ACGME Increases Protected Nonclinical Time for Core FM Faculty

Namely, the Accreditation Council for Graduate Medical Education has approved a request from the AAFP and six other family medicine organizations to significantly increase protected educational time for core faculty teaching in family medicine residencies.

The new requirements, which give programs and residents more flexibility and shift the focus to competency-based learning, were largely applauded by family medicine stakeholders when they were released Sept. 30, 2022, with one glaring exception. The AAFP and other family medicine organizations wrote to the ACGME Board of Directors less than two weeks after their release, urging ACGME to reconsider a request for protected nonclinical time for core faculty.

The issue dates to 2019, when the ACGME removed requirements that faculty have dedicated educational time. The change was part of an update to the common program requirements for all specialties and was implemented despite formal objections from the AAFP, ABFM and Council of Academic Family Medicine.

Previously, the ACGME had required sponsoring institutions to provide family medicine program directors 0.7 full-time equivalent for educational and administrative responsibilities and 0.6 FTE educational time for each core faculty member, including both nonclinical work and resident supervision. Yet, despite calls for the return of protected nonclinical teaching time for faculty, the requirements issued last September included only 0.1 FTE for core faculty for educational and administrative responsibilities that do not involve direct patient care.

The detrimental impact of that decision on family medicine programs included increased burnout among faculty and program directors, impaired clinical supervision of residents, budget cuts, and other challenges.

In their October 2022 letter to the ACGME, the AAFP and the other family medicine groups stated the time requirement was insufficient and said additional time was “essential to create an effective program learning environment,” given changes in the new requirements. In particular, they noted, the transition to competency-based residency education requires “significant faculty time and development.”

With the new program requirements featuring individualized learning plans and more electives tailored to a resident’s future practice, AAFP Vice President of Medical Education Karen Mitchell, M.D., said additional faculty time will be needed for tasks such as assessing, evaluating and coaching residents; career planning and education; curriculum development; and creating and administering learning opportunities.

After hundreds of residency faculty raised similar concerns, the ACGME’s Committee on Requirements and, ultimately, its Board of Directors agreed to increase protected faculty time. Starting July 1, 2024, core faculty will devote 60% of their time to teaching, administration, scholarly activity and supervising patient care within the program.

Essentially, said Mitchell, the change will revert protected faculty time to pre-2019 levels.

“After multiple years of advocacy for the needs of family medicine residencies, we are pleased that the ACGME has heard our educational community and allowed the resumption of dedicated core faculty time in family medicine residencies,” Mitchell said.

“Family medicine residency training is important to the growth of primary care in the United States,” she noted. “Residents cannot be adequately trained without sufficient teaching and supervision. This decision by ACGME to recognize the importance of dedicated faculty time for family medicine sets a positive course for the future of the specialty.”