ROLES, RESPONSIBILITIES, AND PATIENT CARE ACTIVITIES OF GME PARTICIPANTS

Graduate medical education (GME) program participants—residents and fellows—are physicians in training who hold dual roles as caregivers and trainees. Their responsibilities are guided by the Accreditation Council for Graduate Medical Education (ACGME) and are designed to provide safe, effective, and compassionate patient care while fostering professional autonomy and competence.

Core Responsibilities

  • Patient Care: Providing care that is safe, effective, and compassionate under faculty supervision, with increasing responsibility based on experience (graded authority).

  • Safety and Ethics: Adhering to institutional policies, ensuring patient safety, reporting errors or "near-miss" events, and practicing high-quality, cost-effective care.

  • Education and Scholarship: Participating in required conferences, seminars, and scholarly activities (e.g., research, quality improvement projects).

  • Professional Development: Maintaining personal health and alertness to ensure safety, and fostering teamwork with interprofessional teams.

  • Supervision: While supervised themselves, senior residents and fellows are responsible for teaching and mentoring junior residents and medical students.

Patient Care Activities

  • Initial and Ongoing Assessment: Performing history and physical examinations, developing diagnostic and treatment plans, and updating notes (admission, progress, and discharge summaries).

  • Clinical Duties: Conducting daily rounds, writing orders for medications and diagnostic tests, interpreting results, and providing patient counseling.

  • Procedures: Performing diagnostic and therapeutic procedures within their training scope and authorized clinical privileges.

  • Care Coordination: Managing transitions of care, arranging follow-up, and communicating with patients and families about care plans.

Key Distinctions in Roles

  • Interns (PGY-1): Focus on developing fundamental skills under close supervision.

  • Residents (PGY-2+): Assume greater autonomy, manage complex patients, and start supervising junior team members.

  • Fellows: Subspecialty trainees who work with high autonomy but continue to operate within their specialty training requirements.

  • Chief Residents: Serve in a leadership role, helping to schedule, mentor, and represent trainees.

Supervision Structure

A licensed independent practitioner (faculty) is responsible for the care of each patient, ensuring that residents/fellows work within their competence level. Supervision includes direct, indirect, and oversight, adapting to the trainee's skill level.