TIME LINE/CHECKLIST FOR EDUCATIONAL ACTIVITIES
Institute for Continuing Medical Education
310 East 14th Street
New York, NY 10003
Phone: 212-979-4383 Fax: 212-353-5703
E-mail:
In order to comply with ACCME requirements, it is imperative that we at the New York Eye and Ear Infirmary of Mount Sinai Institute for Continuing Medical Education (ICME) have your cooperation in complying with the elements noted below. The ICME cannot maintain its status as an accredited provider with commendation without the full cooperation of its stakeholders. As you go through the planning process for your educational activity, this form will help you to insure that all requirements are met. The ICME staff is here to work with you to achieve this goal. Please feel free to call the CME Coordinator at 212-614-8269 if you have any questions or need assistance.
Minimum ofSIX months prior to activity date–Course Proposal Form
_____CompleteCourse Proposal Formfor preliminary consideration by either the Ophthalmology Educational Activities Committee (for
ophthalmology courses) or the Executive Board of the CME Advisory Committee (for courses from all other NYEE departments).
_____Receive permission from Executive Activities Committee or Executive Board to proceed with course planning
Minimum of FIVE months prior to activity date - Application Submission
_____Complete Accreditation Application form, including Projected Budget, for submission to ICME and review by
CME Advisory Committee.
_____Needs Assessment documentation
_____Signed disclosures for the planning committee
_____List of speakers (as much as possible in the early planning stages)
_____Signed written agreement for commercial sponsors (if applicable)
One month before event
___Send peer review of slides, manuscripts etc…
_____Send Disclosure forms for speakers
_____Send copy of enduring material, if applicable, for approval by ICME
_____ Send pre- and post-test questions, and post activity follow up survey questions to ICME
Day before event (for live events)
_____Print out sign in sheets with date and course title
_____Print out evaluations with date, course titleand presenters’names
Day of event (for live events)
_____Sign in sheet (at Registration Desk)
_____CME Information sheet including course program (distributed to registrants at check in)
_____Credit Request Form (distributed to registrants at check in)
_____Course Evaluations (distributed to registrants at check in)
_____Pre-Test (distributed to registrants at check in + administered and collected prior to start of activity)
_____Post-Test (distributed to registrants at wrap-up and collected prior to their departure)
To be completed immediately after event and sent to ICME office
_____ For Grand Rounds: Disclosure Attestation- If faculty disclosures were not included on a printed CME Information Sheet or PowerPoint slide, a signed and datedAttestation from the Course Director that disclosure was made must be supplied to the ICME. The Attestation must indicate specifically what was disclosed, if anything, and that the verbal disclosure was made prior to the start of the activity. The information outlined in the disclosure Attestation should match that appearing on the individual faculty/planning committeedisclosure forms. Even if a speaker had no commercial relationships to disclose, that must be indicated in the Attestation.
_____Sign in sheet (not required but if you have one, send it)
To be completed within ONE month of the activity
_____ Final Income/Expense Report
_____Completed Credit Request/Activity Evaluations (for live events) submitted to ICME
_____Completed Pre- and Post-Tests submitted to ICME for summarizing
Reminder: Failure to comply with these requirements in a timely fashionmay result in the revocation of accreditation for your activity.
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