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Program Closure and Reduction Policy

I. Purpose of Policy

This policy delineates the responsibilities of leadership when the closure of the Accreditation Council for Graduate Medical Education (ACGME)-accredited Sponsoring Institution at Dartmouth-Hitchcock (D-H), or one of its training programs, is necessary, or should one of is programs be required to reduce its complement.

II. Policy Scope

The policy applies to the Designated Institutional Official (DIO), Graduate Medical Education Committee (GMEC), and departmental ACGME-accredited program leadership at D-H.

III. Definitions

Resident: Any physician in an ACMGE-accredited graduate medical education program including 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.


Sponsoring Institution (SI): The organization (or entity) that assumes the ultimate financial and academic responsibility for a program of GME. The sponsoring institution has the primary purpose of providing educational programs and/or health care services. The Sponsoring Institution at D-H is Mary Hitchcock Memorial Hospital (MHMH).


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 ACGME-accredited 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 training can continue.

  • 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 SI 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 in enrolling in an ACGME-accredited program(s) in which training can continue.

V. References

ACGME Institutional Requirements. (2015). Retrieved from ACGME.org:
www.acgme.org/Designated-Institutional-Officials/Institutional-Review-Committee/Institutional-Application-and-Requirements


D-H Policy ID: 11313

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