WEB ACCREDITATION DATA SYSTEM GLOSSARY

Accreditation Council for Graduate Medical Education (ACGME) - An accrediting agency composed of representatives from five national associations interested in graduate medical education (each of which appoints four representatives) in addition to a federal government representative, three public representatives chosen by the ACGME, and a resident physician representative. The chair of the Residency Review Committee Council, and ACGME advisory body, participates in ACGME meetings in a nonvoting capacity. The ACGME, through its 27 review committees (26 Residency Review Committees, or RRCs, and the Traditional Year Review Committee), accredits graduate medical education programs.
Applicant - Persons invited to come for an interview for a GME program.
At-Home Call (see also Pager Call) - A call taken from outside the assigned institution. The frequency of at-home, or pager calls, is not limited to every third night or less.
Categorical Positions (see also "Graduate Year 1" and "Preliminary Positions") - Positions for residents who begin and remain in a given program or specialty until completion of the year(s) required for admission to specialty board examination.
Chief Resident - A position in the final year of the residency (e.g. surgery) or in the year after the residency is completed (e.g. internal medicine and pediatrics); the individual in this position plays a significant administrative or teaching role in guiding new residents.
Clinical Supervision - Time spent supervising/watching residents during patient care activities. This could include rounding with residents, and time spent supervising/teaching on call.
Combined Specialty Programs - Programs recognized by two or more separate specialty boards to provide GME in a particular combined specialty (listed below). Each combined specialty program is made up of two or three programs, accredited separately by the ACGME, at the same institution. Neither the ACGME nor the Residency Review Committees reviews the combined program as a single entity. Resident physicians completing these programs are eligible for board certification. The web accreditation data system asks programs to indicate each resident participating in a combined specialty track as 0.5 FTE.
Consortium - Two or more organizations or institutions that have come together to pursue common objectives (e.g., GME). A consortium may serve as a "sponsoring institution" for GME programs if it is formally established as an ongoing institutional entity with a documented commitment to GME.
Designated Institutional Official (DIO) - The person in a sponsoring institution of GME who assumes the authority and responsibility for the GME programs and oversees the implementation of the Institutional Requirements. The DIO is responsible for completing the Annual Update for the Web Accreditation Data System and seeing that all sponsored programs complete their updates on schedule.
Didactics/Teaching - Time spent doing classroom style teaching.
DO - A doctor of osteopathy (DO) degree requires four academic years of study. The American Osteopathic Association (AOA) Bureau of Professional Education accredits colleges of osteopathic medicine in the United States that grant the DO degree.
Duty Hours - All clinical and academic activities related to the residency program, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and academic assignments such as conferences.
ECFMG Number - The number assigned by the Educational Commission for Foreign Medical Graduates (ECFMG) to each international medical graduate physician who receives a certification from ECFMG. Graduates of foreign medical schools must have an ECFMG certificate to participate in accredited GME in the US. ECFMG certification provides an assurance to residency programs that IMGs have met the minimum standards, including proficiency in English, required to enter such programs.
Fellow - A physician in a program of graduate medical education accredited by the ACGME that is beyond the requirements for eligibility for first board certification in the discipline. Such physicians are also termed subspecialty residents. Other uses of the term "fellow" require modifiers for precision and clarity, eg, "research fellow".
Fifth Pathway - One of several ways that individuals who obtain their undergraduate medical education abroad can enter GME in the United States. The fifth pathway is a period of supervised clinical training for students who obtained their premedical education in the United States, received undergraduate medical education abroad, and passed Step 1 of the United States Medical Licensing Examination. After these students successfully complete a year of clinical traning sponsored by an LCME-accredited US medical school and pass USMLE Step 2, they become eligible for an ACGME-accredited residency as an international medical graduate.
General Specialty Program - The primary specialty (e.g., anesthesiology, family practice, internal medicine) to which subspecialty programs are attached. Provides resident physicians, under supervision, with the knowledge and skills needed to be practitioners in a specified area of medical practice. General specialty programs function within an institution and are subject to all ACGME accreditation actions, policies, and procedures. Completing an ACGME-accredited residency in a general specialty program is one of the requirements of certification by a specialty board.
GME - Graduate Medical Education
Graduate Year - Refers to an individual's current year of accredited GME; this may or may not correspond to the program year. For example, a resident in pediatric cardiology could be in the first program year of the pediatric cardiology program but in his/her fourth graduate year of GME (including the 3 prior years of pediatrics). The Accreditation Data System (ADS) refers to Program Year rather than Graduate Year.
Graduate Year 1 (GY1) - Used in connection with residents and with residency positions to indicate the first year of training after medical school. Individuals in GY1 positions who plan to complete the entire program are counted as enrolled in Graduate Year 1 (GY1), Categorical. Individuals in GY1 positions who are using their first year in a residency program as a prerequisite to enter another specialty or subspecialty program are counted as enrolled in Graduate Year 1 (GY1), Preliminary. Not all specialties offer GY1 although by definition residents in GY1 positions are not required to have prior GME, some residents who fill such positions may have had previous training.
In-House Call - Duty hours beyond the normal work day where residents are required to be immediately available in the assigned institution.
Institution - An organization having the primary purpose of providing educational and/or health care services (e.g., a university, a medical school, a hospital, a School of Public Health, a health department, a public agency, an organized health care delivery system, a consortium, an educational foundation).
	"Major" Participating Institution - An institution to which residents rotate for a required experience and/or those that require explicit approval by the appropriate RRC prior to utilizations. Generally to be designated as a major participating institution, in a 1-year program, residents must spend at least 2 months in a required rotation; in a 2-year program, the rotation must be 4 months; and in a program of 3 years or longer, the rotation must be at least 6 months. RRCs retain the right to grant exceptions to this formula.
	"Other" Participating Institution - An institution that provides specific learning experiences within a multi-institutional program of GME. Subsections of institutions, such as a department, clinic, or unit of a hospital, do not qualify as participating institutions. Generally, the residents must spend at least 1 month or longer in a rotation to be considered "other participating".
	"Sponsoring" Institution - The institution (or entity) that assumes the ultimate (financial and academic) responsibility for a program of GME.
Institution Type of Relationship - Some Residency Review Committees refer to "Major" participating institutions as having an Affiliated or Integrated relationship.
	Affiliated - The program may establish an affiliated relationship with another institution for the purpose of limited rotations. Rotations to affiliated institutions may not exceed 6 months.
	Integrated - An institution may be considered integrated when the program director a) appoints the members of the faculty and is involved in the appointment of the chief of service at the integrated institution, b) determines all rotations and assignments of residents, and c) is responsible for the overall conduct of the educational program in the integrated institution. There must be a written agreement between the sponsoring institution and the integrated institution stating that these provisions are in effect. Rotations to integrated institutions are not limited in duration.
Institutional Review - The process undertaken by the ACGME to judge whether a sponsoring institution offering GME programs is in substantial compliance with the Institutional Requirements.
Intern - Historically, "intern" was used to designate individuals in the first year of GME; less commonly it designated individuals in the first year of any residency program. Since 1975 the ACGME has not used the term, instead referring to individuals in their first year of GME as residents.
Internal Review - The formal process undertaken by a sponsoring institution of its individual ACGME accredited programs in conformity with Section I.B.3.c of the Institutional Requirements to evaluate the sponsored programs.
International Medical Graduate (IMG) - A graduate from a medical school outside the United States and Canada (and not accredited by the Liaison Committee on Medical Education (LCME)). IMGs may be citizens of the United States or Canada who chose to be educated elsewhere or non-citizens who were admitted to the United States by US immigration authorities. All IMGs should undertake residency training in the United States before they can obtain a license to practice medicine in the United States even if they were fully trained, licensed, and practicing in another country.
In-Training Examination (also known as "in-service examination") - Examinations to gauge residents' progress toward meeting a residency program's educational objectives. Certification boards of the American Board of Medical Specialties (ABMS) and medical specialty societies offer in-training examinations on a periodic basis.
JCAHO - The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is a quality oversight body for health care organizations and managed care in the United States.
LCME - Liaison Committee on Medical Education, an agency cosponsored by the American Medical Association and Association of American Medical Colleges, with participation from the Canadian Medical Association for schools in Canada, accredits educational programs in allopathic schools of medicine in the United States and Canada. Allopathic schools of medicine grant a doctor of medicine (MD) degree.
Major Participating Institution - An institution to which residents rotate for a required experience and/or those that require explicit approval by the appropriate RRC prior to utilizations. Generally to be designated as a major participating institution, in a 1-year program, residents must spend at least 2 months in a required rotation; in a 2-year program, the rotation must be 4 months; and in a program of 3 years or longer, the rotation must be at least 6 months. RRCs retain the right to grant exceptions to this formula.
Medical School Affiliation - Institutions that sponsor an accredited program may have a formal relationship with a medical school. Indicate that a medical school affiliation exists for an institution (or program) if the institution (or program) is an important part of the teaching program for the medical school. Do not include only brief, occasional, and/or unique rotations for students or residents.
Months of Rotation - Refers to the total number of months a typical resident spends at an institution. If the total number of months that each resident spends at a location is different for different residents, use the average (a decimal number may be reported).
National Resident Matching Program (NRMP) - Informally referred to as the "Match," this process matches GME programs and applicants to those programs. Managed by the Association of American Medical Colleges (AAMC), the NRMP system was developed to provide both applicants and residency program directors an opportunity to consider their options for accepting and offering appointments to residency programs, respectively, and to have their decisions announced at a specific time.
Ownership Type of Institution - Refers to the governance, control or type of ownership of the institution.
Pager Call (see also At-Home Call) - A call taken from outside the assigned institution. The frequency of pager calls, or at-home calls, is not limited to every third night or less.
Preliminary Positions (see also "Graduate Year 1") - Positions for residents who are obtaining training required to enter another program or specialty. Some residents in preliminary positions may move into permanent positions in the second year. Preliminary positions are usually 1 year in length and usually offered for Graduate Year 1. Internal medicine, surgery, and transitional year programs commonly offer preliminary positions.
Preliminary Designated Positions - Residents matched by/for other specialties. The resident is designated as having a permanent position after completing the preliminary year(s). Specialties that do not designate preliminary positions will use this option to indicate preliminary positions.
Preliminary Non-Designated - Residents accepted into the program for 1 or 2 years of training; these residents do not have designated permanent positions in the current program or another program at time of acceptance.
Primary Teaching Hospital - If the sponsoring institution is a hospital, it is by definition the primary or principal teaching hospital for the residency program. If the sponsoring institution is a medical school, university or consortium of hospitals, the hospital that is used most heavily in residency program is the primary teaching hospital.
Program - The unit of specialty education, comprising a series of graduated learning experiences in GME, designed to conform to the program requirements of a particular specialty.
Program Director - The official responsible for maintaining the quality of a GME program so that it meets ACGME accreditation standards. Other duties of the program director include preparing a written statement outlining the program's educational goals; providing an accurate statistical and narrative description of the program as requested by the Residency Review Committee (RRC); and providing for the selection, supervision, and evaluation of residents for appointment to and completion of the program.
Program Merge/Split/Absorption - In a merge, two programs combine to create one new program; the new program becomes the accredited unit and accreditation is voluntarily withdrawn from both former programs. In a split, one program divides into two separate programs and each program receives accreditation. In absorption, one program takes over the other program; the absorbed program is granted voluntary withdrawal status, while the other program remains accredited.
Program Letters of Agreement - The sponsoring institution must ensure that for each accredited program appropriate letters of agreement exist between the sponsoring institution and the participating institutions used by a program that provides specific learning experiences.
Program Year (see also "Graduate Year") - Refers to the current year of training within a specific program; this may or may not correspond to the graduate year. For example, a resident in pediatric cardiology could be in the first program year of the pediatric cardiology program but in his/her fourth graduate year of GME (including 3 prior years of pediatrics). The Web accreditation system tracks residents according to his/her current year in the program, regardless of prior training.
Resident - A physician at any level of GME in a program accredited by the ACGME. Participants in accredited subspecialty programs are included. Other uses of the term "resident" require modifiers.
Residency Review Committee (RRCs) - The 27 committees within the ACGME system that meet periodically to review programs within their specialty and/or subspecialty, propose Program Requirements for new specialties/subspecialties, and revise requirements for existing specialties/subspecialties
Scholarly Activity - Educational experiences that include active participation of the teaching staff in clinical discussions, rounds, and conferences in a manner that promotes a spirit of inquiry and scholarship; active participation in journal clubs, research conferences, research, particularly in projects that are funded following peer review and/or result in publications or presentations at regional and national scientific meetings; offering of guidance and technical support, e.g., research design, statistical analysis, for residents involved in research; and provision of support for resident participation as appropriate in scholarly activities. May be defined in more detail in specific Program Requirements.
Sponsoring Institution (See also "Institution") - The institution (or entity) that assumes the ultimate (financial and academic) responsibility for a program of GME.
Subspecialty Program - Provides advanced GME in a narrow field of study within a medical specialty, e.g., geriatric medicine within the field of internal medicine. Most subspecialty programs are subject to ACGME accreditation actions, policies, and procedures. Completing an ACGME-accredited residency in a particular subspecialty program may qualify the physician to seek certification by the related subspecialty board. Some subspecialty programs are accredited independently of the related general specialty program and are not dependant on a general specialty program. Other subspecialty programs function only in conjunction with an accredited general specialty program, and the subspecialty program's accreditation status is related to the status of the accredited general specialty program. The Residency Review Committee (RRC) determines whether accreditation of a given subspecialty program is dependant on accreditation of the related general specialty program.
Substantial Compliance - The determination of substantial compliance results from a judgment based on all available information as to the degree that the entity being evaluated meets accreditation standards.
Suggested - A term, along with its companion “strongly suggested,” used to indicate that something is distinctly urged rather than required. An institution or a program will not be cited for failing to do something that is suggested or strongly suggested.
Teaching Staff - Any individual who has received a formal assignment to teach resident physicians. In some institutions appointment to the medical staff of the hospital constitutes appointment to the teaching staff.
Time Off - One (1) continuous and full 24-hour period free from all administrative, clinical and educational activities.
Transitional Year Program - Broad-based clinical training in an ACGME-accredited residency program that provides a balanced GME curriculum in multiple clinical disciplines. Developed for the year between medical school graduation and a specialty residency program, the transitional year is designed to facilitate the choice of and/or preparation for a specific specialty; it is not meant to prepare participants for the independent practice of medicine. To sponsor a transitional year program, an institution and its affiliate must conduct two or more ACGME-accredited programs that participate in the transitional year.