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Graduate Medical Education

Annual Responsibilities for Leaders

Training program directors and program coordinators play a pivotal role in the educational mission of Mass General Brigham hospitals. Several complex processes are conducted on an annual basis, including trainee recruitment and selection, credentialing, and completing affiliation agreements.

Graduate Medical Education recruitment for leaders

Mass General Brigham is fortunate to attract talented candidates to world-class residency and fellowship programs in nearly all specialties and subspecialties of medicine. Although recruitment is exciting, it is also one of the most complex tasks faced by program directors and coordinators.

To ensure a successful Match, programs should familiarize themselves with the following regulations and guidelines.

  1. Recruitment Policies: In preparation for the recruitment season, Program Directors must review the selection and eligibility guidelines and transfer guidelines available in the Policies section.
  2. Electronic Residency Application Service (ERAS): Many programs utilize ERAS in their recruitment process. ERAS serves to streamline the application process by utilizing a standard application form and electronic submission of Dean's letters and other recommendations. For questions regarding ERAS access and training, please contact Angela Byers.
  3. National Resident Matching Program (NRMP): The NRMP provides a national process to ensure consistency, fairness and a predictable schedule for the mutual selections that are made between resident/fellowship applicants and the training programs. For questions regarding NRMP access and training, please contact Angela Byers.
    • “All In” Policy: The NRMP All In Policy applies to all specialties participating in the Main Residency. Fellowships Match sponsors may voluntarily implement the All In Policy. According to the policy, any program that participates in the Match must register and attempt to fill all positions through the Match or another national matching organization. Requests for exceptions to the All-in Policy must be submitted in writing and, if approved, apply only to the current Match year.
    • Waiver Guidelines: There has been an increase in the number of applicants who, after the Match, change their mind about the program/specialty they want to pursue. Those who have applied to the NRMP for a waiver after the deadline listed on the NRMP website have been consistently denied. Programs are strongly urged to consider interviewees' stated interests in other specialties when ranking candidates and to review an applicant's match history to confirm their NRMP participation eligibility for matching through the NRMP. Applicants who have matched to advanced programs may requests a waiver if they choose to change specialties. The waiver must be requested no later than January 15 prior to the start of the training. For more information about the NRMP Waiver Guidelines, please check the NRMP website and/or contact Angela Byers.
  4. Recruitment of IMGs (International Medical Graduates) and non-U.S. Citizens: Contact the Mass General Brigham Office for Global Professionals and Scholars to discuss candidates who may need J-1 clinical visas, H1-B visa sponsorship, or other visas.
  5. Materials to be Provided to Interviewees: Please be sure to provide the link to Resources for Prospective Trainees to applicants who interview with your program prior to or on interview day. Additionally, you must provide relevant program-specific policies (e.g., drug testing, supervision, duty hours), as well as department- or program-specific information regarding meals, call rooms, laundry services, etc. It is recommended that you send your applicants links to the required documents in their interview confirmation email using a “read request” label. You can then keep an electronic copy of this “read confirmation” in a separate file, in lieu of having applicants sign a printed copy of an attestation on interview day.

Key elements to include in a program description to be given to prospective residents and fellows.

Applicants must be provided with clear and sufficiently specific information about the training program. Information (in writing) can be conveyed to applicants via a brochure, website, letter, etc.

Please address the following elements as they relate to your program:

  • Overall content
    • What topic areas (e.g., diseases, evaluation, procedures, therapeutics) are covered or excluded? [A short synopsis of the curriculum]
    • For subspecialty fellowships, what involvement is anticipated (or required) in the core specialty?
  • Program structure and organization
    • Duration of training and number of trainees in each program year.
    • Types of clinical activities and time spent in each (e.g., block rotations, longitudinal experiences such as clinic sessions, conference/didactic series, or consultations).
    • Required clinical activities at any affiliate institutions.
    • How much elective time is provided and is it elective or “selective”? Can electives be taken outside of the institution? The city?
    • How much research time is provided and is it “protected” from clinical responsibilities? Are certain outcomes expected from the research experience? Can the research experience be based outside of the institution? The city? Any requirement for research funding?
    • Work hours – Does the program adhere to the ACGME standards? Describe any overnight on-call responsibilities either in-hospital or from home.
    • Patient responsibilities: Outline first-call vs. second-call responsibilities for patients and delineation of responsibilities between residents, fellows and attendings. Are ambulatory patients assigned primarily to the trainee (supervised by an attending), or to the attending physician (assisted by a trainee)? Are attendings’ patients covered by other attendings or by the trainee when the attending isn’t available?
    • Description of procedural or other “case” experience, e.g., anticipated number/types (can provide range based on prior years), level of procedural independence/nature of supervision.
    • Describe opportunities for the trainee to participate in teaching.
    • Outline how the trainee will be evaluated—by whom, how often, what methods, and what criteria?
    • Describe the approach to mentoring.
    • Outline any program restrictions on moonlighting.
  • Certification
    • Is there national certification or licensure available (e.g., board certification or CAQ; other certification or licensure in a particular technique)? Does the curriculum cover these and is achievement of certification a goal of the program and/or required for graduation?
    • Are any exams required for graduation?
  • Duration of program
    • If the standard, required duration of the training program can be extended, optionally, what are the criteria for extending the program (e.g., for an additional year or more of research training)? Who decides and when? Is funding guaranteed?
  • Other optional elements that may be helpful for applicants:
    • Career paths of prior program graduates.
    • List of faculty and their clinical and research interests.
    • Program and Department leadership.
  • Additional links that may be helpful to provide applicants:

It is also appropriate to indicate that changes to the program structure or content may be prompted by factors outside of the institution’s control—such as the departure of a faculty member, unexpectedly high or low clinical volume, etc. In such situations, the program would aim to minimize the impact on trainees so that the educational program can be delivered as it was described.

Trainee contracts

Mass General Brigham requires that a contract be issued to each resident and clinical fellow annually. Below are templates and resources for generating and issuing contracts.

Mass General Brigham requires that a contract be issued to each resident and clinical fellow annually. Matriculants must sign their initial contract by July 1st (or August 1 for some fellowships), or upon arrival if they started the program earlier or were accepted into the program after the start of the academic year. Returning residents and clinical fellows should sign a renewal contract prior to the expiration of their current contract. At this time, you do not need to issue a contract to candidates who have just matched to your program, but will not matriculate until July 1, 2025 or later. If you issue an offer letter it should contain the following text and a copy of the USMLE Completion Requirements Policy: “This offer is contingent upon satisfactory completion of the hospital credentialing process and satisfaction of the enclosed USMLE Completion Requirements Policy, and other licensure policies that may be in effect at the time.”

  1. Contract template for residents and ACGME-accredited fellows
    This template should be used to generate contracts for all residents, and for clinical fellows actively enrolled in an ACGME program—that is, the fellow’s program year is accredited by the ACGME, and they will be listed as "active" in the ACGME ADS system.
  2. Contract template for non-ACGME clinical fellows
    This template should be used to generate contracts for clinical fellows in training programs or training years that are not accredited by the ACGME.
  3. Contract documents in Microsoft Word version can be accessed on the GME SharePoint site (login required).
  4. Contract attachments
    Each template specifies required policy and other attachments. The recently revised institutional resident supervision and work hours policies apply to trainees in all programs. You should also give each trainee a copy of your program-specific Supervision and Work Hours Policies. A list of the policies and benefit summaries to be attached to the contract are in the sections below.

  1. Throughout each template there are instructions about how to fill in the preceding blank area. The instructions appear as italicized, shaded text; delete these instructions before printing each contract.
  2. Prepare an original and a copy of the contract with copies of all attachments, and send to the trainee to sign. The trainee should send back the original signed copy to retain in their program folder. This can be done electronically.

The Mass General Brigham resident salary scale for AY 24-25 applies to all residency programs; fellowship programs may choose to use it as a benchmark, apply it to their fellows, or develop their own salary levels. Fellowship programs are advised to write their own policy regarding their fellows' salaries and provide a copy to interviewees.

Additional guidelines for resident salaries and benefits:

  • Salaries for each PGY level should be the same across all residency programs/all departments; any proposed exceptions should be referred to the GME Office for consideration by the Graduate Medical Education Committee.
  • Departments may provide variable academic funds to residents for reimbursement of educational materials/activities, such as books and travel.
  • Loans may be made to residents in the event of unusual circumstances, with oversight from the institutional or physicians’ organization.

Copies of the policies listed below must be attached to the contract. They, as well as copies of the medical staff bylaws referenced in the contract, can be found on the Policies page.

  • Adverse Action Process
  • Intellectual Property Policy
  • Moonlighting Policy
  • Redress of Grievances
  • Supervision Guidelines
  • USMLE Completion Policy
  • Vacation, Sick Time, and Leave Policy
  • Work Hours Policy

Copies of the basic benefits must also be attached to the contract and can be found on the HR Information and Training Resources page.

On-boarding and graduation

Program director/coordinator responsibilities include several tasks from on-boarding to graduation.

The on-boarding process for matriculating trainees should start as soon as Match Day or when a trainee is offered a position in a program that does not participate in the Match. Offer letters should be sent out promptly to welcome the incoming trainee, indicate the dates of the complete training period, and list the initial appointment title. Other paperwork material is briefly outlined below.

The hospital appointment process and trainee limited licenses could take a few months to process and need to be initiated as soon as the new matriculants have been identified. The programs should contact the Central Credentialing Office regarding any materials that need to be included in the packets sent to all new trainees. 

For any trainee that requires a visa, the program should contact the Mass General Brigham Office for Global Professionals and Scholars (GPS).

The United States Medical Licensing Examination (USMLE) Steps 1 and 2 are required for entrance into a Mass General Brigham residency program and Step 3 is required for graduation or entrance into the PGY-3 year. The USMLE Completion Policy can be found on the Policies page. Programs may file for an exemption with the GME Office in certain circumstances. For an exemption form, please contact the accreditation manager for your program.

All programs are required to issue a contract to new and returning trainees prior to the start of the academic year. See the Trainee Contracts above for more information. 

All residents and clinical fellows in both accredited and non-accredited training programs are required to attend a day-long, hospital orientation. A mid-June orientation is scheduled for interns and a July 1 orientation is scheduled for new residents and fellows. For programs whose trainees begin at times other than those listed above, programs should contact the GME Office before scheduling their program orientation. 

Preparing for the start of a new academic year, programs will need to enter information regarding new trainees in many databases, software systems, and distribution lists, such as New Innovations, ACGME Accreditation Data System (ADS), GME Track, departmental databases, and departmental email distribution lists. Some of these same systems should be used to track program’s graduates. 

  • Diplomas: Many programs want to get an early start on the ordering of graduation certificates or diplomas for the graduating trainees. To start the process, the program director should verify the graduation list and confirm with the trainees their exact name preference and title to be used on the diploma. Programs may arrange for the printing of their diplomas or use the hospital printing services, and are encouraged to include the standardized diploma elements, approved by Mass General Brigham Education Committee. Programs should contact their accreditation manager in the GME Office for further questions.
  • Documentation to provide to ABMS or other organizations: Programs should collect new contact information, including their new program or assignment, from all trainees preparing for program completion/graduation. This gives programs the opportunity to update their alumni file. Programs should ensure that prior to graduation their trainees complete all required clinical as well as administrative responsibilities, including updating all applicable data systems (e.g., discharge summaries, case logs in ADS, evaluations in New Innovations, etc.).
  • Graduation event(s): Many programs celebrate the conclusion of the program with a graduation event. Depending on the program, these events range from graduation dinners at outside venues, graduation ceremonies and receptions in the hospital, thesis presentations, and change parties, to name a few. These events are planned well in advance to obtain the optimum space or preferred venues.

Program Letter of Agreement (PLA)

A PLA is a written document that addresses the GME responsibilities between a program and a participating site. The PLA identifies the educational and supervising faculty, the duration and content of the educational experience, the policies and procedures during the rotation, with attachments delineating the purpose of the rotation, the rotation schedule, and the Trainee Financial Agreement (TFA) for salary reimbursement, if applicable.

PLAs are completed by the programs for required educational experiences and are suggested for elective rotations. PLAs must be renewed at least every ten years; however, some attachments require annual updates.

PLA documents can be accessed on the GME SharePoint site (login required).

New Innovations residency management software

Trainees, program directors and administrators, and faculty all use residency management software to help administer the program and evaluate trainees, the faculty, and the program.

New Innovations (NI) is a web-based software application used by program directors and program coordinators to help manage their residency or fellowship, by residents and fellows to log work hours or respond to work hour evaluations (surveys), and evaluate faculty and their program, by faculty, and by the GME office to monitor work hours and, occasionally, other aspects of training programs. It is available via a computer wherever the user has Internet access and on most mobile devices. It also has software that allows residents and fellows to log procedures; access curriculum, conference materials, and rotation or daily schedules; and store scholarly activity information.

Accounts for incoming trainees and new faculty are created at the request of the program staff by the GME office. The program coordinator then contacts the trainee or faculty member with account information.

Program directors and coordinators in ACGME-accredited training programs have the following responsibilities regarding NI:

  1. Maintain a very secure password so that no one else can gain access to the NI account.
  2. Shortly after the match or selection of trainees, provide required information about the incoming trainees so that accounts can be created and then, once accounts have been created, verify that the information is correct. The GME Office will request the data by email.
  3. Upload a copy of each trainee's CV to their personnel record.
  4. If the trainee has an ECFMG certificate, upload a copy of the certificate or proof that the trainee has a certificate to their personnel record.
  5. Monitor the trainees’ required work hour tracking to ensure accurate and complete tracking and to discern and correct scheduling or workload issues that have resulted in work hour violations.
  6. Notify the GME Office when a trainee takes a leave of absence or leaves the program.
  7. Monitor the trainees’ required completion of monthly work hour surveys to ensure that trainees complete them.
  8. Input and update, as needed, the block schedule for trainees and faculty. All trainees in ACGME-accredited training programs need to be on a “primary” rotation for each day in the academic year.

In addition, although it’s not required that programs use New Innovations to evaluate trainees, the faculty, and the program, it is recommended that they do so.

Feedback to and evaluation of residents and fellows

Providing feedback to trainees is essential to progress in their training. The Mass General Brigham Office of Graduate Medical Education offers several resources to promote effective trainee feedback and evaluation. These resources are available to Mass General Brigham-sponsored ACGME and non-ACGME residency and fellowship programs.

  1. The Mass General Brigham Institutional Policy on Resident Evaluation of ACGME and non-ACGME Trainees defines evaluation and feedback requirements for Programs, Program Directors, Trainees, and Faculty
  2. Evaluation tools for assessment of Trainees, Faculty, and Programs include:
    • Competency- based multi-source evaluation templates for the assessment of Trainees by: Faculty (Short and standard versions), other healthcare professionals, peers, and patients
    • Trainee self-assessment
    • Trainee evaluation of Faculty (end of rotation evaluation)
    • Annual Evaluation of Program by Trainee
    • Annual Evaluation of Program by Faculty
  3. Grand rounds, workshops, department-specific conferences focusing on strategies for effective feedback and evaluation
  4. Individual coaching for faculty to enhance trainee feedback

Mass General Brigham GME strongly recommends the use of New Innovations for the distribution and management of trainee, faculty, and annual program evaluations. Anne Rigg can answer specific questions relevant to feedback and evaluation. All assessment templates are available in New Innovations or by contacting Carolyn Ellis.

Further information on the Mass General Brigham initiative to develop and implement multi-source trainee assessment tools can be found on the MedEd Portal site.

Cab voucher administration

If your department currently uses the cab voucher program and are in need of additional vouchers, please contact Boston Cab directly at 617-536-3200 and provide them with the reference number for your department. The reference number is on the current cab voucher booklet.

If your department would like to start using cab vouchers for the first time, send the following information to Michele Johnson in Materials Management:

  1. Department Name
  2. Department Location
  3. Contact Person
  4. Phone #
  5. PeopleSoft # (1200 MGXXXX or 2200 BWXXXX) for Account # 952600 - Local Transportation

Please ask house staff to completely fill in the voucher slips and to keep the carbon copies. Some departments have the residents return copies after use; this is a good practice for oversight and expense tracking.

Please treat these vouchers with great respect, as they are equivalent to cash. The usage of vouchers is regularly audited to ensure their appropriate use.

If you need to see copies of your (cab voucher) invoices, contact John Powers Jr.

Annual program timeline

Timeline of the annual cycle of an ACGME-accredited program for Program Directors and Program Coordinators.

Visit the ACGME website to find a timeline/template of the annual cycle of an ACGME-accredited program. It's provided as a MS Word document so that you can update it for your program. Listed under each month are activities occurring at that time of the year. This summary is meant to put the academic year into perspective chronologically. Please download and edit the document for your specialty and program. Examples of items you may want to add include in-service examinations, board exam preparation, chief resident selection, and specialty-specific conferences and meetings to organize. Once edited for your program, this tool can be an invaluable resource for all program leaders and administrators.