Resident Learning Environment Policy

I. Purpose of policy

This policy defines the support services provided to Residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited residency and fellowship programs at Dartmouth-Hitchcock (D-H).

II. Policy scope

The policy applies to Mary Hitchcock Memorial Hospital (MHMH) as the Sponsoring Institution and the Office of Graduate Medical Education at Dartmouth-Hitchcock (D-H).

III. Definitions

Resident: Any physician in an ACMGE-accredited graduate medical education program including Residents and Fellows.

Sponsoring Institution (SI): The organization (or entity) that assumes the ultimate financial and academic responsibility for a program of GME. The sponsoring institution has the primary purpose of providing educational programs and/or health care services. The Sponsoring Institution at D-H is Mary Hitchcock Memorial Hospital (MHMH).

IV. Policy statement

  • Residents on duty in the hospital must be provided adequate and appropriate food services and sleeping quarters.
  • Patient support services including an intravenous team, phlebotomy services, laboratory services, and transportation services must be provided in a manner appropriate to, and consistent with, educational objectives and patient care.
  • An effective laboratory and radiologic information retrieval system must be in place to provide for appropriate conduct of the educational programs as well as timely, high quality patient care.
  • A medical records system that documents the course of each patent’s illness and care must be available at all times and must be adequate to support patient care, the educational needs of Residents, quality assurance activities, and provide a resource for scholarly activity.
  • Appropriate security and personal safety measures must be provided to Residents in all locations including but not limited to parking facilities, on-call quarters, hospital and institutional grounds, and related clinical facilities.
  • Educational materials to support patient care in the working environment (e.g. computer with internet access, biomedical library materials, etc.) must be available at all times.
  • Patient Safety:
    • Residents must have access to systems for reporting errors, adverse events, unsafe conditions, and near misses in a protected manner that is free from reprisal.
    • Residents must have opportunities to contribute to root cause analysis or other similar risk-reduction processes.
  • Quality improvement:
    • Residents must have access to data to improve systems of care, reduce health care disparities, and improve patient outcomes.
    • Residents must have opportunities to participate in quality improvement initiatives.

V. References

ACGME Institutional Requirements. (2018). Retrieved from

D-H Policy ID: 11272