ACGME Accreditation Council for Graduate Medical Education

How to Submit a Concern or Formal Complaint


Concerns:
open How to Submit a Concern about a Residency or Fellowship Program

A concern is an issue, care, trouble, or distress that someone has about a residency or fellowship program and/or its sponsoring institution that creates uncertainty and apprehension. Concerns cannot be used to adjudicate individual disputes between individual persons and residency/fellowship programs or sponsoring institutions regarding matters of admission, appointment, contract, credit, discrimination, promotion, or dismissal of faculty members, residents, or fellows.

Before a concern is submitted, the concerned individual should utilize all of the resources available in the program and sponsoring institution unless there is a valid reason for not doing so.

Anyone may submit a concern by mail, fax, or e-mail. Be sure to include the following:

  • a brief summary of the issues, including steps taken - if relevant
  • the name, street address, city, and state of the residency or fellowship program
  • your contact information

To Submit a Concern:

E-mail: residentservices@acgme.org

Fax: 312.755.7498

ACGME Staff:

Marsha Miller, MA, Associate Vice President, Resident Services

Amy Beane, Senior Resident Services Associate

Mail:

ACGME Office of Resident Services
ACGME
515 North State Street, Suite 2000
Chicago, Illinois 60654

open Can I submit my concern anonymously?

Yes. Concerns may be submitted anonymously. Providing contact information is useful as it enables the ACGME Office of Resident Services to inform you about the actions taken in response to your concern, and also to contact you should additional information be needed. The ACGME will maintain as confidential a program’s and/or institution’s response to a concern submitted to ACGME.


open Is there a time limit for submitting a concern?

Yes. Concerns that occurred prior to the current and preceding residency or fellowship year may not be considered.

open How will the ACGME Office of Resident Services respond to my concern?

Submitting a concern will not affect a program’s or institution’s accreditation. The specific duties of Resident Services at the ACGME are: to determine the facts in each case; to work with the concerned individual and designated institutional official (DIO) in seeking a satisfactory resolution; and to discuss the use of the formal complaint process to report chronic and routine violations of ACGME Institutional and Program Requirements.

Upon receiving your concern, Resident Services staff members will contact the DIO at your sponsoring institution and ask that he or she investigate the allegations and report back to the ACGME with the results of the investigation and any solutions for problems that are uncovered. By sponsoring institution, we mean the affiliated healthcare system or university system that hosts your residency program; an institution may comprise anywhere from a single residency program to dozens. 

Concerns cannot be used to adjudicate individual disputes.

open Will filing a concern possibly affect my program???s or sponsoring institution???s
accreditation?

Concerns do not affect the accreditation of the program and/or sponsoring institution.

Formal Complaints:
open How to Submit a Formal Complaint about a Residency or Fellowship Program or
Sponsoring Institution

Complaints may affect the accreditation status of the program and/or sponsoring institution.

Sponsoring institutions and their programs that are accredited by the ACGME are expected to comply with the ACGME’s Institutional and Program Requirements. The ACGME and its Review Committees address only matters regarding non-compliance with ACGME accreditation requirements. Formal complaints should, therefore, allege violations of ACGME requirements.

Through its formal complaint process, the ACGME will investigate potential non-compliance with accreditation requirements that relate to program quality. The ACGME does not adjudicate disputes between individual persons and residency or fellowship programs or sponsoring institutions regarding matters of admission, appointment, contract, credit, discrimination, promotion, or dismissal of faculty members, residents, or fellows.

Anyone having evidence of non-compliance with accreditation requirements by a program or sponsoring institution may submit a complaint to the ACGME. Such complaints must be submitted in writing, bear the name and address of the complainant(s), and be signed by the complainant(s). However, before a complaint is submitted, the complainant should utilize all of the resources available in the program and sponsoring institution unless there is a valid reason for not doing so.

You may submit your signed complaint by mail, fax, or e-mail. Be sure to include the following:

  • a brief summary of the allegations of non-compliance with ACGME requirements, including any documentation or evidence  (please review the ACGME Institutional Requirements and the Program Requirements for your specialty on the ACGME website)
  • the name, street address, city, and state of the residency or fellowship program
  • your contact information

To submit a formal complaint, send your signed letter via e-mail, fax, or mail to:

E-mail: residentservices@acgme.org

Fax: 312.755.7498

ACGME Staff:
Marsha Miller, MA, Associate Vice President, Resident Services
Amy Beane, Senior Resident Services Associate

Mail:
ACGME Office of Resident Services
ACGME
515 North State Street, Suite 2000
Chicago, Illinois 60654

open Can I submit my formal complaint anonymously?

No. Formal complaints must be submitted in writing and must be signed. Complainants must include their names and contact information in a formal complaint letter. It is our policy to treat your name as confidential information and not to disclose it without your permission.

The ACGME will take steps to keep the identity of any individual(s) reporting potential non-compliance with requirements confidential, except when a complainant specifically waives the right to confidentiality. However, if a complaint alleges failure of a program or institution to provide due process, the identity of the complainant may be disclosed when a response to the allegation is requested from the program director or designated institutional official (DIO). In addition, there may be the rare occurrence when the identity of the complainant may be disclosed as necessary for the ACGME to provide due process to a program or sponsoring institution appealing an adverse accreditation action.

open Is there a time limit for submitting a formal complaint?

Yes. Allegations of non-compliance that occurred prior to the current and preceding residency/fellowship year should not be submitted.

open How will Resident Services address my formal complaint?

Upon receipt of a formal complaint, Resident Services staff members will determine if additional information from the complainant is required. When sufficient information has been provided, Resident Services staff members will request that the program director and the designated institutional official submit a written response to the allegation(s). This communication shall specify that a written response should be submitted within a time not to exceed one month of the date of the request. The response must be co-signed by both the program director and designated institutional official of the sponsoring institution.

Before submitting the complaint to the Review Committee for formal consideration, Resident Services staff members will review the complaint and the response with the Executive Director of the relevant Review Committee who, in consultation with the Review Committee Chair, will determine whether the allegations were successfully rebutted or whether the complaint requires further investigation. If the Review Committee Chair determines that the allegations were successfully rebutted, the program director, designated institutional official, and complainant will be informed in writing.  If the Review Committee determines that the complaint requires further investigation, a focused site visit will be scheduled.

open Will filing a complaint possibly affect my program or institution???s accreditation?

Filing a formal complaint may affect the accreditation of the program and/or sponsoring institution.