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Kaynak : ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION
Baslık : GLOSSARY OF TERMS
Tarih :September 18, 2009

ACGME GLOSSARY OF TERMS


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

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

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

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

At-Home Call (see also Pager Call): A call taken from outside the assigned site.

Categorical Resident (also see “Graduate Year 1"): A resident who enters a program with the objective of completing the entire program.

Certification: 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 the residency (e.g., surgery) or in the year after the residency is completed (e.g., internal medicine and pediatrics).

Citation: 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.

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

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.

Competencies: Specific knowledge, skills, behaviors and attitudes and the appropriate educational experiences required of residents to complete GME programs.

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

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

Confidential: Information intended to be disclosed only to an authorized person; that an evaluation is deemed confidential does not imply that the source of the evaluation is anonymous. 2

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

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.

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

Disaster: An event or set of events causing significant alteration to the residency/fellowship experience at one or more residency/fellowship programs. Hurricane Katrina is an example of a disaster.

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. (See Common Program Requirements)

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.

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

Essantial: (See "Must")

Extreme Emergent Situation: A local event (such as a hospital-declared disaster for an epidemic) that affect resident education or the work environment but does not rise to the level of an ACGME-declared disaster as defined in the ACGME Policies and Procedures, II.H.2.

Faculty: Any individuals who have received a formal assignment to teach resident/fellow physicians. At some sites appointment to the medical staff of the hospital constitutes appointment to the faculty.

Fellow: 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.

Fellowship: see “subspecialty program”
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Fifth Pathway: One of several ways that individuals who obtain their undergraduate medical education abroad can enter GME in the United States. The fifth pathway is a period of supervised clinical training for students who obtained their premedical education in the United States, received undergraduate medical undergraduate 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 US medical school and pass USMLE Step 2, they become eligible for an ACGME-accredited residency as an international medical graduate.

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 (see AGME Policies and Procedures, II.H.)


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: 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.

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”.

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

Innovation: 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.

Integrated: 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. (See specific Program Requirements)

Intern: Historically, a designation for individuals in the first year of GME. This term is no longer used by the ACGME.
Internal Moonlighting: Any hours a resident work 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 US 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.

JC: Joint Commission, formally known as the Joint Commission on Accreditation of Healthcare Organizations or JCAHO, which evaluates and accredits health care organizations in the United States.

LCME: 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.

Moonlighting: 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.

Must: 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.
New Patient: Any patient for whom the resident/fellow has not previously provided care. An individual Review Committee may further define new patient (See Program Requirements).
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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.

Pager Call: A call taken from outside the assigned site.

PDSA (Plan-Do-Study-Act):
A four part method for discovering and correcting assignable causes to improve the quality of processes; the method may be applied to individual learning, courses, programs, institutions, and systems, in repeated cycles.

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

Preliminary Positions:

Designated Positions: Positions for residents who have already been accepted into another specialty, but who are completing prerequisites for that specialty (see Program Requirements for Surgery).

Non-Designated Positions: Positions for residents who at the time of admission to a program have not been accepted into any specialty (see Program Requirements for Surgery).

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.

Program: 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 the quality and effectiveness of the program.
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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.

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

Resident: A physician in an accredited graduate medical education specialty program.

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

Rotation: 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. (See Common Program Requirements)

Shall: (See must)
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 over night.

Should: 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’.
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Site: An organization providing educational experiences or educational assignments/rotations for residents/fellows.

Major Participating Site: A Review Committee-approved site to which all residents in at least one program rotate for a required educational experience, and for which a master affiliation agreement must be in place. To be designated as a major participating site in a two-year program, all residents must spend at least four months in a single required rotation or a combination of required rotations across both years of the program. In programs of three years or longer, all residents must spend at least six months in a single required rotation or a combination of required rotations across all years of the program. The term “major participating site” does not apply to sites providing required rotations in one year programs. (see “Master Affiliation Agreement”)

Participating Site: An organization providing educational experiences or educational assignments/rotations for residents/fellows. Examples of sites include: a university, a medical school, a teaching hospital which includes its ambulatory clinics and related facilities, a private medical practice or group practice, a nursing home, a school of public health, a health department, a federally qualified health center, a public health agency, an organized health care delivery system, a health maintenance organization (HMO), a medical examiner’s office, a consortium or an educational foundation.

Specialty Program: A structured educational experience in a field of medical practice following completion of medical school and, in some cases, prerequisite basic clinical education designed to conform to the Program Requirements of a

particular specialty; also known as ‘core’ programs.
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 (e.g., a university, a medical school, a hospital, a school of public health, a health department, a public health agency, an organized health care delivery system, a medical examiner’s office, a consortium, an educational foundation).

Clarification: 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 (and address) must represent the satellite clinics (that are located within 10 miles of the main site).

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.
Suggested: 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.
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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 as transfer residents under several conditions including: moving from one program to another within the same or different sponsoring institution; when entering a PGY 2 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. The term ‘transfer resident’ and the responsibilities of the two program directors noted above do not apply to a resident who has successfully completed a residency and then is accepted into a subsequent residency or fellowship program.
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.

Kısaltmalar

AST-KM 7/30/2007
TSW 4/21/2008
TSW 8/7/2008
TSW 9/24/08
TSW 01/20/09
TSW 03/2009
TSW 09/18/2009
COMMON ACRONYMS/ABBREVIATIONS USED IN GRADUATE MEDICAL EDUCATION
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
ADS Accreditation Data System
AHA American Hospital Association
AMA American Medical Association
AMA-CME American Medical Association – Council on Medical Education
CAAR Computer Assisted Accreditation Review
CBE Competency-Based Education
CMS Centers for Medicare and Medicaid Services
CMSS Council of Medical Specialty Societies
CRCC Council of Review Committee Chairs
CRCR Council of Review Committee Residents
DIO Designated Institutional Official
ECFMG Educational Commission for Foreign Medical Graduates
ERAS Electronic Residency Application Service
EVE/ADAM Effective, Very Efficient Accreditation Data Management System
FREIDA Fellowship and Residency Interactive Database (AMA)
FS Accreditation Field Staff
FSMB Federation of State Medical Boards
GME Graduate Medical Education
HIPAA Health Insurance Portability and Accountability Act
IRC Institutional Review Committee
IRD Institutional Review Document
JCAHO Joint Commission on Accreditation of Healthcare Organizations
LCME Liaison Committee on Medical Education
LON Letter of Notification
NBME National Board of Medical Examiners
PD Program Director
PDF Portable Document Format
PGY Post Graduate Year
PIF Program Information Form
PLA Program Letter of Agreement (for residency and fellowship program)
NRMP National Resident Matching Program
RC Review Committee
RQ Resident Questionnaire (used in Internal Medicine)
RRC Residency Review Committee
SV Site Visitor
SSV Specialist Site Visitor
TYRC Transitional Year Review Committee
USMLE United States Medical Licensing Examination
JKH 10/15/2008

Accredited length
The number of years of training the program is accredited to offer by the Accreditation Council for Graduate Medical Education.

Additional training or educational experiences
These include required additional training beyond the accredited length of the program, as well as additional experiences that the program offers, but are not required for completion of the program.

Application dates
The deadline for applications for the next academic year, and the earliest date for which applications will be accepted by the program for the following year

Beeper call
Beeper or home call is on-call time spent away from the institution.

Call schedule
1/wk = once per week
2/wk = twice per week
3/wk = 3 times per week
4/wk = 4 times per week
>5/wk = 5 or more times per week
q2d = every other night
q3d = every 3rd night
q4d = every 4th night
q5d = every 5th night
q6d = every 6th night
q7d = every 7th night
q8d = every 8th night
q9d = every 9th night
q10d = every 10th night
>q11d = every 11th night or more
NGO = negotiable
OTH = other

Community-based program
The majority of experience does not take place in a university academic medical center, or a hospital with a medical school affiliation.

Community-based university affiliated program
The majority of experience takes place in a community hospital that is affiliated with an academic medical center, but is not a primary affiliate or is geographically separate from the academic medical center.

ERAS
Electronic Residency Application Service, by which medical students apply to residency programs through their medical schools; graduates of international medical schools apply through the ECFMG. See www.aamc.org/eras .

GME
Graduate medical education, or medical education training taking place after graduation from medical school.

Graduate year
The year of training in accredited graduate medical education, which may or may not correspond with program year. For example, if a resident has completed training in Internal Medicine, and now is in the first year of a Nephrology programs, the resident would be in his/her 4th Graduate Year, and 1st Program Year.

Hospitalist track
Track or fellowship that provides special training for a career devoted largely to inpatient care.

Institution
Residency and subspecialty programs must be sponsored by an institution. The sponsoring institution assumes the ultimate responsibility for the program. A participating institution is an institution in which residents rotate for a required experience. A clinical site is the institution that functions in many respects as the sponsoring institution in cases of substantial geographic separation from the sponsoring institution.

Last updated
The date for which all or part of the information appearing for the program was last loaded onto FREIDA Online.

Maximum consecutive hours on duty
The maximum number of consecutive hours a resident/fellow is allowed to be on duty by the program, generally in the hospital.

Military-based program
The majority of experience takes place in Army, Air Force, Navy, and Uniformed Services institutions.

Moonlighting within the institution
Moonlighting within the sponsoring institution (as opposed to another hospital). Moonlighting at another institution may or may not be allowed.

Most taxing call schedule and frequency
The call schedule that will put the resident on call the most frequently per week, and the number of weeks or months per year that schedule will occur.

National Resident Matching Program
The NRMP matches medical students and residency programs to optimize the rank ordered choices of students and program directors. The NRMP also conducts matches for fellowship positions in 22 sub-specialties, through its Specialties Matching Services. See www.nrmp.org .

Night float system
A rotation where residents only work during the nights (eg, 10pm-8am), with minimal or no day-time duties

Other program setting
The majority of experience takes place in settings that are not university, community, or military based, such as in foundations, blood banks, or cancer centers.

Part-time/shared positions
Some programs will allow two residents to "share" one position in the program, or allow the resident to progress through the program at a slower pace, or part-time.

PDAs
The program provides PDAs (personal digital assistants) without cost to the resident/fellow.

Performance-based assessments
Objective Structured Clinical Examinations (OSCEs), patient or computer simulations are used to provide standardized assessments of residents’ clinical skills.

Preliminary positions
Positions for residents who are obtaining training required to enter another program or specialty. Preliminary positions are usually 1 year in length, and usually offered for Graduate Year 1. Internal medicine, surgery, and transitional year programs commonly offer preliminary positions.

Primary care track
Track or separate path solely devoted to primary care medicine

Primary teaching site
The site that provides the single largest amount of clinical experience for the program

Program size
The number of resident/fellow positions the program has.

Program year
The year of training in the specialty

Ratio of FTE faculty to positions
This ratio is calculated by adding the number of full-time paid physicians to one-half the number of part-time paid physicians, and dividing this sum by the number of positions in the program.

Required length
The accredited length of the program, plus any additional training that is required (not optional) by the program.

Requires previous GME
The program requires training in another specialty prior to entry. Some programs require all residents to have had previous GME, some programs never require previous GME, some programs in special cases will require previous GME for some residents, and some programs may exempt a resident from the requirement.

Research rotation
Research experience rotation occurring while training in the program, not to be confused with a research track/non-accredited fellowship.

Research track/non-accredited fellowship
A non-accredited research or fellowship year beyond the accredited program length.

Rural track
Track or separate path solely devoted to rural primary care medicine.

San Francisco match
The San Francisco match provides a matching service for several surgical specialties. See www.sfmatch.org .

Specialty in-service examination
This examination parallels the specialty’s board certification examination, and is typically used to provide feedback to the program on the resident’s progress.

Survey received
The date the AMA received the program survey which supplies much of the information about the program on FREIDA Online.

Twenty-four-hour off duty period
A full 24-hours released from program duties, including call.

University-based program
The majority of experience takes place in a hospital that serves as a primary affiliate of the medical school.

USMLE Step 2-CS
The USMLE Step 2 Clinical Skills exam will be available to US medical school graduates of the class of 2005 starting in June 2004. Some programs may require passing this exam before a PGY1 resident can start the program in 2005; others may not, or may not have a policy in place at the time of the survey.

US government affiliation
Programs that are sponsored by or affiliated with federal agencies, i.e., Air Force, Army, Navy, Public Health Service, and the VA.

Women's health track
Track or fellowship that provides special training in the area of women's health.

Kaynak : AMA

BAglantı Adresi :http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online/about-freida-online/glossary-program-information.shtml