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VA Health Care: Adequacy of Resident Supervision Is Not Assured, but Plans Could Improve Oversight

GAO-03-625 Published: Jul 02, 2003. Publicly Released: Jul 02, 2003.
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Highlights

The Department of Veterans Affairs (VA) provides graduate medical education (GME) to as many as one-third of U.S. resident physicians, but oversight responsibilities spread across VA's organizational components and multiple affiliated hospitals and medical schools could allow supervision problems to go undetected or uncorrected. GAO was asked to examine VA's procedures for (1) monitoring VA medical centers' adherence to VA's requirements for resident supervision, (2) using evaluations of supervision by GME accrediting bodies and residents, and (3) using information about resident supervision drawn from VA's programs for monitoring the quality and outcomes of patient care.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should direct the Under Secretary for Health to take steps to improve VA's oversight of the supervision of residents by ensuring that all VA medical centers that provide GME adopt and adhere to the requirements for resident supervision established in VA's handbook.
Closed – Implemented
During fiscal year 2005, VA took steps to improve adherence to its requirements for resident supervision as GAO recommended. For example, VA created a national performance measure for resident supervision based on a random sampling methodology. This performance measure assessed the timeliness of documentation of resident supervision and held facilities accountable for their progress in this area. As another example, VA implemented mandatory procedures for VA facility, network, and headquarters officials to monitor adherence to VA's requirements for the supervision of medical residents.
Department of Veterans Affairs The Secretary of Veterans Affairs should direct the Under Secretary for Health to take steps to improve VA's oversight of the supervision of residents by ensuring that external peer review of documentation of resident supervision includes examination of records from VA's new outpatients.
Closed – Not Implemented
The Department of Veterans Affairs (VA) has indicated that it no longer plans to implement this recommendation.

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Topics

Graduate educationHealth care personnelInternal controlsMedical educationMedical schoolsMonitoringPhysiciansHealth care centersPatient careVeterans' medical centers