The American College of Graduate Medical Education is the national organization which accredits residency programs. An excerpt of their most recent "Program Requirements for Residency Education in Internal Medicine" follows; the complete guidelines can be found at the ACGME website.
 

Effective 7/03 RRC Program Requirement for Internal Medicine

G.Ambulatory Medicine

1.At least one-third of the residency training must be in the ambulatory care setting. (NOTE: In assessing the contribution of various clinical experiences with ambulatory patients to the 33% minimum, the following guidelines can be used: ½ day per week assigned to an ambulatory setting throughout all 3 years of training is equivalent to 10%; a 1-month block rotation is equivalent to 3%; 1 full day per week throughout a single year of training is equivalent to 7%. Examples of settings that may be counted toward this requirement are general medicine continuity clinics, subspecialty clinics, ambulatory block rotations, physicians' offices, managed health-care systems, emergency medicine, walk-in clinics, neighborhood health clinics, and home-care visits.)
a.In an ambulatory setting, one faculty member must be responsible for no more than five residents or other learners.
b.On-site faculty members' primary responsibilities must include the supervision and teaching of residents. On-site supervision as well as the quality of the educational experience must be documented.
c.Residents must be able to obtain appropriate and timely consultation from other specialties for their ambulatory patients.
d.There should be services available from other health-care professionals such as nurses, social workers, language interpreters, and dietitians.

2.Ambulatory Medicine -- Continuity Clinic
a.At the program director's discretion, residents may be excused from attending their continuity clinic when they are assigned to an intensive care unit, to emergency medicine, to an away-elective, or to night float.
b.Residents must attend a minimum of 108 weekly continuity clinic sessions during the 36 months of training.
c.The continuing patient-care experience should not be interrupted by more than 1 month, excluding a resident's vacation.
d.The number of patients seen by a first-year resident, when averaged over the year, must not be less than 3 or greater than 5 per scheduled 1/2-day session.
e.The number of patients seen by a second-year resident, when averaged over the year, must not be less than 4 or greater than 6 per scheduled 1/2-day session.
f.The number of patients seen by a third-year resident, when averaged over the year, must not be less than 4 per scheduled 1/2-day session.
g.During the continuity experience, arrangements should be made to minimize interruptions of the experience by residents' duties on inpatient and consultation services.
h.Each resident must follow patients with chronic diseases on a long-term basis.
i.It is desirable that residents be informed of the status of their continuity patients when they are hospitalized so the resident can make appropriate arrangements to maintain continuity of care.

 

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