This policy defines the responsibilities of the University at Buffalo (UB) as an ACGME-accredited sponsoring institution, and its ACGME-accredited graduate medical education programs, in the event of a disaster or other extraordinary circumstances that significantly alter the educational experience in one or more residency/fellowship programs and/or impede/prevent the continued operation of the institution and/or any of its training programs.
In the event that the continued operation of the institution or a training program is impeded permanently or for an extended period for any reason, timely and appropriate steps will be taken collaboratively by the Office of Graduate Medical Education and the respective program director(s) to restructure the residents’/fellows’ educational experiences as necessary to ensure substantial compliance with ACGME Institutional, Common, and Specialty-specific requirements and/or secure either temporary or permanent arrangements suitable for completion of training. These arrangements will include assistance secured by UB in partnership with the affiliated hospital(s) for continuation of resident/fellow salary, benefits, professional liability coverage, and assignments in accordance with ACGME requirements, policies and procedures.
All efforts will be made to address disasters/extraordinary circumstances locally. In the case of a local disaster that causes a temporary disruption in the educational experience (e.g., blizzard), the Designated Institutional Official (DIO)/designee will communicate with UB-affiliated hospital leaders, department chairs, program directors and residents. Program directors will receive institutional guidance and will be responsible for determining and communicating program-specific circumstances (e.g., clinic closures, schedule changes, call room arrangements) with residents. The institution provides local disaster preparedness guidance to residents/fellows annually. While on duty during a local disaster, residents/fellows must continue to log clinical and educational work hours in accordance with the institutional Clinical and Educational Work Hours Policy, and guidance from program directors and/or the DIO/designee.
The ACGME may also invoke the ACGME Extraordinary Circumstances policy in response to circumstances that significantly alter the ability of a sponsor and its programs to support resident/fellow education, in which case the sponsoring institution will take all necessary steps to comply with ACGME requirements, policies and procedures as outlined below.
ACGME Institutional Requirements Effective 7/1/2022 (IV.N.- IV.N.1.)
ACGME Policies and Procedures Effective 2/5/2022 (25.00-25.40)
The ACGME may invoke the Extraordinary Circumstances policy in response to circumstances that significantly alter the ability of a Sponsoring Institution and its programs to support graduate medical education. Examples of extraordinary circumstances include an abrupt hospital closure, a natural disaster, or a catastrophic loss of funding. The invocation of the Extraordinary Circumstances policy formalizes the ACGME’s oversight and support of Sponsoring Institutions’ and programs’ efforts to ensure the continuation of residents’/fellows’ educational experiences in compliance with the applicable ACGME Requirements. The ACGME shall consider invocation of the Extraordinary Circumstances policy at the request of a Sponsoring Institution’s designated institutional official, in response to verified public information, or on the basis of other information received by the ACGME.
If the ACGME President and Chief Executive Officer, in consultation with the ACGME Board Chair, determines that a Sponsoring Institution’s ability to support graduate medical education has been significantly altered, the ACGME President and Chief Executive Officer shall invoke the Extraordinary Circumstances policy.
Upon invocation of the Extraordinary Circumstances policy, a notice shall be posted on the ACGME website with information relating to the ACGME’s response to the extraordinary circumstances. In this notice, the ACGME shall provide relevant ACGME contact information.
When the Extraordinary Circumstances policy is invoked, the designated institutional official (DIO), or designee(s), on behalf of the affected Sponsoring Institution, shall:
Sponsoring Institutions and programs must minimize disruption to resident/fellow education due to extraordinary circumstances and must consider the preferences of residents/fellows when arranging temporary or permanent transfers to other ACGME-accredited and ACGME- recognized programs.
Programs must appoint transferring residents to approved positions and may request temporary or permanent increases in resident/fellow complement from their respective ACGME Review and Recognition Committees through the Accreditation Data System (ADS). Under extraordinary circumstances, the ACGME Review and Recognition Committees shall expedite their review of requests for temporary or permanent complement increases.
An ACGME Review or Recognition Committee shall expedite review of a program’s request to add or delete participating sites or to change its educational format if the request is associated with a declaration of extraordinary circumstances.
At its discretion, the ACGME may determine a schedule for expedited review of applications for new programs that intend to accept transferring residents/fellows under extraordinary circumstances. If applications will be reviewed on an expedited basis, notice of the expedited review, including information about submission due date(s), shall be provided on the ACGME website.
Upon invocation of the Extraordinary Circumstances policy, the ACGME may determine that one or more accreditation or recognition site visits is required. Prior to the visit(s), the designated institutional official(s) shall receive notification of the advance information that will be required. This information, as well as information received by the ACGME during these accreditation or recognition site visits, may be used in the accreditation or recognition process (Policies 18.20-18.24; 21.30-21.34). Accreditation or recognition site visits under extraordinary circumstances may also be used to exchange information that supports the continuation of residents’/fellows’ educational experiences in compliance with applicable ACGME Requirements.
Established: 2008
Reviewed by GMEC: 05/08; 02/09; 202/13; 03/17; 05/18; 06/22; 11/23