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Program Closure and Reduction Policy

I. Purpose of Policy

The purpose of this policy is the expectation that the Graduate Medical Education Committee (GMEC) as the D-H governing body for graduate medical education, maintain a policy that addresses a reduction in size or closure of a residency or fellowship program or closure of the institution, per the Accreditation Council for Graduate Medical Education (ACGME) Institutional Requirements.

II. Policy Scope

The policy applies to all ACGME-accredited residency and fellowship programs at Dartmouth- Hitchcock (D-H).

III. Definitions

Resident: Any physician in an accredited graduate medical education program, including interns, residents, and fellows.


Designated Institutional Official (DIO): The individual in a sponsoring institution who has the authority and responsibility for all of the ACGME-accredited GME programs.


IV. Policy Statement

  • The senior leadership of the Sponsoring Institution in conjunction with the Department Chair, Program Director, DIO and GMEC will make appropriate efforts to avoid the closure of ACGMEaccredited programs.

  • The Sponsoring Institution must inform the GMEC, the DIO, and the affected residents as soon as possible when it intends to reduce the size of or close one or more programs, or when the Sponsoring Institution itself intends to close.

  • In the event a decision is made that a training program must decrease in size:
    • The appropriate Department Chair and Program Director will inform the DIO, GMEC and the residents as soon as possible following the decision.
    • The DIO and GMEC will be responsible for monitoring the complement reduction process.
    • Plans to reduce the complement of residents in the program will be made, where reasonable, by first reducing the number of positions available to incoming residents.
    • If the reduction needs to include residents currently in the training program, the Department Chair, Program Director and DIO must assist affected residents in enrolling in an ACGME accredited program(s) in which they can continue their education.

  • In the event a decision is made that a training program must close:
    • The appropriate Department Chair and Program Director will inform the DIO, GMEC and the residents as soon as possible following the decision.
    • The DIO and GMEC will be responsible for monitoring the closure process.
    • The sponsoring institution will preferentially structure a closure, when reasonable, that allows enrolled residents to complete the program.
    • In the event a program must be closed before one or more residents are able to complete their training, the Department Chair, Program Director and DIO must assist resident(s) to assist them in enrolling in an ACGME-accredited program(s) in which they can continue their education.


D-H Policy ID: 11313

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