Field Notes from GME

Why a newsletter, and why now

For about twenty years, most of what I've learned in GME came from other people in GME. A coordinator two states away who had already solved my problem. A DIO who explained a requirement in one sentence after I'd spent a week on it. A program administrator who told me, over coffee at a conference, that the tired I was feeling had a name.

That kind of knowledge rarely gets written down. This newsletter is my attempt to write some of it down, once a month, for anyone who works in this field.

Each issue has three parts. Hot topics covers what changed and why it matters to your office. Accreditation corner takes one requirement and explains what it looks like in practice. Wellness is for the people doing the work, because the work only holds up as well as they do.

October is a good month to start. Annual Update season is behind most of us, interview season is in full swing, and the ACGME just asked the whole community for feedback on its most significant rewrite in years.

What changed this month

The coordinator requirement may get a new name

If you work in a program office, the section of the proposed revision you'll want to read first is 2.26.

The draft replaces the term "program coordinator" with "GME administrative professional." The ACGME's impact summary says the change is meant to better reflect the role and to address job classification barriers. The requirement for at least one administrative professional stays. What changes is how support is framed: the draft ties it to program size, complexity, configuration, and changing program and institutional needs, rather than a fixed minimum. Program director time in section 2.14 follows a similar approach.

What this could look like in practice

Flexibility cuts both ways. Without a published minimum, "adequate support" has to be shown, not assumed. The offices that will be in the strongest position are the ones that can describe their workload in concrete terms before anyone asks.

• Count what drives your workload. Number of learners, participating sites, recruitment volume, committees you staff, and reporting cycles you manage.
• Note what changed this year. New sites, a new program director, a self-study, a citation response. These are the fluctuating needs the draft describes.
• Keep it somewhere your DIO can find it. A one-page summary per program is enough to start a conversation during annual review.
• Read the draft and comment. If the language reflects your work, say so. If it doesn't, say that too. The deadline is October 22.

Accreditation corner offers an educational perspective, not official ACGME guidance. The revision described here is a proposal and may change before it's final. Always verify against the current requirements on acgme.org and check with your DIO or institutional GME office.

Take the recovery lap

Runners finish a hard race and keep moving slowly for a few minutes. They don't sprint straight into the next one. GME rarely gives us that lap. The Annual Update closes and recruitment is already filling the inbox. Milestones are around the corner. The calendar never announces a pause, so we have to make one.

A recovery lap doesn't need a day off, although that helps if you can take one. It can be fifteen minutes with a door closed and three questions:

1. What worked this season that I want to repeat?
2. What drained me more than it should have?
3. What is one thing I'll change before next July?

Write the answers down. Next summer, you'll be glad the version of you who just finished left notes for the version of you about to start.

You can't manage the next deadline well if you never finished the last one.

One more thing. Interview season is social, fast, and often after hours. It's fine to decide in advance which evening events you'll attend and which you won't. A boundary set in October is much easier to keep than one invented in December.

If you're carrying more than ordinary stress, please reach out to someone you trust or to your employee assistance program. In the U.S., you can call or text 988 to reach the 988 Suicide & Crisis Lifeline at any time.

Until next month

November's issue will look at Milestones season and the quiet work of preparing a Clinical Competency Committee. If there's a topic you want covered, or a practice from your office worth sharing, I'd like to hear it.

Thanks for reading, and for the work you do that most people never see.

Barbara