GME Forms and Templates

Forms and templates to assist your GME office in the administration of graduate medical education programs.

Topic	Description
CORE GME Staff	Listing of GME staff in CORE hospitals
Corrective Action Letter	Letter to AOA for deficiencies from site visit. This is required 45 days after you receive the letter and needs an OPTI signature.
180 Day Follow-up CA Letter	A letter needs to be sent to the AOA 180 days after a Corrective Action Plan. This letter requires an OPTI signature.
Master Affiliation Agreement	Agreement to use when you have several different programs rotating to the same institution or the intuition reciprocates with sending residents to you.
Office Rotation Letter - NO Compensation	Educational agreement for sending a trainee to an office setting. Use when you will not pay the preceptor and count the FTE in IRIS.
Office Rotation Letter - Compensated	Educational agreement for sending a trainee to an office setting where you will count the FTE in IRIS and pay the preceptor.
Faculty/Preceptor Job Description	Job description for duties and responsibilities of faculty/preceptor.
AOA Internal Review Policy	The policy developed by AOA explaining the internal review, the structure, the purpose, and the outcome.
Guidelines for Conducting an Internal Review	Guidelines and process for conducting an internal review. This includes a sample report that is required.
Resident Job Description	Job description for duties and responsibilities of resident. Helpful with JCHCO inspections.
Sample Policy COMLEX III Exam	Policy to comply with AOA requirement to pass COMLEX III in third year of training.
Sample Report for Internal Review	Guide line for preparing the internal review report; who, what, when, where, and outcomes.
Sample Policy Intern-Resident Selection	Policy to insure consistency in resident intern selection process.
Sample Form for Verification of Leave dates and Program Extension	Form used to ensure dates are properly recorded and documented for time missed from training resulting in contract extensions.

If you need other examples or forms, please contact the CORE System Office at 740.593.2189.