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Away Rotations/Elective and Required

Away rotations at SIU School of Medicine are a time limited experience that must meet unique educational goals which are not available at the local sites established by the training program. A program’s training sites are approved by the employing hospitals as an integral and recurring component of the program to meet accreditation requirements, and an agreement or contract has been established outlining the terms of this affiliation.

The requests outlined in this policy fall outside of the established training sites and must be submitted by the Program Director, according to the following guidelines.

1. The Program Director must approve any away rotation (required or elective) and submit a written request to the Office of Graduate Medical Education (OGME), which will then be brought before the GMEC for review. This request must contain all of the required components outlined in this policy. Once the request packet is complete, it must be submitted to OGME a minimum of 90 days prior to the start date of the rotation.

2. Throughout the course of the training period outlined in the Resident Agreement, a resident employed by a Springfield hospital is limited to one month total of away rotation training. The maximum number of months for away rotations for the affiliate programs is at the discretion of the program and employing hospital.

3. The GMEC will review the request. If the committee approves the educational value of the rotation, it will designate the rotation as elective or required. An OGME representative will notify the program of the committee’s decision after the meeting. There are additional requirements for Springfield programs, addressed under SPRINGFIELD ONLY.

4. Residents participating in away rotations should consult with the HR department of their employing hospital before departure to verify health insurance coverage. Residents are responsible for obtaining verification documentation from HR if the receiving institution requires any (i.e. proof of background check, vaccination records, training verification, etc).

5. Resident rotations outside of the United States must comply with the International Travel for Away Rotations Policy.


1. A letter from the Program Director to the GMEC Chair, which includes the following:

  a. Indicates whether the program considers the request an elective or required away rotation, as defined below:

     i. Elective Away Rotation: The time limited experience is valuable to the resident, but is not essential to meet RRC requirements. In addition, it is not available at the local sites established by the training program.

     ii. Required Away Rotation: The time limited experience is essential to meet RRC Requirements and is not available at the local sites established by the training program. If the request is for a required rotation, the PD letter must include why the rotation is necessary to meet RRC requirements.

  b. Dates of rotation.

  c. Location of experience, including the address of the facility or facilities where the training will take place.

  d. Description of the rotation, including a rationale for why the educational goals cannot be obtained in the core training program.

  e. Verification that the experience provides sufficient clinical credit so that additional time to complete the program will not be required.

  f. Verification that copies of all required program and institutional affiliation agreements have been provided to OGME with the request packet. The resident is responsible for obtaining drafts of all required agreements prior to OGME submission, and must verify the requirements with the receiving institution. If these are not provided in their entirety, the rotation is at risk of being cancelled despite GMEC approval. If an institutional agreement is required by the receiving institution, it must indemnify the employing hospital.

  g. Minimally, the programs must have a Program Letter of Agreement that verifies appropriate supervision. If the rotation supervisor is also the program director, verification of supervision can be included in the program director letter, and the PLA requirement will be waived.

2. Goals and objectives: Can be included in the letter or provided as a separate document.

3. A CV from the site supervisor/local director (SIU Faculty only exception).

4. The program director should be present at the GMEC meeting at which the rotation is presented.


After GMEC approves and designates the request as an elective or required rotation, the request must then be reviewed by the Institutional Residency Affairs Coordinating Committee (IRACC)*. If IRACC approves the rotation request, the subsequent information and procedures will apply.

1. Elective Away Rotations:

  a. The employing hospital will continue the resident’s stipend and fringe benefits while on the elective rotation, not including malpractice insurance.

  b. Malpractice Insurance: The resident, the resident’s program, or the receiving institution must provide malpractice insurance that meets the receiving institution’s minimum requirements for the rotation and provide evidence of such coverage to OGME a minimum of 30 days prior to the start date of the rotation.

2. Required Away Rotations:

  a. The employing hospital will continue the resident’s stipend and fringe benefits while on the required rotation.

  b. Malpractice Insurance:

     i. The program director and resident should make every effort to obtain malpractice insurance through the receiving institution. If secured in this manner, evidence of coverage must be provided to the OGME and this documentation must indemnify the employing hospital.

     ii. If the receiving institution is unwilling or unable to provide malpractice insurance, the employing hospital will provide malpractice insurance for the resident while on the required rotation. A certificate of insurance will be generated for the receiving institution.

*A finite amount of resources are available for support of resident away elective rotations. For priority consideration, all requests for away elective rotations in the upcoming academic year should be submitted by April 1st. If the number of requests that receive educational approval by GMEC exceeds the available funding, requests will be prioritized according to the following criteria.

Decisions regarding prioritization of request will be made by GMEC prior to IRACC consideration.

     Higher preference will be given to rotations with:

          a. Unique content/experience that is not available locally.

          b. Clinical/academic/scholarly experiences that are not locally available and that are instrumental in earning an advanced degree (i.e. MPH, MPHE, etc.)

          c. A unique research experience that is not available locally.

  Lower priority will be given to:

          a. Rotations for which medical mission is the primary goal.

          b. "Audition" electives where one of the primary aims is to improve the resident’s competitiveness for a fellowship position.

If an elective request is approved educationally by GMEC, and funds are not available to provide stipend and benefits, the resident is at liberty to pursue the elective utilizing vacation and educational leave.

 Last Approval Date:  December 15, 2017

 Effective Date: December 15, 2017