TAGME Resident Evaluation, Milestones, and CCC/PEC Operations — Questions and Answers
Question 1: Under ACGME requirements, the Clinical Competency Committee (CCC) must meet at minimum:
- Annually, at the end of each academic year
- Prior to residents' semi-annual evaluations, to advise the program director on each resident's Milestone progress (Correct answer)
- Monthly, after each clinical rotation block
- Only when a resident is placed on remediation or probation
Correct answer: Prior to residents' semi-annual evaluations, to advise the program director on each resident's Milestone progress
The ACGME requires the CCC to meet prior to residents' semi-annual evaluations so it can review all resident evaluations, determine Milestone levels, and advise the program director. This drives the twice-yearly Milestone reporting cycle.
Question 2: What is the minimum number of faculty members required to compose the Clinical Competency Committee (CCC)?
- One — the program director may serve as the sole CCC member
- Two — the program director and one senior faculty member
- Three faculty members appointed by the program director (Correct answer)
- Five — including one external reviewer from outside the sponsoring institution
Correct answer: Three faculty members appointed by the program director
ACGME Common Program Requirements specify that the CCC must include at least three members of the program faculty. The program director appoints the members and may participate, but the committee must have a minimum of three faculty.
Question 3: How frequently must programs report Milestone evaluations for each resident to the ACGME?
- Monthly
- Quarterly
- Semi-annually (twice per year) (Correct answer)
- Annually
Correct answer: Semi-annually (twice per year)
Programs must submit Milestone evaluations for each resident to the ACGME twice per year—typically in June and December. This semi-annual reporting allows the ACGME and program to track resident progress toward specialty-specific outcomes.
Question 4: When a resident's Milestone progress indicates deficiencies, the ACGME requires programs to:
- Immediately terminate the resident's training contract without further process
- Notify the ACGME within 24 hours and place the resident on administrative leave
- Document a specific intervention or remediation plan with benchmarks, and provide the resident with notice and the opportunity to respond (Correct answer)
- Transfer the resident to a participating site without any formal documentation
Correct answer: Document a specific intervention or remediation plan with benchmarks, and provide the resident with notice and the opportunity to respond
ACGME requirements mandate that remediation be documented with clear benchmarks and timelines, and that residents receive due process including notification and the opportunity to respond. Immediate termination without process violates both ACGME requirements and standard employment due process.
Question 5: The Program Evaluation Committee (PEC) differs from the Clinical Competency Committee (CCC) primarily in that the PEC:
- Assigns individual Milestone levels to each resident at semi-annual intervals
- Is composed only of residents with no faculty participation
- Evaluates the quality of the overall educational program through the Annual Program Evaluation (APE), not individual resident performance (Correct answer)
- Reports directly to the ACGME Review Committee rather than to the program director
Correct answer: Evaluates the quality of the overall educational program through the Annual Program Evaluation (APE), not individual resident performance
The PEC conducts the Annual Program Evaluation (APE), examining the program's curriculum, faculty, resources, and outcomes to identify strengths and areas for improvement. The CCC focuses on individual residents' performance and Milestone attainment. These are complementary but distinct functions.
Question 6: The Annual Program Evaluation (APE) conducted by the Program Evaluation Committee must result in:
- A salary benchmarking report for faculty submitted to the sponsoring institution
- A written document identifying program strengths, areas for improvement, and specific action plans (Correct answer)
- A ranked list of residents by Milestone achievement for board certification eligibility
- A detailed budget proposal for the next academic year submitted to the DIO
Correct answer: A written document identifying program strengths, areas for improvement, and specific action plans
ACGME requirements mandate that the APE produce a written document that captures program strengths, areas needing improvement, and specific action plans to address identified gaps. This document guides ongoing program quality improvement and must be reviewed and used to improve the program.
TAGME Resident Evaluation, Milestones, and CCC/PEC Operations
Under ACGME requirements, the Clinical Competency Committee (CCC) must meet at minimum: