Procedures for Away Rotations

The following procedures must be followed when establishing an away rotation for UCSF residents and fellows. In accordance with University of California Office of the President policy, training affiliation agreements must be established with all sites where UCSF residents and fellows rotate (including one-time elective rotations).

Due to processing time of training affiliation agreements, planning for away rotations should begin far in advance of the rotation start date. To ensure rotations can start on the requested date, allow six months processing time for all agreements. However agreements with government agencies (county hospitals, prisons, etc.) may take at least one year.

Rotations at Participating Sites (required rotations and/or multiple trainees)

Steps for Adding a Rotation at a Participating Site:

  1. The program director must review the ACGME program-specific training requirements to ensure the addition of the new training site complies with the requirements.
  2. The program director must work with the desired training site to establish the rotation. This includes identifying a site director who will oversee all elements of the resident/clinical fellow’s training at the site (i.e. education, supervision, duty hours, etc.).
  3. The program director (or program administrator) must submit a request letter for the addition of the new training site to Office of GME (OGME) for review by the UCSF GME Committee (GMEC) (six months prior to start of rotation/one year for government agencies). The request must include the educational rationale of the new training site, competency-based goals and objectives for the assignment, and identify the site director. The GMEC will review the request at its monthly meeting.
  4. The program director must establish a program letter of agreement (PLA) with the site director at the participating site using the UCSF GME PLA template and write goals and objectives.
  5. At least six months (one year for government agencies) prior to the start of the rotation, the program must submit a training affiliation agreement request form to the Office of Graduate Medical Education via email and include the PLA and goals and objectives. The form will be submitted to the UCSF Office of Government and Business Contracts who will negotiate the agreement with the participating site.
  6. The program will be notified after the training affiliation agreement is executed. Residents and clinical fellows cannot rotate to training sites without an established training affiliation agreement or letter of agreement.
  7. The program director or program administrators must add the participating site to the ACGME accreditation data system (ADS) after the GMEC has approved the new training site and the training affiliation agreement is established. Some review committees (i.e. surgical specialties) require a full committee review of requests for an additional site. There is no guarantee that an additional site will be approved by the ACGME.

“One-Time” Elective Rotations (both domestic and international)

At the discretion of the training program and Office of GME, residents and fellows may participate in one-time rotations at training sites outside of their structured program.

Steps for Requesting a One-Time Rotation:

  1. The resident or fellow must request approval for the proposed rotation from his/her program director. The program director must evaluate the proposed rotation and ensure that it fits within ACGME and board requirements.
  2. The program director must identify a site director at the proposed training site. The site director must agree to oversee all elements of the resident or clinical fellow’s training at the site (i.e. education, supervision, duty hours, etc.).
  3. The program director must establish an educational rationale for the training experience and competency-based goals and objectives for the assignment.
  4. The program director must establish a program letter of agreement (PLA) with the site director at the participating site using the UCSF GME PLA template and write goals and objectives. The program should retain a copy of the PLA for their records. 
  5. At least six months (one year for government agencies) prior to the start of the rotation, the program should select the appropriate letter of agreement (LOA) template from the OGME website. The program should add the rotation information to the highlighted sections of the template and then forward it to the affiliate for review.
  6. The affiliate should either sign the template or make edits and comments directly in the template using track changes.
  7. The program should return the template to the Office of GME by email and include the PLA and goals and objectives. The Office of GME will either collect the designated institutional official’s (DIO) signature or review the edits/comments from the affiliate. Depending on the extent of the edits/comments by the affiliate the LOA may need to be reviewed and/or negotiated by the UCSF Office of Government and Business Contracts.
  8. After the LOA is signed by both the affiliate and DIO, the accreditation manager will send the final copy to the program. The program will then need to send a copy to the affiliate. A copy will be maintained in the UCSF Office of Government and Business Contracts database.
  9. Residents and fellows cannot rotate to training sites without an established training affiliation agreement or letter of agreement.

Note: Per ACGME requirements, it is not necessary to add one-time rotations to ADS.

Questions? Contact Amy Day, Director, Office of Graduate Medical Education