Policy Statement
There must be sufficient institutional oversight to assure that trainees are appropriately supervised. Appropriate supervision means that a trainee is supervised by the teaching faculty in such a way that the trainees assume progressively increasing responsibility according to their level of education, proven ability, and experience. On-call schedules for teaching faculty must be structured to ensure that supervision is readily available to trainees on duty. The level of responsibility accorded to each trainee must be determined by the program director and the teaching faculty.
There must be sufficient institutional oversight to assure that trainees are appropriately supervised. Appropriate supervision means that a trainee is supervised by the teaching faculty in such a way that the trainees assume progressively increasing responsibility according to their level of education, proven ability, and experience. On-call schedules for teaching faculty must be structured to ensure that supervision is readily available to trainees on duty. The level of responsibility accorded to each trainee must be determined by the program director and the teaching faculty.
Path of escalation for reporting concerns or conflicts of interest: z.umn.edu/gmesupport
Reason For Policy
To ensure that the University of Minnesota Medical School Graduate Medical Education programs provide appropriate supervision for all trainees that is consistent with proper patient care, the educational needs of trainees, addressing conflicts of interest, and the applicable ACGME Review Committee (RC) and Common Program Requirements.
Program Responsibilities
It is the responsibility of individual program directors to establish detailed written policies describing trainee supervision at each level for their residency/fellowship programs. The policies must be maintained in the Program Manual.
The requirements for on-site supervision will be established by the program director for each residency/fellowship in accordance with ACGME guidelines and should be monitored through periodic departmental reviews.
Conflicts of interest (COI) in supervisory relationships can occur. In the case of nepotism (family members) the GME Nepotism Policy must be followed. In the case that a supervising faculty member is a medical provider for a trainee, the trainee or the faculty may request recusal from completing formal evaluations of the trainee. The program director will entertain requests for recusal for potential COI. Evaluation by the supervising faculty may be necessary (for example the only faculty available in a required subspecialty rotation). In the case of an expressed COI but no option to recuse, the Clinical Competency Committee (CCC) should be informed of the potential conflict prior to review of the evaluation so that there is transparency during holistic review of trainee assessments during deliberations of the committee.
Programs should establish policies that support Effective Supervisor Behaviors.
Definitions
Direct –
- the supervising physician is physically present with the resident or fellow during the key portions of the patient interaction; or,
- Residency: PGY-1 residents must initially be supervised directly, only as described in VI.A.2.c).(1).(a).
- the supervising physician and/or patient is not physically present with the resident or fellow and the supervising physician is concurrently monitoring the patient care through appropriate telecommunication technology. (ACGME Common Program and Requirements VI.A.2.c).(1))
Indirect - “the supervising physician is not providing physical or concurrent visual or audio supervision but is immediately available to the resident or fellow for guidance and is available to provide appropriate direct supervision.” (ACGME Common Program and Requirements VI.A.2.c).(2))
Oversight – the supervising physician is available to provide review of procedures/encounters with feedback provided after the care is delivered. (ACGME Common Program and Requirements VI.A.2.c).(3))