Graduate Medical Education Payment Program Alert: FY 2009 Annual Report Update – Alert #4

Clarification of Instructions for the HRSA 100-1-D:  Positions Approved, Positions Recruited, and Positions Filled

Question:  When does the children’s hospital report a number of approved positions for a program highlighted on the HRSA 100-1-D?

If the graduate medical education program in your hospital is a rotation site and it has a set number of approved slots by the accrediting organization, please report that number as the number of “Approved Positions.”  If the children’s hospital is formally designated as a major participating institution for an accredited GME program or if the children’s hospital is a principal training site for an approved accredited training program sponsored by another institution and annually offers a number of positions for training in the approved program, the hospital should report the number of positions approved for training.    If the children’s hospital is not designated as a major participating institution or does not have a specified number of approved positions, the hospital should report N/A in this column.

Question:  When does the children’s hospital report the number of positions recruited to fill on the HRSA 100-1-D?

If the children’s hospital is actively involved in any aspect of the recruitment or selection of residents to come to the hospital for training, the hospital should report the number of positions recruited to fill.  If the hospital is not actively involved in the selection or recruitment of residents, the hospital should report N/A in this column.

Question:  When does the children’s hospital report the number of positions filled on the HRSA 100-1-D?

If the children’s hospital has significant involvement in an approved program and filled positions, it should report the number of positions filled.  Otherwise, report N/A.

Examples:

Children’s Hospital substantially involved with the medical school and recruitment of residents:

1. Children’s Hospital A is a rotation site and regularly trains all pediatrics residents from XYZ Medical School’s ACGME-approved pediatrics training program.  The medical school is approved for 66 pediatrics residents (all PGY years).  Both the medical school and the children’s hospital are involved in the recruitment of residents each year and recruit 22 residents per year.  All of the residents spend more than 75 percent time training in the children’s hospital.  In addition to the pediatrics residents from XYZ medical school, the children’s hospital serves as a training site for 10 more pediatrics residents from other hospitals, but these residents spend less than 75 percent of their time under the supervision of Children’s Hospital Z.  On form 100-1-D, the numbers to report are:

2. Children’s Hospital A also serves as a rotation site for XYZ Medical School’s for an (adult) anesthesiology program sponsored by XYZ Medical School each year, specifying that it has the capacity to provide training for 12 positions.  The Medical School has been approved for 12 positions and together with the children’s hospital recruited 3 fellows for the most recent (2007-2008) academic year.  All 12 positions of the approved positions have been filled for 2007-2008.  These fellows spend less than 75 percent of their training time in the children’s hospital.  In addition to the 12 fellows in XYZ medical schools anesthesiology program, 44 other anesthesiology residents from other programs spent some time training in Children Hospital A during the academic year.  In total, 56 anesthesiology residents rotated through Children Hospital A in the academic year.  None of them spent more than 75 percent of their training time in the hospital.  On form 100-1-D, the numbers to report are:

Children’s Hospital not substantially involved in the recruitment of residents to the program:

Children’s Hospital B serves as a rotation site for a family medicine program sponsored by a local medical school.  The children’s hospital is not involved in selecting the residents.  Six family medicine residents rotated through the children’s hospital.  None of the six spent 75 percent of his or her training time in the children’s hospital.  On form 100-1-D, the numbers to report are: