ACGME Commonly Used Terms

Attending Physician:

An appropriately credentialed & privileged member of the medical staff who accepts full responsibility for a specific patient’s medical/surgical care.

Clinical Responsibility/Workload Limits:

Reasonable maximum levels of assigned work for residents/fellows consistent with ensuring a quality educational experience. Such work, & its level of intensity, varies by specialty & should be studied by all RRCs before a decision is made to incorporate specifics into the program requirements.

Conditional independence:

Graded, progressive responsibility for patient care with defined oversight.

Continuity clinic:

Setting for a longitudinal experience in which residents develop a continuous, long term therapeutic relationship with a panel of patients.

Duty Hours:

Duty hours are defined as all clinical & academic activities related to the program; i.e., patient care (both inpatient & outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, & scheduled activities, such as conferences. Duty hours do not include reading & preparation time spent away from the duty site.

Fatigue management:

Recognition by either a resident or supervisor of a level of resident fatigue that may adversely affect patient safety & enactment of a solution to mitigate the fatigue.

Fitness for duty:

Mentally & physically able to effectively perform required duties & promote patient safety.


Knowledge, skills, attitudes, and other attributes for each of the ACGME competencies, organized in a developmental framework from less to more advanced. They are descriptors and targets for resident performance as a resident moves from entry into residency through graduation.


Voluntary, compensated, medically-related work performed outside the institution where the resident is in training or at any of its related participating sites.

Scheduled duty periods:

Assigned duty within the institution encompassing hours which may be within the normal work day, beyond the normal work day, or a combination of both.

Strategic napping:

Short sleep periods, taken as a component of fatigue management, which can mitigate the adverse effects of sleep loss.

Transitions of care:

The relaying of complete & accurate patient information between individuals or teams in transferring responsibility for patient care in the healthcare setting.

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