Permanent Complement Increase Request

I. Purpose of policy

It is the policy of the Dartmouth-Hitchcock (D-H) Office of Graduate Medical Education to provide valid and fair procedures to departments that desire to permanently increase the number of residents/fellows in established, Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs.

II. Policy scope

This policy applies to all D-H ACGME-approved residency and fellowship programs.

III. Definitions

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

IV. Policy statement

  • The Program Director request a permanent increase to the number of residents in an established training program by submitting a written request to the Graduate Medical Education Committee (GMEC).
  • The Program Director and Service Line Leader must sign the letter of request.
  • The request to the GMEC to increase the number of residents must:
    • Specifically establish the educational rationale.
    • Detail the distribution of positions including the number of residents per year and the total number of residents.
    • Review the adequacy of the case/procedural volumes to support the requested increase (data required) taking into consideration the impact on established learners.
    • Determine the impact of additional residents on other training programs.
    • Provide letters of support from programs providing required rotations and from programs that could be affected by an increase in complement.
    • Provide assurance that adequate space is available to support the presence of additional learners or identify what steps will be taken to address any space needs.
    • Review current ACGME Review Committee citations and program response.
    • Provide a completed Letter of Financial Support template signed by the Service Line Leader.
  • The GMEC will:
    • Review and vote upon the petition to increase complement.
    • Communicate its recommendations to the Program Director and Service Line Leader requesting the increase (Designated Institutional Official (DIO) responsibility).
    • The findings of the GMEC will constitute a recommendation to the D-H Chief Academic Officer. If the Chief Academic Officer approves the increase, the Program Director is permitted to apply to their respective specialty Review Committee via the ACGME Accreditation Data System (ADS) to increase the number of residents in the established training program. Once submitted, the DIO will then sign-off on the request in the ACGME Accreditation Data System.

D-H Policy ID: 12826