Nomination Form

GME Program Coordinator Excellence Award

Please note that the form is in a table format and the boxes will expand as text is entered.

Nominee Contact Information
Name:
Address:
City, State, Zip:
Telephone:
E-mail:

Name of Institution:

/ Nominator Contact Information
Name:
Address:
City, State, Zip:
Telephone:
E-mail:

Name of Institution:

ACGME Program Number: / Current Accreditation Status:
Specialty for which Program Coordinator is responsible: / Total number of years as Program Coordinator (at the time of nomination submission):

Letters of Support From:

(List name, title, and affiliation, i.e., hospital, medical school, university, etc.)
1. Designated Institutional Official (DIO) or Chair -
2. Program Director -
3. Current resident/fellows -
4. Support of an additional person involved in GME - / Member of a Program Coordinator Association (not all specialties have a program coordinator’s association) yes, or no. If yes, please specify which program coordinator’s association, role, and number of years as member:

Send the Nomination Form and Letters of Support in one single PDF file via e-mail to DeLonda Dowling: .

All nominations must be e-mailed by Friday, March 30, 2018, 5:00 p.m. Central. Nominations received after the deadline will not be considered.


Check-List for Nomination Materials

Eligibility Requirements

q  *Program coordinator for ACGME-accredited residency or fellowship

q  Program has continued accreditation

q  Has at least five years’ experience (at the time of nomination submission) as a program coordinator

Criteria for Selection

Program coordinators must possess one or more of the skills listed under each criterion:

q  Meets eligibility requirements

q  Demonstrates excellent communication and interpersonal skills with internal and external constituents

o  Promotes communication/collaboration among the Program Director, trainees, faculty members, and other individuals within the institution

o  Diplomatically handles problems, especially those of a sensitive and/or confidential nature

o  Demonstrates a flexible “can do” attitude

o  Interacts effectively with applicants to facilitate the program’s application, interview, matching and orientation processes

o  Directly communicates (verbal, written, reports, etc.) with specialty societies medical boards, the ACGME, etc. in an effective, professional manner

q  Demonstrates excellent understanding of, and facilitates the program’s ACGME accreditation process

o  Understands requirements, continuously updates knowledge and can explain requirements to others

o  Monitors that program requirements are being met

o  Regularly reviews and updates the program’s Accreditation Data System (ADS) profile

o  Organizes the program’s Clinical Competency Committee and Milestones activities

o  Organizes and participates in the program’s annual review process, Self-Study and site visits (CLER and accreditation)

q  Possesses superior skills in organizing and coordinating the many activities needed to promote program excellence

o  Works with others to maintain accurate and easily retrievable records of resident evaluation, training history, certification, etc.

o  Oversees schedules regarding conferences, rotations, required activities, and prepares reports for outside organizations as needed

o  Oversees resident recruitment process including Electronic Residency Application Service (ERAS) and National Resident Matching Program (NRMP) activities

o  facilitates credentialing, licensing, and International Medical Graduate activities concerning visas

q  Demonstrates personal lifelong learning and mentorship of others

o  Actively participates in local, regional or national learning opportunities

o  Personally mentors and acts as a role model for other coordinators to enhance their learning/skills

o  Shares knowledge locally, regionally or nationally to enhance the performance of GME programs

q  Has designed and implemented an improvement project for the residency/fellowship program

*The ACGME recognizes that coordinators may have many different titles (e.g., program administrator, residency coordinator, manager, assistant director, etc.) and that the title is often institution or program dependent. Generally, this category refers to the individual who supports the program director, manages the day-to-day operations of the residency or fellowship program, and is actively involved in the ACGME functions of the program.

Nomination Instructions

Two components are required for nomination:

·  A completed nomination form

·  Four signed letters of support (each letter is limited to 500 words or less)

About the Letters of Support

·  Letters should be addressed to ACGME Awards Committee.

·  One of the letters must be from a current resident/fellow.

·  One of the letters must be from the program director.

·  One of the letters must be from the DIO or chair of the Graduate Medical Education Committee

·  The remaining letter may come from another person(s) involved in GME who can attest to the nominee’s excellence as a residency coordinator

·  Comments from a group, e.g. faculty members, residents, etc. should be compiled into one “group letter”; we will not accept more than four letters of support for each nominee

·  Letters should articulate the nominee’s accomplishments in all of the listed criteria.

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