Commentary: the ACGME: fostering public trust and addressing residents' needs

The author explores the relationship between the Accreditation Council for Graduate Medical Education (ACGME)s allegiance to residents' education and its core obligation to protect the broad interests of patients and the public. In an accompanying article, Lypson et al pose the question: who should protect residents' rights and well-being-labor unions or the ACGME? The author contends that unions are ill suited to serve as advocates for residents' concerns about their learning environments because organized labor's fundamentally confrontational approach to negotiation risks compromising residents' professionalism. The ACGME, by contrast, is vitally concerned about the conditions under which residents learn because of its fundamental mission to improve the public's health by ensuring that physicians are optimally prepared. Through the institutional standards it sets and enforces, and through the channels it maintains for direct communication, the ACGME ensures that residents' interests are addressed as a matter of collegial, professional responsibility. Residents are advised to ignore the seductive appeals of organized labor because of what the specter of unionized physicians is likely to do to public trust in the medical profession.