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Chattanooga Coordinators Corner

GME Word Art

GME Acronyms

Acronym          Description

AAMC                    Association of American Medical Colleges

ABMS                    American Board of Medical Specialties

ACCME                 Accreditation Council for Continuing Medical Education

ACGME                 Accreditation Council for Graduate Medical Education

ACLS                     Advanced Cardiac Life Support

ADS                       Accreditation Data System (also called WebAds)

AHA                       American Hospital Association

ALSO                     Advanced Life Support in Obstetrics (for Family Medicine Physicians)

AMA                      American Medical Association

AOA                      American Osteopathic Association

APD                      Associate Program Director

ATLS                     Advanced Trauma Life SUpport

BLS                       Basic Life Support

CCC                      Clinical Competency Committee

CK                         Clinical Knowledge (Exam)

CLER                    Clinical Learning Environment Review

CME                     Continuing Medical Education

CMS                     Clinical Medicare and Medicaid Services

CMSS                   Clinical Medical Specialties Societies

CODA                  Council on Dental Accreditation

COMLEX             Comprehensive Osteopathic Medical Licensing Exam

CPR                     Common Program Requirements

CPT                      Current Procedural Terminology

DGME                 Direct Graduate Medical Education Payments

DIO                      Designated Institutional Official

DNV                     DNV Accreditation for Hospitals (an alternative to JC Accreditation, from the Norwegian company Det Norske Veritas -- DNV means "the Norwegian Truth")

DO                        Doctor of Osteopathic Medicine

ECFMG                Educational Commission for Foreign Medical Graduates

EPA                      Entrustable Professional Activity

ERAS                    Electronic Residency Application Service

FCVS                    Federation Credentials Verification Service

FREIDA               Fellowship and Residency Electronic Interactive Database Access

FSMB                  Federation of State Medical Boards

FTE                      Full-Time Equivalent

G & O                  Goals and Objectives

GME                    Graduate Medical Education

GMEC                 Graduate Medical Education Committee

HIPAA                Health Information Portability and Accountability Act

HS                       House Staff

IME                     Indirect Medical Education Payments

IMG                    International Medical Graduate

IRC                     Institutional Review Committee

IRD                    Institutional Review Document

JC                      Joint Commission

JCAHO            Joint Commission on Accreditation of Healthcare Organizations

LCME              Liaison Committee for Medical Education

LOR                 Letter of Recommendation

MOC                Maintenance of Certification

MSPE              Medical Student Performance Evaluation

NAS                 Next Accreditation System

NBME             National Board of Medical Examiners

NRMP             National Resident Matching Program

NRP                Neonatal Resuscitation Provider

OSCE              Objective Structured Clinical Exam

PALS               Pediatric Advance Life Support

PBLI                Practiced Based Learning and Improvement

PC                   Program Coordinator

PD                   Program Director

PDA                Personal Digital Assistant

PDWS            Program Directors Workstation (within ERAS)

PEC                Program Evaluation Committee

PGY                Post Graduate Year (of training)

PIF                  Program Information Form

PIP                  Performance Improvement Plan

PLA                Program Letter of Agreement

PRA                Per Resident Amount

PSQI              Patient Safety/Quality Improvement

QIPS              Quality Improvement/Patient Safety

RC                  Review Committee

RMS              Residency Management System

RRC              Residency Review Committee

SBP              Systems Based Practice

SOAP           Supplemental Offer and Acceptance Program

SV                 Site Visitor

TQM            Total Quality Management

TY                Transitional Year

USMLE       United States Medical Licensing Exam

GME Glossary of Terms

Academic Appointment
An appointment to a faculty category (e.g. professor, Associate Professor, Adjunct Clinical Instructor, etc.) of a degree-granting school, college or university.

The Accreditation Council for Graduate Medical Education (ACGME) is responsible for the accreditation of post-graduate medical training programs within the United States. Accreditation is accomplished through a peer review process and is based upon established standards and guidelines.

Advanced Cardiac Life Support

A voluntary process of evaluation and review based on published standards and following a prescribed process, performed by a non-governmental agency of peers.

An M.D. or D.O. invited to interview with a GME program.

An ongoing process of gathering and interpreting information about a learner’s knowledge, skills, and/or behavior.

At-Home Call
A call taken from outside the assigned site.

Basic Life Support

Categorical Resident
A resident who enters a program with the objective of completing the entire program.

A process to provide assurance to the public that a certified medical specialist has successfully completed an approved educational program and an evaluation, including an examination process designed to assess the knowledge, experience and skills requisite to the provision of high-quality care in a particular specialty.

Chief Resident
Typically, a position in the final year of residency (e.g., surgery) or in the year after the residency is completed (e.g., internal medicine and pediatrics).

A finding of a Review Committee that a program or an institution is failing to comply substantially with a particular accreditation standard or ACGME policy or procedure.

Refers to the practice of medicine in which physicians assess patients (in person or virtually) or populations in order to diagnose, treat, and prevent disease using their expert judgment. It also refers to physicians who contribute to the care of patients by providing clinical decision support and information systems, laboratory, imaging, or related studies.

Clinical Responsibility/Workload Limits
Reasonable maximum levels of assigned work for residents/fellows consistent with ensuring both patient safety and a quality educational experience. Such workloads, and their levels of intensity, are specialty-specific and must be thoroughly examined by the RRCs before inclusion in their respective program requirements.

Clinical Supervision
A required faculty activity involving the oversight and direction of patient care activities that are provided by residents/fellows.

Clinical Learning Environment Review (CLER)
A review process implemented by the Accreditation Council for Graduate Medical Education (ACGME) as part of its Next Accreditation System. The CLER program is designated to provide U.S. teaching hospitals, medical centers, health systems, and other clinical setting affiliated with ACGME-accredited institutions with periodic feedback that addresses the following six Focus Areas: Patient Safety, Health Care Quality, Care Transitions, Supervision, Well-Being, and Professionalism. The feedback provided by the CLER Program is designated to improve how clinical sites engage resident and fellow physicians in learning to provide safe, high quality patient care. The only accreditation requirement associated with this program is that each sponsoring institution must undergo a CLER site visit every 24 months (+/-6) to maintain accreditation.

Combined Specialty Programs
Programs recognized by two or more separate specialty boards to provide GME in a particular combined specialty. Each combined specialty program is made up of two or three programs, accredited separately by the ACGME at the same institution.

Common Program Requirements
The set of ACGME requirements that apply to all specialties and subspecialties.

Specific knowledge, skills, behaviors and attitudes and the appropriate educational experiences required of residents to complete GME programs. The six resident competencies are: Patient Care; Medical Knowledge; Practice-based Learning and Improvement; Systems-Based Practice; Interpersonal and Communication Skills; and Professionalism.

The maximum number of residents or fellows approve by a Residency Review Committee per year and/or per program based upon availability of adequate resources.

A program’s or institution’s adherence to a set of prescribed requirements.

Conditional Independence (also referred to as graduated responsibility)
Graded, progressive responsibility for patient care with defined oversight.

An association of two or more organizations, hospitals, or institutions that have come together to pursue common objectives (e.g., GME).

Continuity Clinic
Setting for a longitudinal experience in which residents develop a continuous, long-term therapeutic relationship with a panel of patients.

Continuous time on duty
The period that a resident or fellow is in the hospital (or other clinical care setting) continuously, counting the resident’s (or fellow’s) regular scheduled day, time on call, and the hours a resident (or fellow) remains on duty after the end of the on-call period to transfer the care of patients and for didactic activities.

Core Program
See Specialty Program

Cycle Length
The interval between a final accreditation action and the target date identified for the next site visit.

Designated Institutional Official (DIO)
The individual in a sponsoring institution who has the authority and responsibility for all of the ACGME accredited GME programs.

A kind of systematic instruction by means of planned learning experiences, such as conferences or grand rounds.

Duty Hours
All clinical and academic activities related to the residency/fellowship program, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic assignments such as conferences.

Educational Commission for Foreign Medical Graduates

ECFMG Number
The identification number assigned by the Educational Commission for Foreign Medical Graduates (ECFMG) to each international medical graduate physician who receives a certification from ECFMG.

An educational experience approved for inclusion in the program curriculum and selected by the resident in consultation with the program director.

Electronic Residency Application Service is most commonly used by medical graduates or medical students in their final year of medical school to apply for specialized graduate training in ACGME accredited residency programs in the U.S. Many residency and fellowship programs require applicants to apply through ERAS. ERAS was developed by the AAMC. It transmits residency applications, letters of recommendation, medical student performance evaluations (MSPE, formerly dean’s letters), transcripts, and other supporting documents to residency program directors via the Internet. ERAS is also available to IMG’s through the ECFMG.

External Moonlighting
Voluntary, compensated, medical-related work performed outside the institution where the resident is in training or at any of its related participating sites.

Individuals who have received a formal assignment to teach resident/fellow physicians. At some site’s appointment to the medical staff of the hospital constitutes appointment to the faculty.

Fatigue Management
Recognition by either a resident or supervisor of a level of resident fatigue that may adversely affect patient safety and enactment of a solution to mitigate the fatigue.

A physician in a program of graduate medical education accredited by the ACGME who has completed the requirements for eligibility for first board certification in the specialty. The term “subspecialty residents” is also applied to such physicians. Other uses of the term “fellow” require modifiers for precision and clarity, e.g., research fellow.

Fifth Pathway
One of several ways that individuals who obtain their undergraduate medical education abroad can enter GME in the United States. The fifty pathway is a period of supervised clinical training for students who obtained their premedical education in the United States, received undergraduate medical training abroad, and passed Step 1 of the United States Medical Licensing Examination. After these students successfully complete a year of clinical training sponsored by an LCME-accredited U.S. medical school and pass USMLE Step 2, they become eligible for an ACGME accredited residency as an international medical graduate.

Fellowship Residency Electronic Interactive Database. The Graduate Medical Education Directory (also called the Green Book) and FREIDA Online are resources created by the AMA to assist students in finding a residency program. FREIDA Online is a database with over 7,800 graduate medical education programs accredited by the ACGME, as well as over 200 combined specialty programs.

Focused Institutional Site Visit
An on-site review requested by the Institutional Review Committee (IRC) and conducted by a senior member of the ACGME Department of Field Activities (DFA). The focused institutional site visit concentrates on institutional oversight of compliance with duty hour standards, potential egregious violations related to resident safety and security, or serious disruption to the resident educational and work environment at a sponsoring institution following a disaster.

Formative Evaluation
Assessment of a resident/fellow with the primary purpose of providing feedback for improvement as well as to reinforce skills and behaviors that meet established criteria and standards without passing a judgment in the form of a permanently recorded grade or score.

Graduate Medical Education (GME)
The period of didactic and clinical education in a medical specialty which follows the completion of a recognized undergraduate medical education and which prepares physicians for the independent practice of medicine in that specialty, also referred to as residency education. The term “graduate medical education” also applies to the period of didactic and clinical education in a medical subspecialty which follows the completion of education in a recognized medical specialty and which prepares physicians for the independent practice of medicine in that subspecialty.

GME Track
GME Track is a resident database and tracking system created in 2000 by the AAMC and the AMA. Its purpose is to assist GME administrators and program directors in the collection and management of GME data.

Graduate Medical Education Committee (GMEC)
The Graduate Education Committee shall review from an institutional perspective the implementation at UTHSC of the required “Institutional Requirements” of the ACGME. The Committee shall advise and monitor the Office of Graduate Medical Education, the Medical Center, and the Medical School of pertinent issued related to house staff (residents and clinical fellows) programs of the institution. The Sponsoring Institution must have a GMEC that has the responsibility for monitoring and advising of all aspects of residency education.

Graduate Year Level
Refers to a resident’s current year of accredited GME. This designation may or may not correspond to the resident’s particular year in a program. For example, a resident in pediatric cardiology could be in the first program year of the pediatric cardiology program, but in his/her fourth graduate year of GME (including the 3 prior years of pediatrics). Also referred to as “post graduate year” or “PGY”.

Grand Rounds
A formal meeting at which physicians discuss the clinical case of one or more patients. Grand rounds originated as part of residency training wherein new information was taught and clinical reasoning skills were enhanced. Grand rounds today are an integral component of medical education. They present clinical problems in medicine by focusing on current or interesting cases.

Green Book
A book published annually by the AMA that includes allopathic GME Institutional and Program Requirements. The Green Book also includes lists of accredited allopathic residencies and fellowships by specialty and by state as well as contact information, program directors’ names, address, and telephone number for each program.

In-House Call
Duty hours beyond the normal workday when residents are required to be immediately available in the assigned institution.

Experimentation initiated at the program level which may involve an individual program, a group of residents (e.g., PGY1 residents) or an individual resident (e.g. chief resident).

Institutional Review
The process undertaken by the ACGME to determine whether a sponsoring institution offering GME programs is in substantial compliance with the Institutional Requirements.

A site may be considered integrated when the program director a) appoints the members of the faculty and is involved in the appointment of the chief of service at the integrated site, b) determines all rotations and assignments of residents, and c) is responsible for the overall conduct of the educational program in the integrated site. There must be a written agreement between the sponsoring institution and the integrated site stating that these provisions are in effect. This definition does not apply to all specialties.

Historically, a designation for individuals in the first year of GME. This term is no longer used by ACGME.

Internal Moonlighting
Any hours a resident works for compensation at the sponsoring institution or any of the sponsor’s primary clinical sites.

Internal Review
A self-evaluation process undertaken by sponsoring institutions ACGME-accredited programs to judge whether each is in substantial compliance with accreditation requirements.

International Medical Graduate (IMG)
A graduate from a medical school outside the United States and Canada (and not accredited by the Liaison Committee on Medical Education). IMGs may be citizens of the United States who chose to be educated elsewhere or non-citizens who are admitted to the United States by U.S. Immigration authorities.

In-Training Examination
Formative examinations developed to evaluate resident/fellow progress in meeting the educational objectives of a residency/fellowship program. These examinations may be offered by certification boards or specialty societies.

Joint Commission, formally known as the Joint Commission on Accreditation of Healthcare Organizations or JCAHO, which evaluates and accredits health care organizations in the U.S.

Liaison Committee on Medical Education, which accredits programs of medical education leading to the M.D. in the United States and in collaboration with the Committee on Accreditation of Canadian Medical Schools (CACMS) in Canada.

Letter of Notification
The official communication from a Review Committee that states the action taken by the Review Committee.

Master Affiliation Agreement
A written document that addresses GME responsibilities between a sponsoring institution and a major participating site.

Medical School Affiliation
A formal relationship between a medical school and a sponsoring institution.

Patient care activities external to the educational program that residents/fellows engage in at sites used by the educational program (internal moonlighting) and other healthcare sites.

A term used to identify a requirement which is mandatory or done without fail. This term indicates an absolute requirement.

National Resident Matching Program (NRMP)
A private, not-for-profit corporation established in 1952 to provide a uniform date of appointment to positions in graduate medical education in the United States. Five organizations sponsor the NRMP: American Board of Medical Specialties, American Medical Association, Association of American Medical Colleges, American Hospital Association and Council of Medical Specialty Societies. It is the most widely used matching program. There are other matches used by some programs, such as the San Francisco Match or other specialty matches.

Night Float
Rotation or educational experience designed to either eliminate in-house call or to assist other residents during the night. Residents assigned to night float are assigned on-site duty during evening/night shifts and are responsible for admitting or cross-covering patients until morning and do not have daytime assignments. Rotation must have an educational focus.

Notable Practice
A process or practice that a Review Committee or other ACGME committee deems worthy of notice. Notable practices are shared through the ACGME website or other ACGME publications to provide programs and institutions with additional resources for resident education. Notable practices do not create additional requirements for programs or institutions.

One Day Off
One (1) continuous 24-hour period free from all administrative, clinical and educational activities.

Ownership of Institution
Refers to the governance, control, or type of ownership of the institution.

Pediatric Advanced Life Support

An ACGME approved project, which is initiated by the Review Committee and involves several residency/fellowship programs that elect to participate.

PIP (Performance Improvement Plan)
A formal written document issued to a resident or fellow that is designed to outline deficiencies in his/her training. A PIP is executed for a set time period (typically 4 to 6 weeks) and identifies a negative trend in performance and/or an egregious behavior. It is designed to remedy or resolve the problem and once the PID is satisfactorily completed, the resident or fellow will be returned to regular status. If concerns remain, then the PIP may be extended for another month(s). An unsatisfactory achievement in the PIP could result in the resident/fellow being placed on probation, suspension and/or being terminated from the program (with prior approval from the DIO).

Primary Clinical Site
If the sponsoring institution is a hospital, it is by definition the principal or primary teaching hospital for the residency/fellowship program. If the sponsoring institution is a medical school, university, or consortium of hospitals, the hospital that is used most commonly in the residency/fellowship program is recognized as the primary clinical site.  In Chattanooga, our Primary Clinical Site is Erlanger Health.

A structured educational experience in graduate medical education designed to conform to the Program Requirements of a particular specialty/subspecialty, the satisfactory completion of which may result in eligibility for board certification.

Program Director
The one physician designated with authority and accountability for the operation of the residency/fellowship program.

Program Evaluation
Systematic collection and analysis of information related to the design, implementation, and outcomes of a resident education program, for the purpose of monitoring and improving quality and effectiveness of the program.

Program Information Form (PIF)
The PIF is the document completed by the program director in preparation for a site visit. The document is a compilation of requested information that reflects the current status of the educational program. The PIF is organized in two parts: The Common PIF, which addresses the program’s compliance with the Common Program Requirements, and the specialty or subspecialty specific PIF, which addresses compliance with the specialty or subspecialty specific program requirements. The Common PIF is electronically generated through the Accreditation Data System.

Program Letter of Agreement (PLA)
A written document that addresses GME responsibilities between an individual accredited program and a site other than the sponsoring institution at which residents receive a required part of their education.

Program Merger
Two or more programs that combine to create a single program. One program may maintain continued accreditation while accreditation is voluntarily withdrawn from the other program or programs. Alternatively, both programs may be withdrawn, and a new program may be established.

Program Year
Refers to the current year of education within a specific program; this designation may or may not correspond to the resident’s graduate year level.

Educational experiences within a residency/fellowship program designated for completion by all residents/fellows.

A physician in an accredited graduate medical education specialty program.

A program accredited to provide a structured educational experience designed to conform to the Program Requirements of a particular specialty.

An educational experience of planned activities in selected settings, over a specific time period, developed to meet goals and objectives of the program.

Scholarly Activity
An opportunity for residents/fellows and faculty to participate in research, as well as organized clinical discussions, rounds, journal clubs, and conferences. In addition, some members of the faculty should also demonstrate scholarship through one or more of the following: peer-reviewed funding; publication of original research or review articles in peer-reviewed journals or chapters in textbooks; publication or presentation of case reports or clinical series at local, regional, or national professional and scientific society meetings; or participation in national committees or educational organizations.

Short Call
Responsibility for admitting patients to the teaching service during the early part of the day. Residents begin call in the morning, admit patients until some designated time in the afternoon or late morning and do not stay in the hospital overnight.

A term used to designate requirements so important that their absence must be justified. A program or institution may be cited for failing to comply with a requirement that includes the term ‘should’.

An organization providing educational experiences or educational assignments/rotations for residents/fellows.

Site Visitor
The ACGME has several site visitors or site reviews of staff. This is the person to whom you will submit your PIF. He/she is also the person who will personally come to your program and examine your program’s documentation, and meet with the program director, residents, program coordinator, and members of the faculty. The site visitor is only a “fact gatherer”. He/she will not be able to tell you whether or not your program will receive a “favorable” review.

Sponsoring Institution
The organization (or entity) that assumes the ultimate financial and academic responsibility for a program of GME. The sponsoring institution has the primary purpose of providing educational programs and/or health care services. When the sponsoring institution is a non-rotation site the major associated hospital is the participating rotation site. Additionally, for multiple ambulatory medical sites under separate ownership from the sponsoring institution one central or corporate site must represent the satellite clinics.  The Sponsoring Institution in Chattanooga is the University of Tennessee Health Science College of Medicine - Chattanooga and not the primary training site (Erlanger Health).

Strategic Napping
Short sleep periods, taken as a component of fatigue management, which can mitigate the adverse effects of sleep loss.

Subspecialty Program
A structured educational experience following completion of a prerequisite specialty program in GME designed to conform to the Program Requirements of a particular subspecialty.

Dependent Subspecialty Program
A program that is required to function in conjunction with an accredited specialty/core program, usually reviewed conjointly with the specialty program, usually sponsored by the same sponsoring institution, and geographically proximate. The continued accreditation of the subspecialty program is dependent on the specialty program maintaining its accreditation.

Independent Subspecialty Program
A program that is not directly related to, or dependent upon, the accreditation status of a specialty program.

A term along with its companion “strongly suggested”, used to indicate that something is distinctly urged rather than required. An institution or program will not be cited for failing to do something that is suggested or strongly suggested.

Summative Evaluation
Assessment with the primary purpose of establishing whether or not performance measured at a single defined point in time meets established performance standards, permanently recorded in the form of a grade or score.

Transfer Resident
Residents are considered transfer residents under several conditions including: moving from one program to another within the same or different sponsoring institution; when entering a PGY2 program requiring a preliminary year even if the resident was simultaneously accepted into the preliminary PGY1 program and the PGY2 program as part of the match (e.g., accepted to both programs right out of medical school). Before accepting a transfer resident, the program director of the ‘receiving program’ must obtain written or electronic verification of previous educational experiences and a summative competency-based performance evaluation from the current program director.

Transitional Year Program
A one-year educational experience in GME, which is structured to provide a program of multiple clinical disciplines; its design to facilitate the choice of and/or preparation for a specialty. The transitional year is not a complete graduate education program in preparation for the practice of medicine.

Transitions of Care
The relaying of complete and accurate patient information between individuals or teams in transferring responsibility for patient care in the healthcare setting.

United States Medical Licensing Exam – USMLE is a three-part exam by allopathic medical students and residents. Each part of the USMLE is called a Step. Step 1 is usually taken at the end of the second year of medical school. Step 2 is usually taken prior to graduation from US medical schools. Step 2 has two parts: a clinical knowledge (CK) exam and clinical skills assessment (CSA or CS). Step 3 is usually taken during or after the first year of residency training.


May 20, 2024