Scope

This policy was developed for SIU Medicine. SIU Medicine collectively applies to the SIU School of Medicine (SIU SOM), including the Federally Qualified Health Center (FQHC), and SIU HealthCare (SIU HC). These entities are collectively referred to as SIU in this document.

This document applies to SIU staff, faculty, trainees, agents, officers, directors, interns, volunteers, contractors, and any other individual or entity engaged in providing teaching, research and health care items and services at SIU. These individuals are collectively referred to as SIU personnel in this document.

Definitions 

The term “resident” is inclusive of all trainees at SIU SOM, whether training in a residency or fellowship program. The term “program” is inclusive of all SIU residency or fellowship programs, whether accredited or non-accredited.

Purpose

From time to time situations will arise in which a training position may be offered to fill a vacant slot (e.g. unanticipated vacancies, expansion of program number, etc.).  Communication with the Office of Graduate Medical Education (OGME) is essential when considering a candidate for residency in these circumstances.  OGME may need to consult with the NRMP to ensure that the program is not at risk of violating the All-In Policy.  

Procedure 

Approved positions must exist before resident physicians can be accepted.  Credentialing must be completed and approved by the hospitals before a final employment contract may be offered to an applicant.  Licensing and work authorization are always necessary before a physician starts working.

Applicants must submit to the program:

  1.  Application for residency
  2.  Dean’s letter and/or official transcript.
  3.  At least three letters of recommendation
  4.  USMLE or COMLEX scores

A letter of offer is binding for both the applicant and the program.  A letter of offer can only be given to a candidate after approval by the Director of Graduate Medical Education (DGME) or the Associate Dean for Graduate Medical Education (ADGME). The only exception to this requirement is if the program is offering a position through the NRMP’s Supplemental Offer and Acceptance Program (SOAP).  The program must use the template provided, which includes the following required information:

  1.  Level of training 
  2.  Dates of the contract being proposed
  3.  Yearly stipend amount
  4.  Statement indicating the offer is contingent upon departmental and hospital approval (Resident Credentialing  Policy)
  5.  Statement indicating employment is contingent upon obtaining an appropriate Illinois State Medical License
  6.  Statement indicating employment is contingent upon obtaining appropriate work authorization
  7.  Signature of Program Director and Candidate

RESIDENT ENTRANCE INTO UPPER LEVEL POSITIONS

When a program director at a SIU School of Medicine sponsored program wishes to consider accepting an applicant with previous graduate medical education training into an advanced position (i.e., beyond the normal entry level in the program), the program director must first contact the program directors of all programs in which the applicant had previous graduate medical education experience.  The program director must obtain written or electronic verification of previous educational experiences and a summative competency-based performance evaluation of the candidate, prior to acceptance into the program.  If the applicant has already exited the prior GME program, this should include the Final Summative Evaluation.

The program director must personally contact the applicant’s current and/or former program director(s) or the individuals chiefly responsible for the evaluation of the performance of the resident in the previous programs.  These discussions must include an assessment of the following: 

  1.  Circumstances of his/her departure from the program
  2.  Clinical reasoning and judgment
  3.  Medical knowledge
  4.  Clinical skills, including history-taking, physical examination and procedural skills
  5.  Personal skills, including interaction and communication with patients; ability to work cooperatively with  colleagues and subordinates, professional conduct and ethical behavior, level of self-awareness, and  responsiveness to feedback.
  6.  Presence or absence of any concerns regarding patient safety

The program director must document these discussions and maintain a record of them as part of the applicant's file and in the resident's evaluation file if the applicant is appointed to the program.

It is recommended that program directors of fellowship programs which have residency training prerequisites also make personal contact with the program directors or other individuals able to evaluate a fellow's performance at previous levels of training of residency education, and document those discussions as part of the application process.  

Board eligibility status must also be explored and documented.  If the applicant is changing specialties, the board(s) must be contacted to ascertain what, if any, credit the resident can receive for prior training.

Program Directors must secure a signed statement indicating that the resident has given permission to release information concerning his/her performance.

VACANT PGY1: APPLICANT WITH PREVIOUS TRAINING

When a program director at a SIU School of Medicine-sponsored program wishes to consider accepting an applicant with previous graduate medical education training into a PGY 1 position, it is strongly recommended that they make personal contact with the program directors or other individuals able to evaluate the applicant’s performance at their previous training programs, and document those discussions as part of the application/ ranking process.