Graduate Medical Education is the phase of formal medical education beginning at graduation from medical school and ending after the educational requirements for one of the medical specialty certifying boards have been completed. The objective is to prepare physicians for the independent practice of medicine.
State licensing boards have varying requirements for post-MD clinical training, and almost every medical school graduate now spends from three-to-seven years in postgraduate training. The term "residency" is commonly used to describe this training period. At the conclusion of the residency period, some individuals enter an additional year of training as chief resident. Others enter a fellowship in one of the discipline's subspecialties. A fellowship usually encompasses a one to three-year period, and often includes time for research.
The resident physician is both a learner and a provider of medical care. The resident is involved in caring for patients under the supervision of more experienced physicians. As their training progresses, residents gain competence and require less supervision, progressing from on-site and contemporaneous supervision to more indirect and periodic supervision. Throughout their training, residents also serve as teachers and join with faculty members to educate medical students and more junior residents in the hospital setting.
Programs are accredited by the Accreditation Council for Graduate Medical Education (ACGME), which, in turn, acts on the recommendations of 26 Residency Review Committees (RRCs), each of which serves a medical or surgical specialty. Specialty certifying boards establish the educational criteria that residents must achieve to be eligible for board certification. These criteria include the length of time for education and training and, to a significant degree, the content of the training program. These are detailed in the Special Requirements for each specialty's residency programs and complement the Common Program Requirements promulgated by the ACGME.
Mary Hitchcock Memorial Hospital (MHMH), as part of Dartmouth-Hitchcock Medical Center, assumes accountability for the quality of the GME training programs it sponsors. While each program assumes responsibility to ensure integrity under the purview of their RRC, institutional oversight is maintained by the MHMH Graduate Medical Education Committee (GMEC). The GMEC is principally comprised of program directors and has representation from the resident group, program coordinators, the Department of Nursing and Hospital Administration. The Committee meets eleven times a year on the second Monday of the month. The GME Office (hereafter in this manual referred to as GME) implements institutional policies and procedures approved by the GMEC. GME maintains residents and fellows accreditation records, facilitates internal reviews of educational programs, serves as liaison with the ACGME, coordinates benefit programs for residents and fellows, and supports the administration of individual programs.
Statement of Commitment to Graduate Medical Education
Dartmouth-Hitchcock (D-H) is an integrated academic medical center consisting of four distinct entities: Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock Clinic, Veteran Affairs Medical Center (WRJ, VT), and Dartmouth Medical School. Mary Hitchcock Memorial Hospital is the sponsoring institution of record for all accredited graduate medical education (GME) training programs and has supported such programs since 1895.
As the sponsoring institutions for GME, Mary Hitchcock Memorial Hospital and the integrated partners comprising D-H commit to ensuring that all ACGME-accredited programs remain in substantial compliance with the ACGME's institutional and program-specific requirements. Furthermore, D-H strives for continuous improvement in the effectiveness of all its GME programs via ongoing assessment of educational and medical practice. In this way, D-H leads transformation of graduate medical education in our region, helps set new standards at the national level, and supports our vision of achieving the healthiest population possible.
D-H's four component institutions pledge appropriate resources to support GME trainees and their educational environment, including an organized administrative system to oversee all residency and fellowship programs through the activities of our Graduate Medical Education Committee and the Associate Dean for Graduate Medical Education. In addition, D-H is dedicated to the proposition that advancement of patient care is supported by a strong educational environment and as such, is specifically committed to the ongoing development and support of a strong teaching faculty.
D-H's commitment to conduct and support graduate medical education programs furthers our combined missions of providing the highest quality care to our patients and educating future generations of physicians to serve our community, the Northern New England regions, and beyond. The governing authorities; the administration; and teaching faculty and staff of Dartmouth-Hitchcock endorse this statement of institutional commitment as developed by the Graduate Medical Education Committee.