October 10, 2003

Dear Colleagues:

The Residency Review Committee for Internal Medicine (RRC-IM) of the Accreditation Council for Graduate Medical Education (ACGME) has granted the Department of Medicine's internal medicine residency program probationary accreditation. This action was taken in response to our request for reconsideration of a decision to decertify the program.

We now look forward to an expedited repeat site visit, October 14-17. The RRC-IM has pushed the visit up by one month in order to give the program another opportunity to attain full accreditation. The program has enjoyed that status - without warnings or probations of any kind - since 1955. (We must caution, however, that the Residency Review Committee may require what it calls "a longitudinal demonstration of substantial compliance" before withdrawing probationary accreditation.)

We had asked the RRC-IM to reconsider its original action because, in addition to the many changes implemented by the internal medicine program to comply with the work hour rules both before and after July 1, we have redoubled our efforts to assure compliance with those rules.

Specifically, Hopkins documented that despite the very few duty hour violations during the first ten days of the academic year, the internal medicine program has been in substantial compliance with duty hour rules. With the input of residents themselves, new schedules have been designed to avoid any violations at all. In fact, we have made such significant changes to our complex duty hour and educational programs that an independent team of auditors brought in to review the internal medicine program as it now operates found us in compliance.

We are devoting enormous amounts of time and financial resources not just to meet, but to exceed, the ACGME standards. We have allocated many more staff to monitor duty hours and reorganized the Graduate Medical Education Committee structure to provide closer and better oversight of our residency programs. A full time compliance officer, John Rybock, M.D., a member of the neurosurgery faculty, has been hired and a team appointed to verify information provided by each residency program on an ongoing basis.

We believe that standards for resident duty hours are essential to a residency program that strives to provide compassionate patient care, advance scientific research and professionalism, and assure the best possible educational experience for residents.

We know that hundreds of you as residents, faculty and staff are working hard not only to maintain educational and clinical excellence, but also to achieve total compliance with ACGME standards. In many cases, this work goes beyond your own programs and extends to sister programs and to the institution as a whole. Only your faith in the promise of very talented house staff and fellows can explain this level of devotion. We are very grateful for your ongoing efforts in this regard.

Sincerely,