University of Wisconsin Hospital and Clinics
University of WisconsinHospital and Clinics
Graduate Medical Education Oversight Committee
Internal Review Summary Report
PROGRAM REVIEWED:
Accreditation Status:
Date Last ACGME Review:
Date Next ACGME Review:
Length of Training:
Date Last Internal Review:
Date This Internal Review Began:
Date of Internal Review Team Meeting:
Date ACGME Assigned Midpoint:
Date Report Will Be Presented To GMEOC:
Internal Review Panel
Primary Reviewer:
Secondary Reviewer:
Resident Reviewer:
Administrative Reviewer:
Committee Participants: This section will be filled in after presentation to the GMEOC
Materials Used:
Current trainee list, ACGME accreditation letters and follow-up correspondence, Internal review report and follow-up correspondence, ACGME Program and Institutional Requirements, Program Letters of Agreement, Updated ACGME Program Information Form from last site visit, ACGME Resident Survey Results (2010), Annual Program Evaluation and Improvement Plan (2009), Evaluation Forms (residents, faculty, resident and faculty of program and graduate survey), Program Policies, Didactic Schedules, Overall Program Goals and Objectives, Rotation specific goals and objectives, Duty Hour Data, Procedure Volume Data, Learning Portfolio Samples, Resident Handbook.
Internal Review Committee Meetings: (must list all participants with titles and level of training from residents/fellows)
This report is based on a review of the above materials and on information elicited in three separate sets of interviews on ______the first with ______, Program Director and ______, Program Manager; the second with key faculty ______,______and the third with XX number of program residents, Y from Z PG program years. In addition, ______, the Resident Reviewer, met with AAA residents for individual meetings between _____ and ____, 2009, and elicited additional feedback as part of the review process.
Internal Review Process:
The internal review was conducted according to the current GMEOC approved protocol with respect to scheduling, materials reviewed, process and individuals interviewed. Each member of the Review Team was assigned specific tasks and the comprehensive UWHC Internal Review Process Checklist was completed by the team. The document was reviewed n detail by the Primary Reviewer and the Summary Report was reviewed by team members. Following this review the Internal Review Primary Reviewer shared the summary document with the ______Residency/Fellowship Program Director for comments before finalizing and sending it to the GMEOC for its review and approval.
Previous ACGME Citations and Status:
GMEOC Citations (violations of the RRC program requirements):
GMEOC Recommendations:
The ______Residency/Fellowship Program has maintained and increased the faculty, staff, clinical volume and other curricular elements required to be in substantial compliance with Institutional, Common and Specialty/Subspecialty Requirements.
The following section will be completed after the committee has reviewed the report.
GME Oversight Committee Action:
Follow-Up Progress Report Required? YESNO
If follow-up on any citations is required, the Program Director must provide a progress report at the end of six months with evidence of correction action on the problems listed. Response to the following citations is required:
Progress Report Due Date:
Report Distribution:
Residency/Fellowship Program Director
Residency/Fellowship Program Coordinator
Core Residency Program Director (if appropriate)
Department Chair
Donna Katen-Bahensky, UHWC President and CEO
Carl Getto, M.D., UWHC DIO and Senior Vice President for Medical Affairs
Alan Bridges, M.D., VA Hospital Chief of Staff (if appropriate)
Geoffrey Priest, M.D., Meriter Hospital Chief Medical Officer (if appropriate)
Richard Hendricks, M.D., St. Marys Hospital Vice President for Medical Affairs (if appropriate)
Robert Golden, M.D., UWSMPH Dean
UWHC Medical Board