Legal, Ethical, and Policy Frameworks in GME Flashcards

Under the Americans with Disabilities Act (ADA), a GME program must provide reasonable accommodations to a resident with a documented disability unless the accommodation would:

Answer: Create an undue hardship or fundamentally alter the nature of the program

The ADA requires reasonable accommodations unless they impose an undue hardship or fundamentally alter the essential nature of the training program.

A program director discovers that a resident's personal social media post includes identifiable patient information. The FIRST step the program director should take is:

Answer: Conduct a thorough review and notify the privacy officer and compliance department

HIPAA breach response requires immediate internal notification to privacy and compliance officers to assess scope and determine required actions.

Which federal law governs the confidentiality of resident drug and alcohol treatment records and may be MORE restrictive than HIPAA?

Answer: 42 CFR Part 2

42 CFR Part 2 provides heightened confidentiality protections for substance use disorder treatment records, often exceeding HIPAA's requirements.

An ACGME-accredited program wants to require residents to sign mandatory arbitration agreements waiving their right to sue the institution. This practice is:

Answer: Legally complex and potentially unenforceable; institutions should seek legal counsel

Mandatory arbitration clauses in resident contracts are legally contested and may be unenforceable in some jurisdictions, requiring institution-specific legal review.

The principle of 'duty to report' in GME most commonly refers to a program's obligation to report which of the following to the ACGME?

Answer: Sentinel events, significant program changes, and adverse actions meeting defined thresholds

Programs must self-report to ACGME events such as major program changes, loss of key personnel, and certain adverse resident actions as defined in institutional requirements.

A resident who is also an international medical graduate (IMG) on a J-1 visa is placed on unpaid suspension pending investigation. The GME office must FIRST notify:

Answer: The U.S. Department of State or the designated J-1 sponsor organization

Suspensions affecting a J-1 visa holder's training status must be reported to the visa sponsor (typically the Educational Commission for Foreign Medical Graduates, ECFMG) to maintain visa compliance.

Which ethical principle is MOST directly violated when a program director pressures a resident not to report a patient safety event to protect the program's reputation?

Answer: Non-retaliation and transparency

Pressuring residents to suppress safety reports violates non-retaliation principles and the ethical obligation to transparency in patient safety culture.