Opinion ID: 1262958
Heading Depth: 1
Heading Rank: 2

Heading: Overview of Post-Graduate Medical Residency Programs

Text: After completing medical school and receiving a doctor of medicine (M.D.) degree, prospective physicians commence the graduate phase of their medical education. Generally, graduate medical education consists of a residency or fellowship. Most states, including the State of New York, require physicians to complete a residency program of at least one year before becoming eligible for a medical license. Residency programs typically last between three and five years. These residency programs are accredited by organizations such as the Accreditation Council for Graduate Medical Education (ACGME). The ACGME requires residency programs to be organized educational programs that combine a didactic curriculum with direct exposure to patient care under the supervision of attending physicians. Accordingly, these programs include classroom lectures, daily rounds with an attending physician, Grand Rounds in which experts present research, morbidity and mortality conferences, and reading assignments. Residents are tested and evaluated at times, and those residents who have not mastered necessary skills are given remedial instruction or required to repeat the program. Both Memorial Sloan-Kettering Cancer Center (the Cancer Center) and the Albany Medical Center (AMC) (collectively, the Hospitals) claim that residents participate in patient care only as a way of learning how to care for patients; that any benefit to the hospitals resulting therefrom is entirely incidental; that the hospitals do not meet staffing needs through their residents; and that the hospitals cannot bill for care provided by a resident. Residents receive funds from the hospital. The Hospitals characterize these monies as a scholarship or fellowship to aid in the pursuit of their graduate medical education or as a stipend. The Government characterizes these monies as compensation for the provision of services. The Hospitals point out that the ACGME requires, as a condition of accreditation, that the Hospitals provide residents with the financial support needed to ensure the residents' participation in the residency programs. Although we refer to the Cancer Center and AMC as the Hospitals, the precise institutional arrangements are slightly more complicated than that term would suggest. The Albany Medical Center is a private corporation that administratively links the Albany Medical College with the Albany Medical Center Hospital. Graduate medical programs, including the residency program, are under the primary control of the College, but AMC and the Albany Medical Center Hospital also participate in the program. College faculty supervise and train the residents, and the residency program is directed by the College's Associate Dean for Graduate Medical Education. Memorial Sloan-Kettering Cancer Center is comprised of three entities: Memorial Hospital for Cancer and Diseases (Memorial Hospital), Sloan-Kettering Institute for Cancer Research (Sloan-Kettering Institute), and the Memorial Sloan-Kettering Cancer Center (the Cancer Center). The Cancer Center, a teaching institution, is affiliated with the Weill Medical College of Cornell University. The Cancer Center's staff physicians are all on the faculty at Cornell.