• Jeremy S Juern, David M Stahl, and John A Weigelt.
• Division of Trauma/Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: jjuern@mcw.edu.
• J Surg Educ. 2018 Jul 1; 75 (4): 924-927.

BackgroundThe topic of restrictive covenants in fellowships that are not approved by the Accreditation Council for Graduate Medical Education (ACGME) has not been studied.ObjectiveTo investigate the presence of institutional polices at academic medical centers regarding restrictive covenants in non-ACGME fellowships.MethodsThe graduate medical education (GME) office website of 132 academic medical centers was evaluated and searched for the following as of June 1, 2017: presence of any ACGME residency or fellowship, presence of any non-ACGME fellowship, presence of GME policies and procedures, presence of a restrictive covenant policy, and if that policy applies to non-ACGME fellowships.ResultsA total of 96 academic medical centers had non-ACGME fellowships. Of these, 56 prohibit restrictive covenants in non-ACGME fellowships because of either their GME policy or state law. Seven academic medical centers have a GME policy that allows restrictive covenants in non-ACGME fellowships. Two academic medical centers clearly state that fellows in a certain subspecialty fellowship will be required to sign a restrictive covenant.ConclusionsGME policies at academic medical centers that allow restrictive covenants in non-ACGME fellowships are very uncommon. The practice of having fellows sign a restrictive covenant in a non-ACGME fellowship is in conflict with an American Medical Association ethics statement, ACGME institutional requirement IV.L, and the rules of the San Francisco Match.Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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