSN 1949-8349

Journal of Graduate Medical Education

Journal of Graduate Medical Education

Thecommitteespentasignificantamountoftimeonthesearchforaneditor-in-chief.Thepositionattractedapplicationsfrom16candidates.Duringthespring,summer,andearlyfallof 2009 the committee interviewed several candidates. An editor-in-chiefwasselectedinSeptember.Untiltheappointmentof an editorial board for the new Journal, planned for early 2010,theJournalOversightCommitteeservesasthegroupthat provides editorial guidance for the Journal.

Department of Field Activities Enhances Site VisitForms,ImprovesFeedbacktoFieldStaff

TheDepartmentofFieldActivitiescoordinatesallaspectsofapproximately2,000ACGMEaccreditationsitevisits,includingschedulingandlogistics,writingandprocessingofreports,andassociatedpolicyandimprovementactivities.Thedepartmentalso is responsible for the coordination and management of 31professionalaccreditationfieldrepresentativeswhoconductthevastmajorityofACGMEsitevisitsandcoordinationforthespecialistsitevisitorswhoconducttheremainder.Inaddition,thedepartment oversees the publication of the Journal of Graduate Medical Education and the ACGME e-Bulletin, a brief newsletter withpracticalinformationabouttheaccreditationprocess,andmaintains the ACGME’s internal database of accredited programs used for scheduling and associated activities.

Departmental achievements for 2008–2009 include the following:

• Ongoingenhancementstothevisitreportformstoincreasecontentandclarity,withafocusonimprovingtheutilityoftheinformationfortheRRCreviewersandtheaccreditationprocess;

• EffortstoenhancethespecificityandutilityoffeedbackprovidedtotheACGMEfieldstaffbyprogramdirectorsandReviewCommitteereviewers;

• TwodedicatedprofessionaldevelopmentmeetingsfortheACGMEfieldrepresentativesthatincludedupdates,opendiscussions,andbriefingsessionsonavarietyoftopicsrelatedtotheaccreditationsitevisit;

• Nationalandregionalpresentationsontheaccreditationsitevisit,dutyhourcompliance,simulationandpatientsafety,residenteducationinpatient-andfamily-centeredcare,andothertopics;and

• CoordinationofthelaunchoftheJournal of Graduate Medical Education and the publication of two issues.

Committee on Innovation in the Learning Environment Sunsets after Completing Work on ProgramandInstitutionalInnovationandImprovement

TheCommitteeonInnovationintheLearningEnvironmentreacheditsscheduledsunsetdateinSeptember2009.Thecommittee had been authorized in 2004 and charged with promoting innovation in the greater environment in which residents learnandparticipateinpatientcare.Duringitslast18months,thecommitteecompletedsomeactivitiesrecommendedinitsfirstreport,releasedin2007.Theseactivitiesincludedthefollowing:

• Effortstostudyanddescribeinnovationandimprovementinthelearningenvironment;

• Projectstocollectanddisseminateinformationoninnovativepracticesinthelearningenvironment,includingthedesignofinnovationpilots;

• Identificationofthefactorsthatcontributetoexcellenceinthe learning environment through an initiative titled “Learning InnovationandImprovement”;and

• Relatedworkthatincludedcollectinganddisseminatinginformation on innovative practices in the learning environment and exploring ways to share ideas with programs,sponsoringinstitutions,andotherorganizations in graduate medical education.

Site Visits and New Program Applications in 2009

Institutional Reviews

Core Program Site Visits

Subspecialty Program Site Visits

Site Visits by Specialist Site Visitor

New Program Applications

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Council of Review Committees Organizes into ThreeSectionsandThreeSubcommittees

TheCouncilofReviewCommittees(CRC)advisestheACGMEBoard of Directors on matters related to accreditation and the work of the Review Committees. Council members include the chairsofthe27specialtyReviewCommittees,InstitutionalReviewCommittee,TransitionalYearReviewCommittee,andCouncilofReviewCommitteeResidents.E.StephenAmis,MD,chairoftheReviewCommitteeforDiagnosticRadiology,chairstheCRC.OfficialobserversincludeamemberrepresentingtheOrganizationofProgramDirectorsAssociations,arepresentativeoftheRoyalCollegeofPhysiciansandSurgeonsofCanada,andadirectorofmedicalanddentaleducationfromtheOfficeofAcademicAffiliationsoftheVeteransAdministration.

TheCRCengagedinseveraladditionalkeyactivitiesduring2008–2009:

• ProposedchangestotheACGMEBylaws,Policies,andProceduresresultingfromtheCRC’sredesigninitiativewereforwarded to the Board of Directors and were discussed and approved at its February 2009 meeting.

Firstrow,lefttoright: Neal Cohen, MD; Danny Takanishi Jr., MD; Victor Reus, MD; E. Stephen Amis Jr., MD (Chair); Rosemarie Fisher, MD (Vice-Chair); John Engstrom, MD; Karen Hsu Blatman, MD. Second row: Robert Havlik, MD; Robert Muelleman, MD; Michael Koch, MD; Bryan Martin, DO; Suzanne Powell, MD; Darlene Metter, MD; Lois Bready, MD; Thomas Whalen, MD; James Martin, MD; Linda Famiglio, MD; Barbara Chang, MD (Veterans Administration). Thirdrow:Mark Juzych, MD; Stephen Ludwig, MD; Bradley Marple, MD; Ralph Dacey Jr., MD; Irving Kron, MD; Eric Weiss, MD; William Bockenek, MD; Bruce Haffty, MD; Timothy Key, MD; John Potts III, MD (Organization of Program Directors Associations); Bruce Korf, MD; George Wendel, MD. Not pictured: Stephen Albanese, MD; Brian Burkey, MD; Janice Nevin, MD; Randall Roenigk, MD.

• CRCmembersorganizedthecommitteeintothreesectionsbaseduponrespectivespecialties:hospital/ancillary,medical,and surgery. Each section has since convened several times to identify and prioritize needs perceived by each section. Section activities will guide the future work and focus of the CRC.

• TheCRCdivideditselfintothreeworkingsubcommittees:Standardization,CommonProgramRequirements,andInnovationandImprovement.Eachsubcommitteehasmetseveraltimestodiscussissuespertainingtothesesubjects.

• TheCRCcontinuestouseDirectors’Desk©,anelectronicportal that moves the CRC steadily toward a more paperless environment.Thistoolhasalreadyfacilitatedcommunication,especiallyinterimdiscussion,amongmembers.Ithasprovideda way to conduct anonymous votes between meetings and a space to post materials pertinent to the committee and upcoming meetings.

Each chair member of the CRC engages in regular Review Committee review work in addition to participation in this leadership organization within the ACGME. Members’ collective efforts are a vital manifestation of ACGME’s commitment to its vision for exemplary accreditation.

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Department of Accreditation Committees ReviewsNotificationLetters,UpdatesWebPages,AssistsProgramDirectors

TheDepartmentofAccreditationCommitteesiscomposedofabout 55 staff members for the 28 ACGME Review Committees. Thedepartmentservesseveralcommunities,bothinternal(e.g.,ACGMEfieldstaffmembers,otherdepartmentalstaff)andexternal(ACGMEvolunteers,programdirectors,DIOs),withprimarycommitments to improve external and internal communication andcollaboration,increaseefficiencyandtransparencyinaccreditation,andfosterinnovationandimprovement.

Duringacademicyear2008–2009,weprepared53newslettersfollowing Review Committee meetings to highlight committee work and communicate these activities to program directors and DIOs.InadditiontoprovidingmultiplesessionsattheACGMEAnnualEducationalConference,ReviewCommitteechairsandexecutive directors and other staff attended many annual program directororDIOmeetingstoprovideupdatesandindividualhelpsessions. Review Committee members and staff participated in more than 210 presentations or publications about graduate medical education. We also began to foster quicker navigation of our web pages as we revised the Review Committee web pagestoamoreuser-friendlyformatwithstandardsections.

Firstrow,lefttoright: Georgia Andrianopoulos, PhD (Executive Director); William Rodak, PhD (Senior Executive Director); Jeanne K. Heard, MD, PhD, FACP (Senior Vice President); Larry Sulton, PhD (Senior Executive Director); Louise King, MS (Executive Director). Second row: Peggy Simpson, EdD (Executive Director); Missy Fleming, MEd, PhD (Executive Director); Caroline Fischer, MBA (Executive Director); Susan Mansker (Associate Executive Director); Karen Lambert (Associate Executive Director). Thirdrow: Lynne Meyer, MPH, PhD (Executive Director); Felicia Davis (Associate Executive Director); Eileen Anthony (Executive Director); Jerry Vasilias, PhD (Executive Director). Not pictured: Linda Thorsen (Executive Director); Patricia Surdyk, PhD (Executive Director).

Tobemoreefficientandtransparentforourexternalcommunities,werevisedthestandardformatfortheLetterofNotificationtoincludethetextoftheprogramorinstitutionalrequirement for each citation and developed consistent review templates for the Review Committees to use to complete theirreviewsofprogramsforaccreditation,progressreports,rebuttalsofproposedadverseactions,andcomplaintsagainstprograms. We also updated the Program Director Guide for the Common Program Requirements and the Virtual Program Director Guide and revised the welcome letter we provide to new program directors.

Our focus on improvement centered on the annual orientation for58newReviewCommitteemembers,inwhichwereviewedconflictofinterest,confidentialityandfiduciaryresponsibilities,andspecialty-specificreviewprocesses,andincludedpeerevaluations of 37 Review Committee members who had completed their second year of volunteer commitment to the Review Committees.Thedepartmentwasinsubstantialcompliancewith the 20 internal quality measures for Review Committee accreditation activities.

Theday-to-dayworkofthedepartmentisforthecommunitiesnotedabove;however,allofthisworkfocusesonthemostimportant community — the patients and public whom we all serve.

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Department of Education TeamMembersAdvanceACGMEEducationalEfforts,DevelopAssessmentandEvaluationRecommendations,LaunchNewMilestoneGroups,andPublishScholarlyResearch

TheDepartmentofEducation,ledbyTimothyP.Brigham, MDiv,PhD,hadabusyandproductiveyear.Thedepartmentencompassesmanyeducation-relatedactivitiesandservices attheACGME,includingtheACGMEAnnualEducationalConference,programcoordinatorconferences,theOfficeofResidentServices,theAdvisoryCommitteeonEducationalOutcomeAssessment,andscholarlyresearch.

ActivitiestoadvanceimplementationoftheOutcomeProjectcontinuedthisyearundertheleadershipofSusanSwing,PhD,vicepresidentofoutcomeassessment.TheAdvisoryCommitteeon Education Outcome Assessment completed its work with preparationofitsfinalreportofrecommendationstotheACGMEBoard.Standardsforevaluatingassessmenttools,establishmentofareviewgroupforassessmenttools,andfeatures for assessment systems in residencies were among therecommendations.AnextstepintheOutcomeProjectbegan with the launch of Milestone Groups in pediatrics and surgery (see sidebar on page 9). Milestone development will continue as a centerpiece of ACGME work on outcome assessment during the next few years.

TheDivisionofEducationalActivities,ledbydirectorDebraDooley,hasasitsprimaryresponsibilitythedevelopmentoftheACGMEAnnualEducationalConference(seearticle,pages8–9).Inadditiontoorganizingthe2009AnnualEducationalConference,theDivisionofEducationalActivities,tofurtherthedepartment’s commitment to providing quality education for residentprogramcoordinators,developedsixone-dayworkshopsfornewprogramcoordinatorsinallspecialties.Thesedaylongworkshops were staffed by ACGME employees and provided an introductiontotheACGMEandtheaccreditationprocess.ThedivisionalsoorganizedtheACGMEDutyHourCongress,whichwasheldinJune2009(seearticle,page9).

TheOfficeofResidentServices,underthedirectionofMarshaMiller,associatevicepresident,andAmyDunlap,residentservicesassociate,assistedresidentswithresidency-relatedconcerns(seearticle,page11).

As part of an ongoing effort to increase communication and interactionwithothermedicalorganizations,departmentstaffgave presentations at a meeting of the Association for Hospital Medical Education.

Firstrow,lefttoright: Marsha A. Miller, MA (Associate Vice President, Resident Services); Timothy P. Brigham, MDiv, PhD (Senior Vice President, Education); Susan R. Swing, PhD (Vice President, Outcome Assessment); DeWitt C. Baldwin Jr., MD (Scholar-in-Residence). Second row: Patrick Ryan, MD (Research Associate); DeLonda Y. Dowling (Executive Assistant); Robert A. Doughty, MD (Senior Scholar for Experiential Learning and Leadership Development); Amy Dunlap (Resident Services Associate); Karen Pokorny, MA (Educational Project Associate). Thirdrow: Karla Wheeler, MA (Educational Project Associate); Anna Isaacson (Administrative Assistant); Elizabeth Eccleston (Project Assistant); Kenji Yamazaki, PhD (Outcome Assessment Project Associate). Not pictured: Debra L. Dooley (Director, Educational Activities); Laura Irwin (Portfolio Administrator).

Intheareaofscholarlyresearch,Dr.Brigham;seniorscholar-in-residenceDeWittC.Baldwin,MD;andRobertA.Doughty,MD,seniorscholarforexperientiallearningandleadershipdevelopment,wrotemultiplepapers,aswellasgaveseveralpresentations,symposiums,andworkshops.Dr.BaldwinandPatrickRyan,MD,surveyed a large national sample of residents regarding working conditions and learning environment. Results were presented to theDutyHoursTaskForceandwillbepublishedin2010.

2009 ACGME Annual Educational Conference FeaturesMoreSessionChoices,DutyHoursSymposium,andIntroductoryCourse

The2009ACGMEAnnualEducationalConference,“ShapingtheFuture,”heldMarch4–8attheGaylordTexanResortandConventionCenterinGrapevine,Texas,onceagainsoldoutwithmorethan1,000peoplecomingfromacrossthecountrytoattendtheevent.The2009conferencefeaturedanexpansionofthenumberofsessionsfrom60to81,drop-intechnologyconsultations,theMarvinR.DunnPosterSession,andCMEcredit sponsored through Jefferson Medical College. K. Anders Ericsson,PhD,theConradiEminentScholarandaprofessorofpsychologyatFloridaStateUniversityinTallahassee,Florida,gavethekeynoteaddress,inwhichhediscussedthetheoryofdeliberate practice and how it can be applied to graduate medical education.

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MilestoneProjectTheACGME’sinitiativetoincreaseemphasisoneducational outcome assessment took a step forward this year with the launch of milestone development. Milestones describe performance levels residents are expectedtodemonstrateforskills,knowledge,andbehaviors in the general competency domains. Milestones will lay out a framework of observable behaviors and other attributes associated with progressive levels of development.Identificationofassessmentmethodsthatwill be effective in evaluating performance on the milestones is a part of this effort. Milestones will assist residency programs in planning learning opportunities for residents and evaluating resident performance. After aperiodofstudy,ReviewCommitteeswilluseindicatorsof resident accomplishment of milestones in their assessments of programs’ educational effectiveness to identify curriculum improvements that are needed. Boards may use an individual resident’s accomplishment of milestonesasevidencethatindividualsarequalifiedtotake the initial certifying examination and are prepared for unsupervised practice.

ThisworkisbeingundertakenasajointinitiativeoftheACGMEandspecialtycertificationboards.Eachspecialtyhas its own Milestone Group composed of prominent physician educators who are active in the specialty’s professionalorganizations.Inputfromconstituentsandevidence from the research literature are being used to informdevelopment.Initialevaluationsofresidentaccomplishment against milestones will likely be collected from programs in one or more specialties beginning in 2011.

Sowing the SeedsDirectlyprecedingtheconference,theACGMEheldtwopre-conferencesattheGaylord—adutyhourssymposiumandaone-dayintroductorycoursefornewprogramdirectorsandcoordinators.The2010ACGMEAnnualEducationalConference,“TransitionsinGME,”willtakeplaceMarch4–7attheGaylordOprylandinNashville,Tennessee.

ACGME Convenes Duty Hours Task Force, Holds Symposium and Congress

Five years after the introduction of the ACGME’s common duty hourstandards,theACGMElaunchedacomprehensivereviewof the duty hour standards.

In2003,theyearinwhichthecommondutyhourstandardswereintroduced,DavidC.Leach,MD,whowasexecutivedirectoroftheorganizationatthetime,pledgedthattheACGMEwouldexaminetheimpactofthecommondutyhourstandardsfiveyearsaftertheywereintroduced.Honoringthatcommitment,the ACGME took several steps to review and assess the duty hour standards during academic year 2008–2009.

• OnMarch4and5,2009,theACGMEheldanInternational DutyHourSymposium,“PromotingGoodLearningandSafe,EffectiveCare:AFive-YearReviewoftheACGME’sDutyHourStandards,”inGrapevine,Texas,inconjunctionwiththe2009ACGMEAnnualEducationalConference.Thesymposiumfeaturedexpertsinthefieldsofsleep,patientsafety,andmedicaleducation.Attendeesincludedprogramdirectors,designatedinstitutionalofficials,faculty,andresidents,aswell as invited speakers from Canada and Great Britain.

• InJune2009,theACGMEBoardofDirectorsappointeda16-memberDutyHoursTaskForcetodeveloprecommendationsforrefiningthedutyhourstandards.ThepanelcomprisestheCEOoftheACGME,ThomasJ.Nasca,MD,MACP;ACGMEChairSusanH.Day,MD;threeotherBoardmembers;ninerepresentativesoftheACGMECouncilofReviewCommittees;andtworesidentrepresentatives.Thetaskforcemetperiodically throughout the year with a goal of presenting its recommendations to the ACGME Board of Directors and Council of Review Committees. Any changes to the duty hour standards will undergo a period of public comment before being adopted by the Board.

• InJune2009,theACGMEconvenedaDutyHourCongress,at which representatives from appointing medical organizations presented testimony to the task force on their experiences with and opinions on the duty hour standards.

• TheACGMEcommissionedthreeindependentliteraturereviewsofpeer-reviewedstudiesrelatedtoresidentdutyhours,residentfatigue,residentlearning,andthelearningenvironment.

Milestone Groups in Progress

• GeneralSurgery

• InternalMedicine

• Pediatrics

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Council of Review Committee Residents AdvocatesforUniformLeaveofAbsencePolicies, Helps Develop New Leadership Conference

TheCouncilofReviewCommitteeResidents(CRCR)issowingseedstobenefittheresidentcommunity,graduatemedicaleducation,andpatientcare.Withstrongleadershipandgenerativeconversations,theCRCRhasaccomplishedmanygoalsthisyear.

TheCRCRwelcomedanewchair,RupaDainer,MD,who,havingrecentlycompletedherpediatricanesthesiologyfellowship, hasbeendeployedtoAfghanistanforsevenmonths.Evenso,Dr. Dainer will guide the CRCR from her remote location because she views it as her professional duty to serve her country and the ACGME.

“Thisyearwillbefullofexcitingchangestooureducationalenvironment,andthevoicesoftheresidentswithintheACGMEmustbeclearandstrong,”saidDr.Dainer.

TheCRCRadvocatedforsimilar,fairleaveofabsencepoliciesacross the specialty boards by calling the disparity to the attention oftheAmericanBoardofMedicalSpecialties(ABMS).Currently,

Firstrow,lefttoright: Todd Mondzelewski, MD; Joanna Fair, MD; Rupa Dainer, MD (Chair-Elect); Karen Hsu Blatman, MD (Chair); Adeline Deladisma, MD (Vice-Chair); Charles Scales, MD. Second row: Stefanie Campbell, MD; Sara Brenner, MD; Hannah Zimmerman, MD; Jeffrey Kozlow, MD; Brian Freeman, MD; Audrey Woerner, MD; Matthew Poppe, MD; Jamie Bohl, MD; Deborah Erlich, MD. Thirdrow: Gretchen Glaser, MD; Michael Swaby, MD; Alexander Khalessi, MD; Meredith Riebschleger, MD; William J. Walsh III, MD, MPH; Stephen Tantama, MD; Meredith Runke, MD; William Huang, MD; Monica Rho, MD; Carla Marienfeld, MD; Samuel Seiden, MD.

each specialty has a different set of rules and consequences whenextendedmedicalleaveisrequired,someofwhichmaybedetrimentaltoresidentsandnoteducationallybeneficial.TheABMS did not take the CRCR’s concern lightly and created a task force to study the problem and make a recommendation to itsCommitteeonCertification,Subcertification,Recertification,andMaintenanceofCertification.JoannaFair,MD,RRCforNuclearMedicineresidentmember,representstheCRCRonthe task force.

Recognizing the need and desire of residents to develop and honetheirleadershipskills,theCRCRplayedamajorroleinassistingtheACGMEDepartmentofEducationandtheOfficeof Resident Services in designing its 2010 inaugural Leadership Conference for program directors and residents in order to develop a community of excellent educators who will assist the ACGME in designing and perfecting needed educational activities. Some of the goals of the workshop include building relationships betweenprogramdirectorsandchiefresidents,givingparticipantsanexperientiallearningexperience,developingparticipants’leadershipskills,promotinghealthyresidentsandhealthytrainingprograms,andencouragingparticipantstoincorporateexperiential learning into their training programs. Deborah

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New Office of Resident Services Addresses ResidentConcernsQuicklyandConfidentially

TheOfficeofResidentServices(ORS)openeditsdoorsinJanuary2009 to help physicians in graduate medical education receive fairsolutionstoresidencytraining-relatedconcernsandformalcomplaints.Whenaconcern,whichisdifferentthanaformalcomplaint,issubmitted,itplaysnoroleinaccreditation;concernsdonotaffecttheinstitutionand/orprogram’saccreditation,whileformalcomplaintsmayaffectaccreditation.TheORSisnotanadvocateforindividuals,butanadvocateforfairprocess.

Forthefirstsixmonthsofitsoperation,theORSprocessed 218concernsand37formalcomplaintsfromresidents,faculty,andothers.Predominantconcernsincludedexcessivedutyhours,hostileworkenvironment,termination/nonrenewalofcontract,andnonresponsivenesstoverificationoftrainingrequests.Therewas also a smattering of individual concerns that did not fall into any one category. Formal complaints generally have been about thelackofteaching,supervision,evaluation,anddueprocess;dutyhourviolations;andhostileworkenvironment.Thusfar,residentsandDIOsseempleasedwiththeACGME’snewprocessbecause concerns are addressed in a timely manner and the DIOcanaddressthemconfidentialitywithoutitaffectingtheprogramorinstitution’saccreditation.Likewise,residentsfeelthey are being heard and their concerns and complaints are being addressed.

TheORSisinvolvedinsomeotherimportantwork,includingmanaging the work of the Council of Review Committee Residents (CRCR).Recently,theDepartmentofEducationandORS(whichisanofficewithintheDepartmentofEducation),inconjunctionwiththeCRCR,designedtheACGME’sMarch2010inauguralLeadershipConferenceforprogramdirectorsandresidents.Thesuccess of this workshop may launch other leadership workshops across the country. Managing the ACGME’s awards programs is anotherORSresponsibility.Thisyear,theACGMEannouncedits David C. Leach Award and GME Coordinator Excellence Award for residents and resident teams and program and institutional coordinators,respectively.

ORS is sowing seeds and growing strong as it strives to build a collegial and trusting relationship with and among residents andDIOs.

Erlich,MD,residentrepresentative,RRCforFamilyMedicine;JasonItri,MD,residentrepresentative,RRCforRadiology;CarlaMarienfeld,MD,residentrepresentative,RRCforPsychiatry;andMeredithRiebschleger,MD,residentrepresentative,RRCforPediatrics,servedonthesubcommittee.

Communication within the resident community continues to be oneoftheCRCR’stoppriorities.TohelpclosethegapbetweenresidentsandtheACGME,theCRCRcreatedaPowerPointpresentation focusing on the roles and responsibilities of the ACGME and Review Committees. CRCR members will use the PowerPointslideswhenspeakingtoresidentorganizations.SamSeiden,MD,residentrepresentative,RRCforAnesthesiology,was instrumental in its development.

Residentphysiciansareofferedmedical,dental,andvisioncareattheirindividualtraininghospitals,andrecentchangesintheACGMEInstitutionalRequirementshavemandatedthatresidentshavehealthcarecoverageonthefirstdayoftheirappointment.However,aresident’sworkdaystartsearlyandendslongafterphysicianofficesareclosed.Workingsixdaysaweek,often onSaturday,alsolimitsthetimeavailabletoseeaphysician;therefore,residentsoftendonothavethelogisticalabilitytoaccessroutinehealthcare.TheCRCRhascraftedandproposeda new institutional requirement that will allow residents protected timeforroutinemedical,dental,andvisioncare.Thisinitiativewasledbythe2007–2009CRCRchair,KarenHsuBlatman,MD.

Last,butnotleast,twomembersoftheCRCRandtheAMAresidentdirector—JamieBohl,MD,RRCforColonandRectalSurgery;Dr.Riebschleger;andWilliamJ.WalshIII,MD,Pulmonaryand Critical Care Fellow — are members of the ACGME Duty HoursTaskForce.ThetaskforceisstudyingdutyhoursinresponsetoACGME’scommitmenttoreviewthestandardsafterfiveyearsandtheInstituteofMedicinereport.TheCRCRbroughttotheattentionoftheACGMECEOThomasJ.Nasca,MD,MACP,andACGMEChairSusanH.Day,MD,thefactthatcurrentdutyhour requirements are forcing residents to choose between followingtherulesanddoingwhatisbestfortheirpatients.TheCRCR made it clear that residents do not want to be placed in thatpositionbecausetheirchoicemustbetoplacepatientsfirstandforemost.OtherACGMEcommitteesthatbenefitfromresidentrepresentationaretheCouncilofReviewCommittees,CommitteeonRequirements,andMonitoringCommittee.Dr.Dainer serves on both the Council of Review Committees and CommitteeonRequirements.TheCRCRvice-chair,AdelineDeladisma,MD,servesontheMonitoringCommittee.

BecauseoftheCRCR’swork,theresidentvoiceisgrowingstrong.

ACGME Learning Portfolio TeamContinuestoTestandRefinePortfolio,CreatesOnlineUserGroup

EarlyadoptersoftheACGMELearningPortfolio(ALP)continueto make strides in using the portfolio to support resident learning andassessmentwithintheirprograms,exploringwaystocaptureimportantelementsoftheircurriculumandallowforreal-timefeedback on resident performance.

TofacilitatethesharingofideasacrossprogramsandtoprovideaforumfordiscussingandcollectingideasforimprovingALP,theALPUserGroupwasformedinsummer2008.Thegroupisopen to all users and is supported by an online blog and discussion page.Theinauguralface-to-facemeetingoftheUserGroupwasheldattheMarch2009EducationalConferenceinGrapevine,Texas,withfutureannualmeetingsscheduledtocoincidewiththe educational conferences.

While the number of active alpha programs and users — close to 20andmorethan2,400respectively—hasremainedrelativelyconstantoverthepastyear,effortsareinprocessthatwillundoubtedly expand participation in the coming year.

• Beta Redesign and Testing — Redesign efforts are currently under way for a new and improved beta version of the portfolio that will link with other ACGME systems (Accreditation Data System and Case Logs)bymeansofasinglelog-infeature,and that will also improve and optimize key modules within the portfolio based on feedback from our alpha test sites. We anticipatethebetaversionwillbeavailableinmid-2010toacadreofprograms—ourcurrentalphausers,thoseprogramsacceptedaspartoftheinitialbetaapplicationprocess,andanynewly interested programs.

• Integration with the Milestones Initiative — Specialty Milestone Groups are being convened to develop milestones thatwillultimatelydefinethebehavioralattributesthatareessential to be demonstrated in each competency domain before a resident graduates and at other key points during theresident’seducation.Theportfoliowillserveastherequired repository for semiannual documentation of resident performance against the milestones.

Inthecomingyear,weanticipateincorporatingtheworkofseveraloftheMilestoneGroupsintotheportfolio,whichwillentail preloading the newly developed milestones (along with

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ACGMEInternationalTheACGMEcreatedanewsubsidiaryorganization,ACGMEInternational,whichwillaccreditresidencyprogramsinothercountries.Infall2009,ACGMEInternationalsignedanagreementwiththeSingaporeMinistry of Health to accredit residency programs in that country.

ThomasJ.Nasca,MD,MACP,chiefexecutiveofficerof theACGME,servesaspresidentofACGMEInternational.WilliamE.Rodak,PhD,wasnamedvicepresident,accreditationservices,forACGMEInternational.

Sowing the Seeds

assessment tools and common curriculum components that havebeenidentified)intospecialty-specificversionsoftheportfolio.ALPwillfacilitatethetestingandvalidationof such components by aggregating the data and producing local and national reports for review and comparison across programs. Such reporting will ultimately support the streamlining of the accreditation process and the facilitation of program improvement.

AdemonstrationoftheACGMELearningPortfolio,FAQs, atimeline,andthelatestnewsonALPcanbeviewedon theACGMEwebsiteatwww.acgme.org/acWebsite/portfolio/learn_alp_welcome.asp.

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InordertorefinetheACGMELearningPortfoliobeforemakingitavailabletoallresidencyprograms,theACGMEhas been testing the portfolio at residency programs throughoutthecountry.TheLeadershipPreventiveMedicineResidencyProgramatDartmouth-HitchcockMedicalCenterinLebanon,NewHampshire,isoneofthetestsites.Residents and faculty there have been using the portfolio and providing feedback to the ACGME since 2007.

BecausetheLeadershipPreventiveMedicineResidencyProgram,whichcombinestraininginpreventivemedicinewiththatofseveralotherdisciplines,emphasizescontinualassessmentandreflection,itwasanidealplacefortheACGME to test the portfolio.

“We knew when we were designing this program that we wanted to have a portfolio as an integral part of the resident’s experience,”said,TinaFoster,MD,MPH,theprogram’sdirector. “Having a portfolio as a way for residents to keep trackofwhattheyaredoing,lookbackatwhattheyhavedone,andreflectisreallyimportant.Aspracticingdoctors,we are being asked much more to show that we know how to improve our own practices and how to continue to educate ourselves. Our residents are moving into a world where that will be an expectation.”

Left to right: Jerzy Knobloch (Systems Analyst); Laura Irwin (Portfolio Administrator); Lisa Johnson (Learning Portfolio Program Manager); John Nylen (Chief Operations Officer).

Residentsusetheportfoliotostorelearningplans,evaluations,notes,presentations,andpapers,alongwiththeirownreflections.Residentslikehavingasecure,easy-to-access,centralplacetostoredocumentsandwritingsrelatedtotheirresidency,saidDr.Foster.

Inaddition,shenoted,facultyappreciatebeingabletoconveniently review the materials the residents have compiled in their portfolio and quickly give feedback to the residents.

Tohelpresidentsandfacultybecomeadeptatusingtheportfoliosystem,theprogram’sadministrativedirectortutors the residents and faculty on the technical aspects of the portfolio and leads a national online users’ group for portfoliotestersthatincludesadiscussiongroup,listserv,and blog.

Theportfoliosystemdoesmorethansimplyprovidearecordoftheresidents’learning,notedDr.Foster.Italsohelps her and the rest of the faculty to see the residency program through the eyes of residents.

“You get a different view of their individuality and how they areshapingtheirlearningexperiences,”shesaid.

Residents and Faculty Testing Alpha Version of ACGME Learning Portfolio

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William H. Hartmann, MD, Presented with John C. Gienapp Award for Distinguished Achievement

FormerACGMEChairWilliamH.Hartmann,MD,wastherecipient of the 2009 John C. Gienapp Award in recognition of hisnotablecontributionstograduatemedicaleducation.Theaward,namedafterthefirstexecutivedirectoroftheACGME,honors lifetime achievement in graduate medical education.

Dr. Hartmann served as chair of the ACGME’s Board of Directors from2006–2008.Priortohistermaschair,Dr.Hartmannwasa member of the Board for six years. He was a volunteer reviewer ontheResidencyReviewCommitteeforPathologyfor12yearsand also chaired the Review Committee.

William H. Hartmann, MD, received the 2009 John C. Gienapp Award at the ACGME Annual Educational Conference, held March 5–8 at the Gaylord Texan in Grapevine, Texas. Left to right: Timothy Flynn, MD (Chair, Awards Committee, 2008–2009); Dr. Hartmann; Thomas J. Nasca, MD, MACP (ACGME CEO); David C. Leach, MD (who retired as CEO of the ACGME in 2007).

The John C. Gienapp AwardWritten by William H. Hartmann, MD

Itdoeshonoryou John and humbles me tho’proudIamto have it.

For recognition of your service to the ACGME and does acknowledge mine tho’ of much lesser degree.

But it sends a message to all the volunteers that visible rewards are there for all to see for those who serve in the educational halls of GME so as to assure the care to be given to you and me will be of the highest degree.

Iproudlyaccept this award as it means so much to me.

Thankyou.

From1993untilhisretirement,Dr.Hartmannwasaclinicalprofessor of pathology at the University of South Florida and executivevicepresidentoftheAmericanBoardofPathology.He also served as director of pathology service at Long Beach MemorialMedicalCenter,andprofessorandchairofpathologyatVanderbiltUniversitySchoolofMedicine.

“Leadingwithknowledge,heart,andspirit,Dr.Hartmannisabelovedrolemodel,”saidtheCEOoftheACGME,ThomasJ.Nasca,MD,MACP.“Hisresidentshavegoneontobecometrueleadersinthefieldofpathology.Hespeakshismind;hecaresnaughtforpolitics,butforwhatisright;heplacesthecareofpatientsandtheeducationofresidentsfirst.”

When accepting his award at the 2009 ACGME Annual Educational Conference,Dr.Hartmannreadashortpoemthathehadwritten,“TheJohnC.GienappAward.”Thepoemisreprintedhere.

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Firstrow,lefttoright: Diane Hartmann, MD; Lori Schuh, MD; Nancy Gaba, MD; William H. Hartmann, MD; Lois Bready, MD; Sheela Kapre, MD. Second row: James Valentine, MD; Andrew Filak, MD; Peter Carek, MD; Richard Welling, MD; James Burks, MD; Michael S. Beeson, MD; D. Karl Montague, MD. Not pictured: Edmund Cibas, MD; Gail Manos, MD.

ACGME Honors Program Directors, DIOs with Parker J. Palmer Courage to Teach and Courage to Lead Awards

Atthe2009AnnualEducationalConference,theACGMEhonored 11 program directors and three designated institutional officialswhowerechosenasthe2009ParkerJ.PalmerCouragetoTeachandCouragetoLeadawardees.Therecipientswerepresentedtheirawardplaques,alongwithchecksfor$1,000,ataluncheonheldduringtheconference.InMay,theyattendedaneducationalretreatattheFetzerInstituteinKalamazoo,Michigan.

TheCouragetoTeachAwardisgivenannuallytoprogramdirectors,nominatedbyfacultyandresidents,whohaveimprovedgraduate medical education and served as exemplary role models forresidents.TheawardisnamedforParkerJ.Palmer,PhD,asociologist and teacher who wrote The Courage to Teach.

TheParkerJ.PalmerCouragetoLeadAwardispresentedeachyeartodesignatedinstitutionalofficials,alsonominatedbyfacultyandresidents,whohavecreatedanoptimallearningenvironmentforresidents;encouragedtheethical,professional,andpersonaldevelopmentofresidents;andensuredsafeandappropriatepatient care.

2009 Parker J. Palmer Courage to Teach Award Recipients:

• Michael S. Beeson, MD,emergencymedicine,SummaHealthSystem,Akron,Ohio

• James Burks, MD,internalmedicine,TexasTechUniversity,Lubbock,Texas

• Peter Carek, MD,familymedicine,MedicalUniversityofSouthCarolina,Charleston,SouthCarolina

• Edmund Cibas, MD,cytopathology,BrighamandWomen’sHospital,Boston,Massachusetts

• Nancy Gaba, MD,obstetricsandgynecology,GeorgeWashingtonUniversity,Washington,DC

• Sheela Kapre, MD,internalmedicine,SanJoaquinGeneralHospital,FrenchCamp,California

• Gail Manos, MD,psychiatry,NavalMedicalCenter,Portsmouth,Virginia

• D. Karl Montague, MD,urology,ClevelandClinic, Cleveland,Ohio

• Lori Schuh, MD,neurology,HenryFordHospital, Detroit,Michigan

• James Valentine, MD,surgery,UniversityofTexasSouthwesternMedicalSchool,Dallas,Texas

• Richard Welling, MD,surgery,GoodSamaritanHospital,Cincinnati,Ohio.

2009 Parker J. Palmer Courage to Lead Award Recipients:

• Lois Bready, MD,UniversityofTexasHealthScienceCenter,SanAntonio,Texas

• Diane Hartmann, MD, University of Rochester Medical Center,Rochester,NewYork

• Andrew Filak, MD, University of Cincinnati College of Medicine,Cincinnati,Ohio

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Who Sows the Seeds?Thankyouforteaching!ThisismysimplifiedmessagetoyouasthechairoftheACGMEBoardofDirectors.ThiseditionoftheannualreporthighlightssomeofthewaysthattheACGMEensuresour training programs provide the best possible physicians to care for all people. You will read how weareactivelyidentifying“milestones”oflearning,howwecontinuetoimprovetheconceptofindividualresidentportfolios,andhowweareworkingtohelptheAnnualEducationalConferencebetter suit your needs.

Andyet…Themostimportantelementof“sowingtheseeds”iswhatyoudoeveryday.Teaching ishardwork;itrequirespatience,perseverance,andthebestofcommunicationskills.Itrequiresattentiontothedetailsofprogramrequirements,flexibilitytoeachandeveryresident’suniquewayoflearning,crisismanagement,andvisionarythinking.Helpingtheresidentwhoseparenthasjustbecomeillorwhohasjustbecomeaparentortheonewhostruggleswithcareerdecisionstakesthosewhoteachfarbeyondanypolicyorprocedure.Alloftheseexamplesarejustsomeoftheresponsibilitiesofthosewhoshepherdinterns,residents,andfellows.

Andyet…Whataretherewards?Iwouldsubmitthatteachersshareinaspecialformofeternity.What teachers provide these learners is eventually transmitted to the next generation of both patientsanddoctors.Thepowerofarolemodelshouldneverbeunderestimated.Myhunchisthateach of us had some role models who turned us on to the best of the profession of medicine — caring,curing,consoling,andfindingwaystohelpmoreeffectively.Theseelementsexistacross all specialties. Helping a resident through a conversation with an unhappy patient is every bit as important as helping the resident acquire an examination skill. Showing a resident how to advocate for a patient is yet another fundamental responsibility. Helping a resident understand why a patient trusts — even when he or she cannot fully grasp the complexity of a situation — is a gift that will be carried for the full extent of a career. All of these are within your power.

Andyet…Whyisitsohardsometimes?Weallknowtheseanswers.Wehavepressures,botheconomicandpersonal.Wehavedisappointmentswithsometeachingefforts.Thereismoretoteach and seemingly less time and support.

Andso…Iinviteyoualltobecomereinvigorated!Whatothervocationissorichwithopportunity tomakeapositivedifference,stretchthemind,and,onadailybasis,contributetothebettering ofsociety?Let’sallmakegraduatemedicaleducationbetter.Takeaseriouslookatprojectsandactivitiesfeaturedinthisannualreport.Pushtheenvelopeatyourprogramorinstitutiontoproducemorequalifiedphysicians.LettheACGMEknowifthedirectionswehavetakenareontargetforyour needs as teachers. And so…

Thank you for teaching.

SusanH.Day,MD Chair, 2008–2009 Board of Directors Accreditation Council for Graduate Medical Education

Message from the Chair

ACGME Board of Directors July1,2008toJune30,2009

Firstrow,lefttoright: Richard J.D. Pan, MD, MPH; Carol M. Rumack, MD; Carl Patow, MD, MPH; Susan H. Day, MD (Chair); Roger L. Plummer; Paige Amidon. Second row: Anton N. Hasso, MD; John C. Maize Sr., MD; Mahendr Kochar, MD; Rosemarie Fisher, MD (Vice-Chair, CRC); Thomas J. Nasca, MD, MACP (CEO, ACGME); David L. Brown, MD; Debra F. Weinstein, MD; Edward T. Bope, MD; Peter F. Rapp. Thirdrow: E. Stephen Amis Jr., MD (Chair, CRC); William J. Walsh III, MD, MPH; Timothy Goldfarb; Kenneth B. Simons, MD; Dorothy Lane, MD, MPH; Baretta R. Casey, MD, MPH, FAAFP; Karen Hsu Blatman, MD (Former Chair, CRCR); Christopher C. Colenda III, MD, MPH. Not pictured: Louis B. Cantor, MD (Chair, CRC); Rupa Dainer, MD (Chair, CRCR); John F. Duval; David J. Fine; Timothy Flynn, MD (Chair-Elect); Daniel G. Mareck, MD; Ajit Sachdeva, MD, FRCSC, FACS.

TheACGMEBoardcomprisesfourmembersfromeachoftheACGME’sfivememberorganizations:theAmericanBoard ofMedicalSpecialties,theAmericanHospitalAssociation,theAmericanMedicalAssociation,theAssociationofAmericanMedicalColleges,andtheCouncilofMedicalSpecialtySocieties.Thememberorganizationsnominatethedirectors,whoareelectedbytheBoard.TheBoardalsoincludesthechairoftheCouncilofReviewCommittees,thechairoftheCouncilofReviewCommitteeResidents,aresidentappointedbytheAMA’sResidentandFellowSection,threepublicmembers,onetofourdirectors-at-large,andtwononvotingfederalgovernmentrepresentatives.TheACGMEisgratefultotheBoardmembersfortheirservice.

Paige AmidonConsumers UnionNewYork,NewYorkPublic Director

E. Stephen Amis Jr., MDAlbert Einstein College of MedicineBronx,NewYorkChair, Council of Review CommitteesTerm began July 1, 2009

Karen Hsu Blatman, MDChicago,IllinoisResident DirectorFormer Chair, Council of Review Committee ResidentsTerm expired September 30, 2009

Edward T. Bope, MDRiverside Methodist HospitalColumbus,Ohio

David L. Brown, MDCleveland ClinicCleveland,Ohio

Louis B. Cantor, MD IndianaUniversitySchoolofMedicineIndianapolis,IndianaFormer Chair, Council of Review CommitteesTerm expired September 30, 2009

Baretta R. Casey, MD, MPH, FAAFPUniversity of Kentucky College of MedicineHazard,Kentucky

Christopher C. Colenda III, MD, MPHTexasA&MHealthScienceCenterCollegeStation,Texas

Rupa Dainer, MDChildren’s National Medical CenterBethesda,MarylandChair, Council of Review Committee ResidentsTerm began July 1, 2009

Susan H. Day, MDCaliforniaPacificMedicalCenterSanFrancisco,CaliforniaChair, Board of Directors

John F. DuvalMedicalCollegeofVirginia Hospitals and ClinicsMidlothian,Virginia

David J. FineSt. Luke’s Episcopal Health SystemHouston,Texas

Rosemarie Fisher, MDYale-NewHavenHospitaland Yale University School of MedicineNewHaven,ConnecticutVice-Chair, Council of Review Committees Term began July 1, 2009

Timothy Flynn, MDUniversity of Florida College of MedicineGainesville,FloridaChair-Elect, Board of Directors

Timothy GoldfarbShands HealthCareGainesville,Florida

Anton N. Hasso, MDUniversityofCalifornia,IrvineMedical CenterOrange,California

Mahendr Kochar, MDTheMedicalCollegeofWisconsinMilwaukee,Wisconsin

Dorothy Lane, MD, MPHStonyBrookUniversity, School of MedicineStonyBrook,NewYork

John C. Maize Sr., MDMaize Center for DermatopathologyMountPleasant,SouthCarolina

Daniel G. Mareck, MD BureauofHealthProfessions/HRSARockville,MarylandFederal Representative

Thomas J. Nasca, MD, MACPACGME,ChiefExecutiveOfficerChicago,IllinoisEx-Officio

Richard J. D. Pan, MD, MPHUniversity of CaliforniaSacramento,California

Carl Patow, MD, MPHHealthPartnersInstitutefor Medical EducationBloomington,Minnesota

Roger L. PlummerPlummerandAssociatesChicago,IllinoisPublic Director, Treasurer

Peter F. RappOregon Health and Science UniversityPortland,Oregon

Carol M. Rumack, MDUniversity of Colorado Denver Health Sciences Center Aurora,Colorado

Ajit Sachdeva, MD, FRCSC, FACSAmerican College of SurgeonsChicago,Illinois

Kenneth B. Simons, MDMedical College of WisconsinMilwaukee,Wisconsin

William J. Walsh III, MD, MPHUniversity of UtahSaltLakeCity,UtahResident Director

Debra F. Weinstein, MDPartnersHealthCareSystemBoston,Massachusetts

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18

Allergy and Immunology

Colon and Rectal Surgery

Dermatology

Anesthesiology

Emergency Medicine

Internal Medicine

Family Medicine

AmericanBoardofAllergy&Immunology (a conjoint board of the American Board of Internal Medicine and the American Board of Pediatrics)

Adult CardiothoracicCritical Care MedicineHospice&PalliativeMedicinePainMedicinePediatricAnesthesiology

American Board of AnesthesiologyAmerican Society of Anesthesiologists

AmericanBoardofColon&RectalSurgeryAmerican College of Surgeons

DermatopathologyProceduralDermatology

American Board of Dermatology

Hospice&PalliativeMedicineMedicalToxicologyPediatricEmergencyMedicineSports MedicineUndersea&HyperbaricMedicine

American Board of Emergency MedicineAmericanCollegeofEmergencyPhysicians

Geriatric MedicineHospice&PalliativeMedicineSports Medicine

AmericanBoardofFamilyPracticeAmericanAcademyofFamilyPhysicians

AdvancedHeartFailure&TransplantCardiology (Approved September 2009)Cardiovascular DiseaseClinical Cardiac ElectrophysiologyCritical Care MedicineEndocrinology,Diabetes&MetabolismGastroenterologyGeriatric MedicineHematologyHematology&OncologyHospice&PalliativeMedicineInfectiousDiseaseInternalMedicine–PediatricsInterventionalCardiologyNephrologyOncologyPulmonaryDiseasePulmonaryDisease&CriticalCareMedicineRheumatologySleep MedicineTransplantHepatology

AmericanBoardofInternalMedicineAmericanCollegeofPhysicians

Medical Genetics

Neurological Surgery

Medical Biochemical GeneticsMolecularGeneticPathology

American Board of Medical GeneticsAmerican College of Medical Genetics

Endovascular Surgical Neuroradiology American Board of Neurological SurgeryAmerican College of Surgeons

Review Committees

Review Committee Specialized Areas Appointing Organizations*

** The AMA’s Council on Medical Education is an appointing organization for all RRCs except Transitional Year programs.

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Nuclear Medicine

Obstetrics and Gynecology

Orthopaedic Surgery

Ophthalmology

American Board of Nuclear MedicineSociety of Nuclear Medicine

Hospice&PalliativeMedicine AmericanBoardofObstetrics&GynecologyAmerican College of Obstetricians &Gynecologists

OphthalmicPlastic&ReconstructiveSurgery American Board of OphthalmologyAmerican Academy of Ophthalmology

Adult Reconstructive OrthopaedicsFoot&AnkleOrthopaedicsHand SurgeryMusculoskeletal OncologyOrthopaedic Sports MedicineOrthopaedic Surgery of the SpineOrthopaedicTraumaPediatricOrthopaedics

American Board of Orthopaedic SurgeryAmerican Academy of Orthopaedic Surgeons

Pathology — Anatomic and Clinical

BloodBanking/TransfusionMedicineChemicalPathologyCytopathologyDermatopathologyForensicPathologyHematologyMedical MicrobiologyMolecularGeneticPathologyNeuropathologyPediatricPathologySelectivePathology

AmericanBoardofPathology

Otolaryngology NeurotologyPediatricOtolaryngologySleep Medicine

American Board of OtolaryngologyAmerican College of Surgeons

Child NeurologyClinical NeurophysiologyEndovascular Surgical NeuroradiologyHospice&PalliativeMedicineNeurodevelopmental DisabilitiesNeuromuscular MedicinePainMedicineSleep MedicineVascularNeurology

AmericanBoardofPsychiatry&NeurologyAmerican Academy of Neurology

Neurology

Review Committee Specialized Areas Appointing Organizations*

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Review Committee Specialized Areas Appointing Organizations*

Pediatrics Adolescent MedicineDevelopmental&BehavioralPediatricsHospice&PalliativeMedicineInternalMedicine–PediatricsNeonatal–PerinatalMedicinePediatricCardiologyPediatricCriticalCareMedicinePediatricEmergencyMedicinePediatricEndocrinologyPediatricGastroenterologyPediatricHematology/OncologyPediatricInfectiousDiseasesPediatricNephrologyPediatricPulmonologyPediatricRheumatologyPediatricTransplantHepatologySleep MedicineSports Medicine

AmericanBoardofPediatricsAmericanAcademyofPediatrics

Physical Medicine and Rehabilitation

Hospice&PalliativeMedicineNeuromuscular MedicinePainMedicinePediatricRehabilitationSpinalCordInjuryMedicineSports Medicine

AmericanBoardofPhysicalMedicine &RehabilitationAmericanAcademyofPhysicalMedicine &Rehabilitation

Preventive Medicine

Psychiatry

Plastic Surgery

MedicalToxicologyUndersea&HyperbaricMedicine

AmericanBoardofPreventiveMedicine

AddictionPsychiatryChild&AdolescentPsychiatryForensicPsychiatryGeriatricPsychiatryHospice&PalliativeMedicinePainMedicinePsychosomaticMedicineSleep Medicine

AmericanBoardofPsychiatry&NeurologyAmericanPsychiatricAssociation

Craniofacial SurgeryHand Surgery

AmericanBoardofPlasticSurgeryAmerican College of Surgeons

Radiology — Diagnostic Abdominal RadiologyCardiothoracic RadiologyEndovascular Surgical NeuroradiologyMusculoskeletal RadiologyNeuroradiologyNuclear RadiologyPediatricRadiologyVascular&InterventionalRadiology

American Board of RadiologyAmerican College of Radiology

** The AMA’s Council on Medical Education is an appointing organization for all RRCs except Transitional Year programs.

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Review Committee Specialized Areas Appointing Organizations*

Radiation Oncology Hospice&PalliativeMedicine American Board of RadiologyAmerican College of Radiology

Thoracic Surgery Congenital Cardiac Care AmericanBoardofThoracicSurgeryAmerican College of Surgeons

Urology PediatricUrology American Board of UrologyAmerican College of Surgeons

Transitional Year Members appointed by ACGME Board of Directors

Surgery Hand SurgeryHospice&PalliativeMedicinePediatricSurgerySurgical Critical CareVascularSurgery

American Board of SurgeryAmerican College of Surgeons

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2008–2009 Review Committee Members

Allergy and Immunology

Marianne Frieri, MD, PhDNassau University Medical CenterNewYork,NewYork

James E. Gern, MDUniversity of Wisconsin HospitalMadison,Wisconsin

J. Andrew Grant, MDUniversityofTexasMedicalBranchGalveston,Texas

George R. Green, MD Abington Medical SpecialistsAbington,Pennsylvania

Dennis K. Ledford, MDUniversity of South Florida College of Medicine Tampa,Florida

Bryan L. Martin, DONationalCapitalConsortium/Walter Reed Army Medical CenterWashington,DistrictofColumbiaChair

David B. Peden, MDTheUniversityofNorthCarolinaSchool of MedicineChapelHill,NorthCarolinaVice-Chair

Laurie J. Smith, MD Walter Reed Army Medical Center Washington,DistrictofColumbia

Benjamin P. Soule, MDNationalInstitutesforHealthBethesda,MarylandResident

John W. Yunginger, MD American Board of Allergy andImmunologyPhiladelphia,PennsylvaniaEx-Officio

Anesthesiology

Audrée A. Bendo, MDSUNY Downstate Medical CenterBrooklyn,NewYork

Lois L. Bready, MDUniversityofTexas Health Science CenterSanAntonio,TexasChair

Neal H. Cohen, MD UCSF School of MedicineSanFrancisco,CaliforniaVice-Chair

Douglas Baird Coursin, MDUniversity of WisconsinMadison,Wisconsin

O. Frederick Guidry, MD Medical University of South CarolinaCharleston,SouthCarolina

Jeffrey R. Kirsch, MD Oregon Health and Science UniversityPortland,Oregon

Rita M. Patel, MD UniversityofPittsburgh Medical CenterPittsburgh,Pennsylvania

James P. Rathmell, MD Massachusetts General HospitalBoston,Massachusetts

Mark A. RockoffAmerican Board of AnesthesiologyBoston,MassachusettsEx-Officio

Samuel Seiden, MDStanford University Medical CenterStanford,CaliforniaResident

Kenneth J. Tuman, MDRush Medical CollegeChicago,Illinois

Colon and Rectal Surgery

Patrice Blair, MPHAmerican College of SurgeonsChicago,IllinoisEx-Officio

Jaime Bohl, MDLahey ClinicBurlington,MassachusettsResident

Eric J. Dozois, MDMayo ClinicRochester,Minnesota

Bruce A. Orkin, MDTuftsMedicalCenterBoston,Massachusetts

David J. Schoetz Jr., MDLahey ClinicBurlington,MassachusettsEx-Officio

Clifford L. Simmang, MDCoppell,Texas

Michael J. Stamos, MDUniversityofCalifornia,Irvine School of MedicineOrange,California

Eric G. Weiss, MDCleveland Clinic FloridaWeston,FloridaVice-Chair

W. Douglas Wong, MDMemorial Sloan Kettering Cancer Center NewYork,NewYorkChair

Dermatology

Terry L. Barrett, MD UniversityofTexasSouthwesternMedical CenterDallas,TexasVice-Chair

Jeffrey P. Callen, MDUniversity of LouisvilleSchool of Medicine Louisville,Kentucky

Antoinette F. Hood, MDAmerican Board of DermatologyDetroit,MichiganEx-Officio

Maria K. Hordinsky, MDUniversity of MinnesotaMinneapolis,Minnesota

Ronald L. Moy, MDUCLA Medical CenterLosAngeles,California

Lee T. Nesbitt Jr., MDLSU Health Sciences CenterNewOrleans,Louisiana

Randall K. Roenigk, MDMayo Clinic Rochester,MinnesotaChair

R. Stan Taylor, MDUniversityofTexasSouthwesternMedical CenterDallas,Texas

Ruth Ann Vleugels, MDHarvard Medical SchoolBoston,MassachusettsResident

Karen E. Warschaw, MDMayo ClinicScottsdale,Arizona

Emergency Medicine

Michael Beeson, MDSumma Health SystemAkron,Ohio

Louis Binder, MDMetroHealth Medical CenterCleveland,Ohio

Wallace Carter, MDNewYork–PresbyterianHospitalBronxville,NewYorkVice-Chair Term began January 1, 2009

Marjorie Geist, PhDAmerican College ofEmergencyPhysiciansIrving,TexasEx-Officio

Jeffrey Graff, MDNorthShore University HealthSystemEvanston,Illinois

Mark Hostetler, MDPhoenixChildren’sHospitalPhoenix,Arizona

Samuel M. Keim, MDUniversity of Arizona College of MedicineTucson,Arizona

Robert Muelleman, MDUniversity of Nebraska Medical CenterOmaha,NebraskaVice-Chair Term ended December 31, 2008ChairTerm began January 1, 2009

Susan Promes, MDUniversityofCalifornia,SanFranciscoSanFrancisco,California

Mary Ann Reinhart, PhDAmerican Board of Emergency MedicineEastLansing,MichiganEx-Officio

Sandra M. Schneider, MDUniversity of Rochester School of Medicine and DentistryRochester,NewYorkChair Term ended December 31, 2008

Victoria Thornton, MDDuke University Medical CenterDurham,NorthCarolina

Michael J. Tocci, MDUniversity of ConnecticutNewHaven,ConnecticutResident

Family Medicine

Peter J. Carek, MD, MSMedical University of South CarolinaCharleston,SouthCarolinaTerm began July 1, 2008

Molly Cohen-Osher, MDMacNeal Memorial HospitalBerwyn,IllinoisResidentTerm ended December 31, 2008

Colleen Conry, MDUniversity of Colorado School of MedicineAurora,Colorado

Deborah Erlich, MDTuftsUniversityFamily Medicine Residency at Cambridge Health AllianceMalden,MassachusettsResidentTerm began January 1, 2009

James Martin, MDChristus Santa Rosa HospitalSanAntonio,TexasVice-ChairTerm began July 1, 2009

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Richard Neill, MDUniversityofPennsylvania Health SystemPhiladelphia,Pennsylvania

Janice E. Nevin, MD, MPHChristiana Care Health SystemWilmington,DelawareChair

James Puffer, MDAmerican Board of Family MedicineLexington,KentuckyEx-Officio

Perry A. Pugno, MDAmerican Academy of FamilyPhysiciansLeawood,KansasEx-Officio

Martin A. Quan, MDUCLA Medical CenterLosAngeles,CaliforniaVice-ChairTerm ended June 30, 2009

Thomas C. Rosenthal, MDUniversity at BuffaloState University of New YorkBuffalo,NewYork

Penelope K. Tippy, MDSouthernIllinoisUniversityCarbondale,Illinois

Robin O. Winter, MDJohn F. Kennedy Medical CenterEdison,NewJersey

Internal Medicine

Beverly M. K. Biller, MDMassachusetts General HospitalBoston,Massachusetts

Karen Hsu Blatman, MDChicago,IllinoisResident

Dennis Boulware, MDKaiserPermanenteMedicalGroupHonolulu,Hawaii

Roger Bush, MDTheVirginiaMasonMedicalCenterSeattle,Washington

Blase A. Carabello, MDMichaelE.DeBakeyVeteransMedical Affairs CenterHouston,Texas

Thomas Cooney, MDOregon Health and Science UniversityPortland,OregonVice-Chair

Rosemarie Fisher, MDYale–New Haven HospitalNewHaven,ConnecticutChair

John Fitzgibbons, MDStamford,Connecticut

Bruce R. Korf, MD, PhDUniversity of Alabama Birmingham,AlabamaChair

Cynthia M. Powell, MDUniversity of North Carolina ChapelHill,NorthCarolina

Nathaniel H. Robin, MDUniversity of Alabama at BirminghamBirmingham,Alabama

Howard M. Saal, MDCincinnati Children’s Hospital Medical CenterCincinnati,Ohio

Audrey C. Woerner, MDUniversityofTexasatHoustonHouston,TexasResident

Neurological Surgery

Daniel Barrow, MDEmory University School of MedicineAtlanta,GeorgiaEx-Officio

Patrice Blair, MPHAmerican College of SurgeonsChicago,IllinoisEx-Officio

Ralph G. Dacey Jr., MDWashington University School of MedicineSt.Louis,MissouriChair

Arthur L. Day, MDBrigham and Women’s HospitalBoston,Massachusetts

Michael Louis DiLuna, MDYale School of MedicineNewHaven,ConnecticutResident

A. John Popp, MDBrigham and Women’s HospitalBoston,Massachusetts

Robert A. Ratcheson, MDUniversity Hospitals of ClevelandCleveland,Ohio

Volker K.H. Sonntag, MDBarrowNeurologicalInstitutePhoenix,Arizona

Dennis D. Spencer, MDYale School of MedicineNewHaven,ConnecticutVice-Chair

Neurology

Jose Carrillo, MDHarbor–UCLA Medical CenterLongBeach,CaliforniaResident

Terrence L. Cascino, MDMayo ClinicRochester,Minnesota

Patricia Crumrine, MDChildren’sHospitalofPittsburghPittsburgh,Pennsylvania

John W. Engstrom, MDUniversityofCalifornia,SanFranciscoSanFrancisco,CaliforniaVice-Chair

Larry Faulkner, MDAmericanBoardofPsychiatry and NeurologyDeerfield,IllinoisEx-Officio

Ronald Kanner, MDLongIslandJewishMedicalCenterNewHydePark,NewYorkChair

Brett Kissela, MDUniversity of CincinnatiCincinnati,Ohio

Robert Pascuzzi, MDIndianaUniversityMedicalSchoolIndianapolis,Indiana

Catherine Rydell, CAEAmerican Academy of NeurologySt.Paul,MinnesotaEx-Officio

Nuclear Medicine

Joanna Fair, MD, PhDUniversity of New MexicoAlbuquerque,NewMexicoResident

Leonie Gordon, MDMedical University of South CarolinaCharleston,SouthCarolinaVice-Chair

Michael Graham, MD, PhDUniversityofIowaIowaCity,IowaAlternate Member

Darlene Metter, MD UniversityofTexasHealthScienceCenter at San AntonioSanAntonio,TexasChair

Christopher J. Palestro, MDLongIslandJewishMedicalCenterNewHydePark,NewYork

J. Anthony Parker, MDBethIsraelDeaconessMedicalCenterBoston,Massachusetts

Harvey Ziessman, MDJohnsHopkinsMedicalInstitutionsBaltimore,Maryland

Brian Freeman, MDCoralville,IowaResident

John G. Frohna, MDUniversity of WisconsinMadison,Wisconsin

Eric Holmboe, MDAmericanBoardofInternalMedicinePhiladelphia,PennsylvaniaEx-Officio

Lynne Kirk, MDUniversityofTexasSouthwesternMedical CenterDallas,Texas

Michael R. Lucey, MDUniversity of Wisconsin–MadisonSchool of MedicineMadison,Wisconsin

Glenn Mills, MDLouisiana State UniversityShreveport,Louisiana

Grace Y. Minamoto, MDMontefioreMedicalCenterBronx,NewYork

Jeanette Mladenovic, MDUniversity of Miami Leonard M. Miller School of MedicineMiami,Florida

Stuart F. Quan, MDHarvard Medical SchoolBoston,Massachusetts

Eileen Reynolds, MDBethIsraelDeaconessMedicalCenterBoston,Massachusetts

Paul H. Rockey, MD American Medical AssociationChicago,IllinoisEx-Officio

Stephen M. Salerno, MD, MPHMadigan Army Medical CenterTacoma,Washington

Kenneth G. Torrington, MDSan Antonio Uniformed Services Health Education ConsortiumLacklandAFB,Texas

Mary N. Walsh, MDTheCareGroupLLCIndianapolis,Indiana

Steven Weinberger, MDAmericanCollegeofPhysiciansPhiladelphia,PennsylvaniaEx-Officio

Medical Genetics

Mira B. Irons, MD Children’s HospitalBoston,MassachusettsVice-Chair

Susan J. Gross, MDAlbert Einstein College of MedicineBronx,NewYork

24

Obstetrics and Gynecology

Dee Fenner, MDUniversity of MichiganAnnArbor,Michigan

Norman F. Gant, MDTheAmericanBoardofObstetricsand GynecologyDallas,TexasEx-Offcio

Larry C. Gilstrap, MD TheAmericanBoardofObstetricsand GynecologyDallas,TexasChair

Gretchen E. Glaser, MDAbington Memorial HospitalAbington,PennsylvaniaResident

Ralph Hale, MDAmerican College of Obstetricians and GynecologistsWashington,DistrictofColumbiaEx-Officio

Diane M. Hartmann, MDUniversity of Rochester Strong Memorial HospitalRochester,NewYork

Rebecca P. McAlister, MDWashington University School of MedicineSt.Louis,Missouri

Michael Mennuti, MD UniversityofPennsylvaniaPhiladelphia,Pennsylvania

Kenneth L. Noller, MDNew England Medical CenterBoston,Massachusetts

Andrew Satin, MDUniformed Services UniversityBethesda,Maryland

Roger P. Smith, MDUniversity of Missouri Kansas CityTrumanMedicalCenterKansasCity,Missouri

Cyril O. Spann Jr., MDEmory HospitalAtlanta,Georgia

Ronald Strickler, MDHenry Ford HospitalDetroit,Michigan

George D. Wendel Jr., MDUniversityofTexasSouthwesternMedical SchoolDallas,TexasVice-Chair

Carolyn L. Westhoff, MDColumbia University Medical CenterNewYork,NewYork

Ophthalmology

Maria M. Aaron, MD, FACSEmory University School of MedicineAtlanta,Georgia

Preston H. Blomquist, MDUniversityofTexasSouthwesternMedical CenterDallas,TexasVice-Chair

Louis B. Cantor, MDIndianaUniversityHospitalsIndianapolis,IndianaChair

John G. Clarkson, MDUniversity of MiamiMiami,FloridaEx-Officio

Martha J. Farber, MD Albany Medical CenterAlbany,NewYork

Mark S. Juzych, MDWayne State University Detroit,Michigan

Paul D. Langer, MDUMDNJ–New Jersey Medical SchoolNewark,NewJersey

Andrew Lee, MDTheMethodistHospitalSystemHouston,Texas

Todd J. Mondzelewski, MDNavy Medical CenterSanDiego,CaliforniaResident

James C. Orcutt, MD VAPugetSoundHCSSeattle,Washington

R. Michael Siatkowski, MDUniversity of OklahomaOklahomaCity,OklahomaTerm began January 1, 2008

Orthopaedic Surgery

Stephen A. Albanese, MDSUNY Upstate Medical UniversitySyracuse,NewYorkVice-Chair

Jeffrey O. Anglen, MDUniversityofIndianaIndianapolis,Indiana

Shepard R. Hurwitz, MDAmerican Board of Orthopaedic SurgeryChapelHill,NorthCarolinaEx-Officio

Michelle A. James, MDSchriner’s Hospital for ChildrenSacramento,California

Robert H. Miller, MD, MBA American Board of OtolaryngologyHouston,TexasEx-Officio

Richard T. Miyamoto, MD, MSClarianIndianaUniversityHospitalIndianapolis,Indiana

Stephen S. Park, MDUniversityofVirginiaHealthSystemCharlottesville,Virginia

Pathology

Betsy D. Bennett, MD, PhDAmericanBoardofPathologyTampa,FloridaEx-Officio

Mark D. Brissette, MDUniversity of Colorado DenverDenver,Colorado

Diane D. Davey, MDUniversity of Central FloridaOrlando,Florida

Julia C. Iezzoni, MDUniversityofVirginiaHealthSystemCharlottesville,Virginia

Rebecca L. Johnson, MDBerkshire Medical CenterPittsfield,MassachusettsChair

Patrick E. Lantz, MDWake Forest University Winston-Salem,NorthCarolina

Wesley Y. Naritoku, MD, PhDLos Angeles CountyUSC Medical CenterLosAngeles,California

Miriam D. Post, MDMassachusetts General HospitalBoston,MassachusettsResident

Suzanne Z. Powell, MD TheMethodistHospitalSystemHouston,TexasVice-Chair

Gary W. Procop, MDJackson Memorial HospitalMiami,Florida

Michael G. Swaby, MDUniversityofTexasHealth Science CenterSanAntonio,Texas

Pediatrics

Robert Adler, MDChildren’s HospitalLosAngeles,California

William F. Balistreri, MDCincinnati Children’s Hospital Medical CenterCincinnati,Ohio

David M. Lichtman, MDJohnPeterSmithHospitalFortWorth,Texas

Terrance D. Peabody, MDUniversity of ChicagoChicago,Illinois

Vincent D. Pellegrini Jr., MDUniversity of Maryland School of MedicineBaltimore,Maryland

Keri A. Reese, MDUniversityofCalifornia,IrvineOrange,CaliforniaResident

Craig S. Roberts, MDUniversity of LouisvilleLouisville,Kentucky

Peter J. Stern, MDUniversity of Cincinnati Cincinnati,OhioChair

Lisa A. Taitsman, MD, MPHUniversity of WashingtonSeattle,Washington

Otolaryngology

Patrice Blair, MPH American College of SurgeonsChicago,IllinoisEx-Officio

Patrick Brookhouser, MDBoysTownNationalResearchHospitalOmaha,Nebraska

Brian B. Burkey, MD VanderbiltMedicalGroupandClinicNashville,TennesseeChair

Esther J. Cheung, MDUniversityofTexasMedicalSchoolof HoustonHouston,TexasResident

David W. Eisele, MDUCSF Medical CenterSanFrancisco,California

Ellen M. Friedman, MDTexasChildren’sHospitalHouston,Texas

Donald A. Leopold, MDUniversity of Nebraska Medical CenterOmaha,Nebraska

Bradley F. Marple, MD UniversityofTexasSouthwesternMedical CenterDallas,TexasVice-Chair

Jesus Medina, MDOklahoma University Health Science CenterOklahomaCity,Oklahoma

25

Thomas DeWitt, MDCincinnati Children’s Hospital Medical CenterCincinnati,Ohio

J. Carlton Gartner, MDAlfredI.duPontHospitalforChildrenWilmington,Delaware

Joseph Gilhooly, MDOregon Health and Science UniversityPortland,Oregon

Marcia B. Hutchinson, MDMedical Center of Central GeorgiaMacon,GeorgiaChairTerm ended June 30, 2009

Mary W. Lieh-Lai, MDChildren’s Hospital of MichiganDetroit,MichiganTerm ended June 30, 2009

Stephen Ludwig, MDChildren’sHospitalofPhiladelphiaPhiladelphia,PennsylvaniaVice-ChairTerm ended June 30, 2009ChairTerm began July 1, 2009

Gail A. McGuinness, MDAmericanBoardofPediatricsChapelHill,NorthCarolinaEx-Officio

Julia McMillan, MDJohns Hopkins University School of MedicineBaltimore,MarylandVice-ChairTerm began July 1, 2009

Robert Perelman, MDAmericanAcademyofPediatricsElkGroveVillage,IllinoisEx-Officio

Meredith Riebschleger, MDUniversity of Michigan Medical CenterAnnArbor,MichiganResident

Ann E. Thompson, MDChildren’sHospitalofPittsburghPittsburgh,Pennsylvania

Modena Wilson, MDAmerican Medical AssociationChicago,IllinoisEx-Officio

Yolanda Wimberly, MDMorehouse School of MedicineAtlanta,Georgia

Edwin L. Zalneraitis, MDConnecticut Children’s Medical CenterHartford,Connecticut

Physical Medicine and Rehabilitation

William L. Bockenek, MDCharlotteInstituteofRehabilitationCharlotte,NorthCarolinaChair

Diane D. Cardenas, MDUniversity of MiamiMiami,Florida

Gail L. Gamble, MDRehabilitationInstituteofChicagoChicago,Illinois

Teresa L. Massagli, MDUniversity of Washington Medical CenterSeattle,Washington

Jacob A. Neufeld, MDChildren’s Hospital and Research CenterOakland,California

Monica Rho, MDNorthwestern UniversityChicago,IllinoisResident

Barry S. Smith, MDMontgomery,TexasVice-Chair

Tom StautzenbachAmericanAcademyofPhysicalMedicine and RehabilitationRochester,MinnesotaEx-Officio

Anthony M. Tarvestad, JDAmericanBoardofPhysicalMedicine and RehabilitationRochester,MinnesotaEx-Officio

Plastic Surgery

Patrice Blair, MPHAmerican College of SurgeonsChicago,IllinoisEx-Officio

Gregory Borah, MDUMDNJ–Robert Wood JohnsonMedical SchoolNewBrunswick,NewJerseyVice-Chair

Robert J. Havlik, MDIndianaUniversitySchoolofMedicineIndianapolis,IndianaChair

Jeffrey H. Kozlow, MDUniversity of MichiganAnnArbor,MichiganResident

David L. Larson, MDTheMedicalCollegeofWisconsinMilwaukee,Wisconsin

Victor L. Lewis, MDNorthwestern Memorial HospitalChicago,Illinois

Mary H. McGrath, MDUniversityofCalifornia,SanFranciscoSanFrancisco,California

R. Barrett Noone, MDAmericanBoardofPlasticSurgeryPhiladelphia,PennsylvaniaEx-Officio

Rod J. Rohrich, MDTheUniversityofTexasSouthwesternMedical CenterDallas,Texas

Thomas Ray Stevenson, MDUniversityofCalifornia,DavisSacramento,California

Berish Strauch, MDMontefioreMedicalCenterBronx,NewYork

Nicholas B. Vedder, MDUniversity of WashingtonSeattle,Washington

Preventive Medicine

Miriam Alexander, MD, MPHJohns Hopkins School of PublicHealthBaltimore,Maryland

William W. Greaves, MD, MSPH HealthPolicyInstituteMedical College of WisconsinMilwaukee,Wisconsin

Mark Johnson, MD, MPHGolden,ColoradoConsultant

Timothy J. Key, MD, MPHBirmingham,AlabamaChair

Shauna Lawless, MDUniversity at BuffaloState University of New YorkBuffalo,NewYorkResident

CAPT Glenn Merchant, MC, USN U.S. Air Force Academy USAFA,Colorado

Clyde B. Schechter, MD, MAAlbert Einstein College of MedicineBronx,NewYorkVice-Chair

Gail M. Stennies, MD, MPHCenters for Disease Control andPreventionAtlanta,Georgia

Michael R. Valdez, MD, MPHCorrales,NewMexico

James Vanderploeg, MD, MPH Center for Aerospace and Occupational MedicineHouston,TexasEx-Officio

Andrew R. Wiesen, MD, MPHMadigan Army Medical CenterFortLewis,Washington

Psychiatry

Elizabeth L. Auchincloss, MDCornell Medical CollegeNewYork,NewYork

Jonathan F. Borus, MDBrigham and Women’s HospitalBoston,Massachusetts

Larry Faulkner, MDAmericanBoardofPsychiatry and NeurologyDeerfield,IllinoisEx-Officio

Marshall Forstein, MDHarvard Medical SchoolBoston,Massachusetts

Deborah J. Hales, MDAmericanPsychiatricAssociationArlington,VirginiaEx-Officio

James J. Hudziak, MDUniversityofVermontCollege of MedicineBurlington,Vermont

Gail Manos, MDNaval Medical CenterPortsmouth,Virginia

Jonathan E. Morris, MDMaine Medical CenterPortland,Maine

David Mrazek, MDMayo ClinicRochester,MinnesotaVice-Chair

Kayla Pope, MDBaltimore,MarylandResident

Burton V. Reifler, MDWake Forest University School of MedicineWinston-Salem,NorthCarolina

Victor Reus, MDUniversityofCalifornia,SanFranciscoSchool of MedicineSanFrancisco,CaliforniaChair

Donald Rosen, MDOregon Health and Science UniversityPortland,Oregon

Cynthia Santos, MDUniversityofTexasHealth Science CenterHouston,Texas

26

Kailie Shaw, MDUniversity of South FloridaTampa,Florida

Aradhana A. Sood, MDMedicalCollegeofVirginiaHospitalsRichmond,Virginia

Christopher R. Thomas, MDUniversityofTexasMedicalBranchat GalvestonGalveston,Texas

Michael J. Vergare, MDJefferson Medical CollegePhiladelphia,Pennsylvania

Radiology — Diagnostic

E. Stephen Amis Jr., MDAlbertEinsteinCollegeofMedicine/MontefioreMedicalCenterBronx,NewYorkChair

Gary Becker, MDAmerican Board of RadiologyTucson,ArizonaEx-Officio

Stephen R. Baker, MDUMDNJ–New Jersey Medical SchoolNewark,NewJersey

Thomas H. Berquist, MDMayo ClinicJacksonville,Florida

Jannette Collins, MDUniversity of Cincinnati College of MedicineCincinnati,Ohio

Lawrence P. Davis, MDLongIslandJewishMedicalCenterNewHydePark,NewYork

Jason Itri, MDUniversityofPennsylvaniaPhiladelphia,PennsylvaniaResidentTerm began July 1, 2009

Valerie P. Jackson, MDIndianaUniversitySchoolofMedicineIndianapolis,Indiana

Jessica B. Robbins, MDUniversity of MichiganAnnArbor,MichiganResidentTerm ended June 20, 2009

Anne C. Roberts, MDUCSDMedicalCenter/ ThorntonHospitalLaJolla,CaliforniaVice-Chair

Janet L. Strife, MDCincinnati Children’s Hospital Medical CenterCincinnati,Ohio

Robert D. Zimmerman, MDNewYork–PresbyterianHospitalNewYork,NewYork

Radiation Oncology

Lawrence W. Davis, MDEmory ClinicAtlanta,GeorgiaEx-Officio

Beth A. Erickson, MDMedical College of WisconsinMilwaukee,WisconsinVice-Chair

Laurie E. Gaspar, MD, MBAUniversityofColorado,DenverAurora,Colorado

Bruce G. Haffty, MDUMDNJ–Robert Wood Johnson Medical SchoolNewBrunswick,NewJerseyChair

Larry E. Kun, MDSt. Jude Children’s Research HospitalMemphis,Tennessee

W. Robert Lee, MD, MSDuke University School of MedicineDurham,NorthCarolina

Matthew M. Poppe, MDUniversity of Medicine and Dentistry of New JerseyNewBrunswick,NewJerseyResident

Christopher G. Willett, MDDuke University Medical CenterDurham,NorthCarolina

Surgery

Timothy R. Billiar, MDPresbyterianUniversityHospitalPittsburgh,Pennsylvania

Patrice Blair, MPHAmerican College of SurgeonsChicago,IllinoisEx-Officio

G. Patrick Clagett, MDUniversityofTexasSouthwesternMedical CenterDallas,Texas

Adeline M. Deladisma, MDMedical College of GeorgiaAugusta,GeorgiaResident

Peter J. Fabri, MDUniversity of South Florida Medical CenterTampa,Florida

Linda M. Harris, MDUniversity of Buffalo at Kaleida HealthBuffalo,NewYork

James C. Hebert, MDFletcher Allen Health CareBurlington,Vermont

George W. Holcomb III, MDChildren’s Mercy HospitalKansasCity,Missouri

Frank Lewis, MDTheAmericanBoardofSurgeryPhiladelphia,PennsylvaniaEx-Officio

Mark A. Malangoni, MDMetroHealth Medical CenterCleveland,Ohio

J. Patrick O’Leary, MDFloridaInternationalUniversityCollege of MedicineMiami,FloridaVice-Chair

Bradley M. Rodgers, MDUniversityofVirginiaSchool of MedicineCharlottesville,Virginia

Charles W. Van Way III, MDUniversity of Missouri–Kansas CityKansasCity,Missouri

Marc K. Wallack, MDMetropolitan Hospital CenterNewYork,NewYork

Thomas V. Whalen, MDLehighValleyHospitalAllentown,PennsylvaniaChair

Thoracic Surgery

William A. Baumgartner, MDAmericanBoardofThoracicSurgeryChicago,IllinoisEx-Officio

Patrice Blair, MPHAmerican College of SurgeonsChicago,IllinoisEx-Officio

R. Morton Bolman III, MDBrigham and Women’s HospitalBoston,Massachusetts

James Huang, MDMemorialSloan-Kettering Cancer CenterNewYork,NewYorkResident

Irving L. Kron, MDUniversityofVirginiaMedicalCenterCharlottesville,VirginiaChair

Walter H. Merrill, MDUniversity of Mississippi Medical CenterJackson,Mississippi

Michael R. Mill, MDUniversity of North Carolinaat Chapel HillChapelHill,NorthCarolina

Mark B. Orringer, MDUniversity of Michigan Health SystemAnnArbor,Michigan

Douglas E. Wood, MDUniversity of WashingtonSeattle,WashingtonVice-Chair

Transitional Year

Claire E. Bender, MDMayo School of Health SciencesRochester,Minnesota

Robert Bing-You, MDMaine Medical CenterPortland,Maine

David KuoMorristown Memorial HospitalMorristown,NewJersey

Jo Ellen Linder, MDMaine Medical CenterPortland,Maine

Philip D. Lumb, MDUniversity of Southern CaliforniaLosAngeles,California

M. Cathy Nace, MDWalter Reed Army Medical CenterSilverSpring,MarylandChair

Danny M. Takanishi Jr., MD, FACSJohn A. Burns School of MedicineHonolulu,HawaiiVice-Chair

Captain Sarah Taylor, MDNational Capital ConsortiumSilverSpring,MarylandResident

Urology

Peter C. Albertsen, MDUniversity of Connecticut School of MedicineFarmington,ConnecticutTerm ended June 30, 2009

Christopher L. Amling, MDOregon Health and Science UniversityPortland,Oregon

Anthony Atala, MDWake Forest University Baptist Medical CenterWinston-Salem,NorthCarolina

Patrice Blair, MPHAmerican College of SurgeonsChicago,IllinoisEx-Officio

Michael Coburn, MDBaylor College of MedicineHouston,TexasVice-Chair

27

Linda M. Dairiki-Shrotliffe, MDStanford University Medical CenterStanford,CaliforniaTerm ended June 30, 2009

Stuart Howards, MDAmerican Board of UrologyCharlottesville,VirginiaEx-Officio

Michael O. Koch, MDIndianaCancerPavilionIndianapolis,IndianaChair

Brian R. Lane, MD, PhDGlickmanUrologicalInstituteCleveland,OhioTerm ended June 30, 2009

Allen F. Morey, MDUniversityofTexasSouthwesternMedical CenterDallas,Texas

Martha K. Terris, MDMedical College of GeorgiaAugusta,Georgia

Willie Underwood III, MDRoswellParkCancerInstituteBuffalo,NewYork

Institutional Review Committee

Linda B. Andrews, MDBaylor College of MedicineHouston,Texas

Rupa J. Dainer, MDNational Capital ConsortiumBethesda,MarylandResident

Linda Famiglio, MD Geisinger Medical CenterDanville,PennsylvaniaChair

John R. Musich, MD William Beaumont HospitalRoyalOak,Michigan

Linda Phillips, MDUniversityofTexasMedical Branch HospitalsGalveston,Texas

John C. Russell, MDUniversity of New MexicoAlbuquerque,NewMexico

Andrew M. Thomas, MD Ohio State University HospitalColumbus,OhioVice-Chair

Christopher Veremakis, MDSt. John’s Mercy Medical CenterSt.Louis,Missouri

John L. Weinerth, MDDuke University HospitalDurham,NorthCarolina

ACGME Staff July1,2008toJune30,2009

Department of Accreditation Committees

Steve Nestler, PhDSeniorExecutiveDirector,Group2 Retired December 31, 2009

William E. Rodak, PhDSeniorExecutiveDirector,Group1 ExecutiveDirector,RRCfor InternalMedicine

Larry Sulton, PhDSeniorExecutiveDirector,Group3 ExecutiveDirector,RRCforNeurological Surgery

Georgia Andrianopoulos, PhDExecutiveDirector,RRCsforDermatology,MedicalGenetics,OrthopaedicSurgery,Pathology

Eileen Anthony, MJExecutiveDirector,RRCforPhysicalMedicine and Rehabilitation

Caroline Fischer, MBAExecutiveDirector, Accreditation Standards

Missy Fleming, MEd, PhD ExecutiveDirector,RRCsforAnesthesiology,DiagnosticRadiology,NuclearMedicine

Louise King, MSExecutiveDirector,RRCsforColonandRectalSurgery,Urology

Patricia B. Levenberg, PhDExecutiveDirector,RRCsforAllergyandImmunology,Ophthalmology,Otolaryngology,PreventiveMedicine

Lynne Meyer, PhD, MPHExecutiveDirector,RRCsforEmergencyMedicine,Neurology,Psychiatry

Peggy Simpson, EdDExecutiveDirector,RRCsforPlasticSurgery,Surgery,ThoracicSurgery

Patricia M. Surdyk, PhDExecutiveDirector,InstitutionalReviewCommittee,RRCforObstetrics and Gynecology

Linda Thorsen, MAExecutiveDirector,RRCforRadiationOncology,TransitionalYearReview Committee

Jerry Vasilias, PhDExecutiveDirector,RRCsforFamilyMedicine,Pediatrics

Department of Education

Susan Swing, PhDVicePresident,OutcomesAssessment

Marsha Miller, MAAssociateVicePresident, Resident Services

Department of Human Resources

Richard MurphyDirector of Human Resources

Department of Meeting Services

Linda Gordon, MAManager,MeetingServices

The complete list of the more than 150 individuals who are on the staff of the ACGME is posted at www.acgme.org/acWebsite/about/ab_ACGMEstaff.asp

Thomas J. Nasca, MD, MACPChiefExecutiveOfficer

John H. Nylen, MBAChiefOperationsOfficer

Rebecca Miller, MSSeniorVicePresident,Applicationsand Data Development

Timothy Brigham, MDiv, PhDSeniorVicePresident,Education

Jeanne K. Heard, MD, PhD, FACPSeniorVicePresident,Departmentof Accreditation Committees

Ingrid Philibert, PhD, MHA, MBASeniorVicePresident,FieldActivities

28

Statistical Highlights July1,2008toJune30,2009

Items/decisions on Review Committee agendas

(e.g.,statusdecisions,programdirectorchanges,progressreports,complementincreasesordecreases,temporaryincreases,participatinginstitutionchanges)

Review Committee status decisions during 2008–2009

• 7.6%ofprogramsreceivedfirst-timeproposedadverseactions– 35.2%proposedadverseactionssustained– 60%proposedadverseactionsrescinded

• 2,016reviewedprogramsreceivedaccreditationorcontinuedaccreditationstatus

• 94reviewedprogramsreceivedinitialaccreditation

• 28programsreceivedprobation

• 98programsweregrantedvoluntarywithdrawal

• 5programshadtheiraccreditationwithdrawn

Program Reviews and Decisions

Accredited Programs

10,000

2003–04

7,968 8,037 8,186 8,3558,734

8,490

2004–05 2005–06 2006–07 2007–08 2008–09

8,000

6,000

4,000

2,000

0

Academic Year

CorePrograms

Subspecialty Programs

29

8,734 accredited programs

• 4,020coreprograms

• 4,714subspecialtyprograms

328 programs had status of initial accreditation

98 programs closed or voluntarily withdrew their accreditation

82 programs were on probation or had status of warning

4.03 years was the average cycle length across all accredited programs

688 Sponsoring Institutions

• 385institutionssponsormultipleprograms

• 303institutionssponsorasingleprogram

3,399 institutions participated in resident education/rotations

Program Status (effective 2008–2009)

Sponsoring Institutions

Program Director and DIO Turnover During the Past Five Years

25%

2003–04

10%

22%

16%

13%

15%15%

13% 13% 13% 13%12%12%

2004–05 2005–06 2006–07 2007–08 2008–09

20%

15%

10%

5%

0%

Academic Year

Institutionswith DIOChanges

Programswith Director Changes

30

Resident Statistics

Residents on Duty the Past Five Years

GY1 Residents by Type of Medical School (2008–2009)

120,000

2003–04

Canadian Medical School

100,176

22,230

28

101,810

22,510

7,499

103,367

23,071

2,068

106,383

16,317

23,596

107,851 109,482

23,135 24,071

4

2004–05

InternationalMedical School

2005–06

Osteopathic Medical School

2006–07

USLCME-Accredited Medical School

2007–08 2008–09

Medical School Unknown

100,000

80,000

60,000

40,000

20,000

0

Academic Year

TotalNumber of Residents

Number of Residents inEntry-LevelPositionsWhoHaveNoPriorGME(i.e.;first-timeentrance)

Resident Does Not HavePriorGME

Resident Has PriorGME

20,000

15,000

10,000

5,000

0

31

Resident Statistics

Academic Year

Resident Case Logs

Accredited Programs

ProgramsUsingCaseLogSystem

% of Programs Using Case Log System

On-Duty Residents in Accredited Programs

On-DutyResidentsUsingCaseLogSystem

% of On-Duty Residents Using Case Log System

ProceduresEnteredintoCaseLogSystem

2007–08

8,490

2,622

31%

107,851

37,605

35%

10,142,517

2008–09

8,734

2,665

31%

109,482

40,775

37%

10,678,485

2006–07

8,355

2,531

30%

106,383

40,376

38%

11,259,467

2005–06

8,186

2,463

30%

103,367

39,237

38%

10,021,517

2004–05

8,037

2,390

30%

101,810

36,358

36%

9,409,965

2003–04

7,968

2,511

32%

100,176

25,195

26%

6,388,253

Residents by Specialty Type (2008–2009)

Type of Medical School

Canadian Medical School

International Medical School

Osteopathic Medical School

US LCME-Accredited Medical School

Medical School Unknown

Canadian Medical School

International Medical School

Osteopathic Medical School

US LCME-Accredited Medical School

Medical School Unknown

% of Specialty Type

0.21%

26.21%

7.06%

66.52%

0.01%

100.00%

0.81%

33.50%

5.36%

60.31%

0.03%

100.00%

Number of Residents

188

23,951

6,448

60,790

7

91,384

147

6,062

970

10,914

5

18,098

Specialty Type

Core

Subspecialty

TotalNumberofOn-DutyResidents 109,482 100.00%

32

Residents Completing Programs or Not ActiveResidents Leaving Programs

Number of Resident Status Specialty Type Residents

Number of Resident Status Specialty Type Residents

Completed All Accredited Training (for this specialty)

Completed Preliminary Training

In Program but Doing Research/Other Training

Leave of Absence

Deceased

Dismissed

Transferred to Another Program

Withdrew from Program

Core

Subspecialty

Core

Core

Subspecialty

Core

Subspecialty

Core

Subspecialty

Core

Subspecialty

Core

Subspecialty

Core

Subspecialty

25,346

8,968

34,314

3,776

3,776

1,097

289

1,386

76

9

85

39,561

23

5

28

258

21

279

1,446

86

1,532

863

202

1,065

2,904

TotalNumberofResidents CompletingProgramsorNotActiveTotalNumberofResidentsLeavingPrograms

33

2008 Financial Report

Revenues

Expenses

TheACGME’sfiscalyearrunsfromJanuary1toDecember31.Revenuein2008againcameprimarily from annual fees charged to all programs accredited during the academic year 2007–2008,accountingfor91percentofACGMEincome.Revenuedecreased$3millionin2008from2007,dueprimarilytolessthanexpectedapplicationsfornewprogramsandlessincomefromACGMEworkshops.Expensesincreased$1,000,000,duetoincreasedtravelandmeetingexpenses.

Feesfor2008remainedunchangedforthefourthconsecutiveyear.ACGMEreserves,definedascashandinvestments,totaled$21.8million,equivalenttoninemonthsofoperatingexpenses,atyear-end.Reservesweredownfrom2007asaresultofincreasedoperatingexpensesandpoorperformance of investments.

Workshops&MiscellaneousIncome $ 890,934 3.10%

TechSupportRevenue 88,665 0.31%

ApplicationIncome 1,367,600 4.76%

AnnualProgramAccreditationIncome 26,179,526 91.21%

RentRevenue 330,739 1.15%

Publications&OtherIncome 144,069 0.50%

AppealsIncome(not visible in chart) 33,429 0.12%

Grants (not visible in chart) 20,000 0.07%

InvestmentRevenue(not shown in chart) -351,999 -1.23%

Total $28,702,963 100.00%

Salaries&FringeBenefits $17,917,420 58.03%

AdministrativeExpenses 723,395 2.34%

MeetingExpenses 5,234,869 16.95%

ITExpenses 1,945,359 6.30%

Rent&RealEstateTaxes 2,768,375 8.97%

OfficeSupplies&Expenses 701,107 2.27%

ProfessionalServices 1,579,829 5.12%

Other Expenses (not visible in chart) 8,425 0.03%

Total $30,878,779 100.00%

2

Accreditation Council for Graduate Medical Education

515 North State Street Suite 2000 Chicago, Illinois 60654

Phone 312.755.5000 Fax 312.755.7498 www.acgme.org