Organizations overseeing physician training (like ABMS1 and ACGME2) have recently demonstrated a renewed commitment to supporting physicians’ holistic development by adopting new mandatory leave requirements for physicians-in-training (Residents and Fellows).
These changes come at a time when the US is reacting to a post COVID-19 pandemic vision of work: long gone are the days when personal identities and commitments are expected to drop at the workplace door. Rather, employers are being asked to see their personnel as whole people, with conflicting personal and professional priorities. In Medicine, residency and fellowship training programs are finding a similar need to accommodate their trainees’ personal lives—particularly in family planning and wellness. Residency and Fellowship years collide with prime family development years. Recognizing this, the ABMS and ACGME have adopted new minimum leave requirements to standardize medical, parental, and caregiver leave rights across training programs nationwide.
Specifically, last year, the ABMS adopted new leave policies3 expressly calling for its programs to offer medical, parental and caregiver leave to all Residents/Fellows. Now, beginning on July 1, 2022, the ACGME will require all ACGME-accredited Programs to offer six (6) weeks of paid leave to all Residents/Fellows for medical, parental and caregiver leave, with the right to take such leave kicking- in on the individual’s very first day in the Program.4
The new requirements apply to Sponsoring Institutions (the institutions that administer ACGME-accredited Programs) and call for them to take key steps prior to July 1, 2022 to be in compliance with the new core institutional requirements. The ACGME recently clarified that the ACGME Institutional Review Committee will not take enforcement actions against Sponsoring Institutions pertaining to the new requirements until after July 1, 2023. However, the requirements go into effect on July 1, 2022, making now the time for Sponsoring Institutions to develop and implement new leave policies and align their existing leave framework with the new requirements.
The following checklist describes activities Sponsoring Institutions should consider now to ensure their teaching program remains compliant with ACGME accreditation requirements:
Recruitment Materials: Ensure interview processes for Residents/Fellows include information regarding institutional policies for vacation and leaves of absence, including paid benefits during such absences.
Appointment/Employment Agreements: Amend all Appointment Agreements and Employment Agreements entered with Residents/Fellows (and associated templates for future agreements) to describe the new medical, parental and caregiver leave policies.
Institutional Policies: Adopt institutional policies and procedures describing the new leave rights and how to apply for the leave. (This may be a new policy or modification of an existing policy, but it must be clear on when the leave entitlement arises, address the additional one week paid leave right during applicable years, and clearly provide for continuation of certain insurance policies during the leave period. It’s also important to ensure these rights align with and are properly integrated with other leave policies, such as federally-required family and medical leave rights under FMLA.)
GMEC Oversight: Ensure the Sponsoring Institution’s Graduate Medical Education Committee (“GMEC”) is charged with oversight of leave policies and actually reviews implementation of all institutional policies governing vacation and leaves of absence (including this new leave requirement) no less than annually. Your institution may need to revise policies and/or processes to ensure this requirement is met.
Resident/Fellow Program Progress: Ensure that each ACGME-accredited program provides Residents/Fellows with information about the impact of taking extended leaves on their completion of the program and their eligibility to participate in certifying board exams.
Well-Being Support: Ensure each ACGME-accredited program dedicates institutional resources to, and adopts processes to, make resources available to Residents/Fellows to support their overall well-being and education and to minimize how leave of absences impact clinical assignments.
1 American Board of Medical Specialties (“ABMS”)
2 Accreditation Council for Graduate Medical Education (“ACGME”)
3 American Board of Medical Specialties Policy on Parental, Caregiver and Medical Leave During Training
4 ACGME Institutional Requirements
© Polsinelli PC, Polsinelli LLP in CaliforniaNational Law Review, Volume XII, Number 87