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Residency Benefits Waiting Periods Cease

Residents making an impact

Upon graduating from medical school, we all believe that we are equipped with the skills necessary to succeed in residency. We are wide-eyed, optimistic, and excited to finally be "doctors." Once we become residents and start treating patients, we realize that a significant portion are uninsured. Imagine, as a new resident, if you were one of those uninsured patients for the first 30 to 90 days of your residency. It is ironic to be in a teaching hospital with hundreds of doctors, nurses, and testing facilities, yet not be able to take advantage of these resources without incurring significant financial hardship.

This scenario was a reality for some residents and fellows across the country and prompted one resident member to submit a resolution to the AMA Resident and Fellow Section (AMA-RFS) entitled "Eliminating Benefits Waiting Periods for Residents and Fellows." The resolution highlighted discrepancies in the provision of health, dental, vision and other benefits between Graduate Medical Education (GME) training institutions. It stated that although the majority of GME training institutions provide benefits to physician trainees starting on the first day of employment, some impose a 30- to 90-day waiting period before activating benefits. In addition, many residents do not discover the lack coverage until orientation, which does not allow adequate time to fill this coverage gap.

With strong support from resident and fellow members, the resolution became AMA policy. The AMA then worked with the ACGME to close this coverage gap, which resulted in the following revisions to the ACGME institutional requirements (new language is in bold): The sponsoring institution must provide hospital and health insurance benefits for the residents and their families. Coverage for such benefits should begin upon the first recognized day of their respective programs, unless statute or regulation requires a later date to begin coverage. The Sponsoring Institution must also provide access to insurance to all residents for disabilities resulting from activities that are part of the educational program.

All residency programs seeking to maintain ACGME accreditation are now expected to comply with this provision. The policy-making process of the AMA-RFS is one of the most powerful benefits of membership because it gives a single resident the ability to make a substantial impact.

Michelle Powers, MD, MBA Alternate Delegate, AMA House of Delegates Governing Council, AMA Resident and Fellow Section