Role and Responsibilities of the Program Administrator

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ACGME Citation

II.C.1. There must be a program coordinator.

II.C.2. At a minimum, the program coordinator/administrator must be supported at 50 percent FTE (at least 20 hours per week) for administrative time.

II.C.2.a). Programs with more than 20 residents should be provided with additional administrative personnel.

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Job Duties and Responsibilities

The following is a list of duties common to most Program Coordinators/Administrators:

• Review and ensure compliance and implementation of the Accreditation Council for Graduate Medical Education (ACGME) and specialty/subspecialty board policies and requirements.
• Assist Program Director and faculty in the development of program curriculum, including integration and evaluation of core competencies into all educational activities.
• Serve as liaison for residents/fellows; evaluate morale and respond to concerns.
• Maintain files on all residents/fellows.
• Serve as a member of, develop agendas, take minutes, and implement decision and actions for residency/fellowship committees (i.e. GME Committees, Program Evaluation Committees (PEC), etc.
• Serve as a key member in finalizing and submitting the Annual Program Evaluation to GME office
• Oversee residency/fellowship program budget.
• Review, update and implement program-specific policies.
• Compile data and prepare/submit reports for Program Director, GME office, accrediting bodies, and other organizations to include, but not limited to:  
  • Annual Program Evaluation, 
  • CCC documents for evaluations 
  • Semi-Annual Evaluations for PD and resident
  • Milestones to ACGME bi-annually
  • Distribution of in-service training results 
• Create, distribute, track and file evaluations 
• Track and monitor resident/fellow case logs and alert Program Director and Service of deficiencies.
• Track and monitor resident/fellow conference attendance
• Track and monitor faculty conference attendance
• Track and monitor resident / faculty scholarly activity
• Track and monitor faculty development
• Regularly track and monitor resident/fellow duty hours and alert Program Director and Service of violations or potential overage of hours average to mitigate ahead of time.
• Manage all aspects of resident/fellow recruitment, including review all incoming applications through the Electronic Residency application Service (ERAS) or Fellowship Match; create and update brochures, posters and websites; schedule interview dates; and coordinate pre-interview dinners and interview day activities.
• Plan and coordinate department events including resident/fellow orientations, graduation dinner, and welcome parties.
• Proctor and coordinate all required examinations.
• Create, distribute and update resident/fellow rotation schedules, resident/fellow handbook and rotation goals & objectives manual.
• Enter resident/fellow call schedules into hospital on-call schedule software (i.e. Perfect Serve, AMION, etc.)
• Track resident/fellow vacations, sick leave, and leaves of absence.
• Process letters of recommendation and training verification forms.
• Process requests of training verification for all former residents.
• Assist in preparation of chief packets to specific certification board.
• Do administrative documentation submission to GME for all outside rotators and upon approval do necessary access/privileges/capabilities in necessary systems
• May assist with faculty recruitment and new faculty onboarding and orientation

Additional duties for higher level coordinators/administrators/managers may include: 

• Planning and coordinating mock oral examinations (*Note each program’s timeline may vary)
• Coordinating research activities / annual forums (* Note each program’s timeline may vary)
• Manage additional staff members – develop performance standards, hire/fire, conduct performance reviews, and initiate personnel action forms. 
• Interpret hospital policies and procedures and guide staff, residents and faculty to ensure compliance. 

 Many senior level coordinators/administrators/managers have masterfully tested their knowledge, competence and expertise needed to successfully manage their GME programs by passing the National Board of Certification for Training Administrators of Graduate Medical Education Programs (TAGME). Some institutions may require TAGME certification for promotions and justifications for salary increases. 

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ERAS and the NRMP: ERAS®-Electronic Residency Application Service

Electronic Residency Application Service (ERAS®) is a service that transmits the MyERAS application, letters of recommendation (LoRs), Medical Student Performance Evaluations (MSPEs), medical school transcripts, USMLE transcripts, COMLEX transcripts, and other supporting credentials from applicants and their Designated Dean’s Office (DDO) to program directors. ERAS consists of MyERAS, Dean’s Office Workstation (DWS), Program Director’s Workstation (PDWS), Letter of Recommendation Portal (LoRP) and ERAS PostOffice. ERAS simplifies the process for the applicants, schools, and residency programs by transmitting residency application materials and supporting credentials from medical schools to residency programs via the internet.

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Components of ERAS

MyERAS is the website where applicants complete their MyERAS Application, select programs to apply to, and assign documents to be received by programs.

DWS is the software used by the Designated Dean’s Office.  From this software, medical school staff creates the ERAS electronic token that applicants use to access MyERAS.  They also use this system to scan and attach supporting documents to the application, such as photographs, medical school transcripts, MSPE, and LoRs.  These documents are then transmitted to the ERAS PostOffice.

PDWS: is the ERAS Software used by program staff to receive, sort, review, evaluate, and rank applications.

LoRP: is a tool that enables LoR Authors and administrative users to upload letters directly to ERAS. 

ERAS PostOffice: is the central bank of computers that transfer application materials from applicants and their designated dean’s office to residency programs. 

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How Does ERAS Work?

• Applicants receive an electronic token from their Designated Dean’s Office and use it to register with MyERAS.
• Applicants complete their MyERAS application, select programs, assign supporting documents, and transmit their application to programs.
• Schools receive notification of the completed application, and start transmitting supporting documents, transcripts, LoRs, photographs, MSPE.
• Examining boards receive and process requests for score reports.
• Programs contact the ERAS PostOffice on a regular basis to download application materials.

Please visit the website for up-to-date announcements and information regarding ERAS: https://www.aamc.org/services/eras

The NRMP is not a centralized application service for GME programs and cannot advise applicants in selecting specialties or programs.  The NRMP is simply a mechanism for the matching of applicants to programs according to the preference expressed by both parties.

Programs accredited by the ACGME are eligible for participation in the NRMP.  Institutions wishing to offer residency positions in the Match must register their program annually.  As a result of participation in the NRMP, hospitals enrolling programs in the NRMP agree to select senior student applicants in U.S. Allopathic medical schools only through the Match in accordance with the policies established by the NRMP.  Positions may be offered through the Match to physician graduates of U.S. and Canadian schools of allopathic medicine, U.S. schools of osteopathic medicine, and schools of medicine located outside the U.S. and Canada who meet eligibility requirements set forth by the NRMP.

An annual schedule of dates is published by the NRMP on the back cover of the Handbook for Institutions and Program Directors.  Notice of any changes to the schedule is posted to the NRMP web site (www.aamc.org/nrmp). Adherence to these dates is essential.  Materials must be received by the NRMP by the published deadlines. For fellowships, the PC is responsible for knowing this information. 

The listing of an applicant by a program on its Rank Order List or of a program by an applicant on the individual’s Rank Order list establishes a commitment to offer or to accept an appointment when a match results.

Under certain conditions, applicants may withdraw from the NRMP, provided such withdrawal occurs prior to the Rank Order list submission deadline.  

Applicants who have accepted a residency position through any previous match or outside the NRMP Match must withdraw from the NRMP; or if the position secured is for an advanced program the applicant can only rank first year preliminary or transitional programs.

All-In Policy

Beginning with the 2013 Main Residency Match, any program that participates in The Match must register and attempt to fill all of its positions through The Match or another national matching plan.  A “program” is defined by its ACMGE number.  The All-In Policy applies to positions for which the NRMP offers matching services, including PGY-1-2.  All PGY-1 positions and PGY-2 positions in specialties that can begin at either PGY-1 or PGY-2 level must be placed in the Match, regardless of whether the program begins in the PGY-1 or PGY-2 year.  Programs can create “Physician Reserved” (“R”) program tracks in the Registration, Ranking, and Results (R3) system for applicants who are eligible to begin advanced training in the year of the Match.  PGY-2 or higher positions, in specialties accredited to begin only at the PGY-1 level, and PGY-3 or higher positions in specialties accredited to begin at either the PGY-1 or PGY-2 level are not subject to the Policy because the NRMP does not match for those positions.

Programs may withdraw, or may withdraw positions, from the NRMP, provided such withdrawal occurs prior to the date established by the NRMP, and published as the final date for changes in programs and/or available positions for the NRMP.  The registration fee paid by applicants and the GME office is nonrefundable.  

NRMP Main Match Schedule

Note: The Main Match Schedule is distributed to the PCs and PDs each year by the GME office.  Dates will change from year to year.  

Supplemental Offer and Acceptance Program (SOAP)

Note: SOAP-eligible unmatched applicants shall initiate contact with the directors of unfilled programs only through ERAS.  Other individuals or entities shall not initiate contact on behalf of any SOAP-eligible unmatched applicant prior to contact from directors of unfilled programs.  Contact between programs and matched applicants prior to the general announcement of Match results at 1:00 p.m. eastern time on Match Day also is a violation of the Match Participation Agreement.

Federal Funding: CMS (Center for Medicare and Medicaid Services)

The Center for Medicare and Medicaid Services (CMS) is the means by which the hospital gets money to support the residency programs.  CMS established an annual reporting process called the Intern Resident Information System (IRIS).  IRIS must be used to collect Direct Medical Education funds (DME) and Indirect Medical Education funds (IME).

All residents’ time in the hospital is recorded in IRIS.  Although resident rotation information is recorded by residencies based on an academic year, the IRIS report is submitted to Medicare based on the hospitals’ fiscal year.  This is why it is so important that all rotation schedules be maintained and updated at all times. Coordinators should record vacation times as well.

DME Payments are made to cover Medicare’s share of a hospital’s overall cost to operate a resident training program.  These costs include both direct expenses (e.g. resident compensation, teaching physician remuneration), and costs to operate the GME Office, plus hospital overhead to support resident training activities (e.g. administration, housekeeping, and information system costs).

IME payments from Medicare are intended to cover the “indirect” costs of GME.  IME is calculated based on a complicated formula and is paid to teaching hospitals to recognize the higher operating costs that result from teaching activities. 

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Timeline: Residency/Fellowship Timeline of Annual Events

July 

• July 1 is the first day of the academic year for most residency/fellowship programs.  This is the day residents and fellows will officially begin their training.
• Coordinate new resident/fellow orientation and welcome events.
• Make sure PD and Service Chief (usually Department Chair) have submitted the updated resident “capabilities” (clinical privileges).  
• Schedule and coordinate Annual Program Evaluation meeting(s). 
• Residents select their Resident Forum member(s). 
• Continue interviewing fellowship applicants. 
• Deadline to report PY milestones to ACGME via WebADS

August

• Complete ACGME WebADS updates.
• PD needs to complete the physical requirements document distributed by GME. 
• Submit Annual Program Evaluation form to GME office.
• Determine residency interview dates and make any necessary room reservations.

September

• ERAS opens [residency] – applications begin to arrive mid-September. 
• Prepare recruitment materials (brochures, packets, freebies, etc.) for interviewees. 

October

• Orient new faculty on ERAS.
• Review departmental selection criteria and employment law issues with all interviewers. 
• Medical Student Performance Evaluations (MSPE) – aka Dean’s Letters – are released the first week of October. 
• Begin to review residency applications in ERAS (daily). 
• Send residency interview invitations. 
• Begin interviewing residency candidates. 
• Schedule / conduct faculty advisor meetings with residents

November

• Continue interviewing residency candidates. 
• Request resident/fellow completion of semi-annual self-evaluation – CCC Meeting. 
• Schedule semi-annual resident/fellow evaluations. 
• Deadline to update American Board of Surgery rosters

December

• Continue interviewing residency candidates. 
• Conduct & document semi-annual resident/fellow evaluations. 
• Register trainees for in-training board exams (ABS)

January

• Wrap up residency interviews. 
• Coordinate ‘second look’ visits (if your program allows).
• Deadline to confirm quotas in NRMP (end of January) [residency]. 
• Proctor In-training Exam 
• Deadline to report milestones to ACGME via WebADS

February

• Compile and submit preliminary/draft Rank Order list to GME office for review and submission to NRMP. 
• ACGME Annual Education Conference is usually held the last week of February. 

March

• Match Day [residency] occurs mid-March (results are posted on the NRMP website). 
• Email welcome letter to matched applicants. 
• Submit required information for matched applicants to GME Office. 
• Ensure that a decision maker is available to manage SOAP. 
• Schedule / conduct faculty advisor meetings

April

• Chief residents need to be appointed for next academic year. 
• Begin creating next year’s resident rotation schedules. 
• Begin updating resident handbook, rotation goals & objectives manual, policies & procedures, and rotation syllabi. 
• Assist chief residents with ABS application information

May

• Annual Requirements Session provided by GME office for advancing residents. 
• Send new resident/fellow information to appropriate departments and individuals. 
• Request appropriate access and/or training for new residents/fellows. 
• Schedule resident/fellow semi-annual evaluations. 
• Schedule CCC and PEC. 
• Prepare and distribute annual program evaluation forms to faculty and residents. 
• Finalize and print resident handbook, rotation goals & objectives manual, policies & procedures manual, and rotation syllabi. 

June

• Coordinate graduation dinner. 
• Conduct & document semi-annual resident/fellow evaluations – PEC. 
• Update database with graduation resident/fellow information (new address, phone, etc.). 

On-going

• Program Letters of Agreement (PLA) must be current at all times.  
• Keep WebADS current with any changes to program (new faculty, off cycle residents/fellows, leaves of absence, etc.).  
• Quarterly Clinical Competency Committee (CCC) Meetings – must be semi-annual. Some programs have it more frequently. 
• Review resident/fellow duty hours. 
• Review resident/fellow case logs. 
• Monitor monthly evaluation completion. 
• Update rotation/call schedules as needed. 
• Verify resident/fellow training and process letters of recommendation. 

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Recruitment and Selection

Most residents are selected through a formal matching process.  The majority of residency applications are downloaded from the Electronic Residency Application Service (ERAS® – covered in previous section).  ERAS® transmits standardized application, letters of recommendation (LoRs), the Medical Student Performance Evaluation (MSPE), transcripts, USMLE scores, and other supporting credentials from applicants and designated dean’s offices to program directors.  All transmissions are sent to and received from the ERAS® Post Office.  Coordinators usually begin downloading applications and supporting documents on September first.  Each program sets its own deadline for applications to be completed, but once complete, they are reviewed and selections are made for those applicants who are invited for an interview.  The number of sessions and actual interview process is set by each program.  Interviews are offered for predetermined interview sessions.  These offers may be made by e-mail or regular mail.  Phone calls are not recommended because there is no documentation of what is offered.

Interviewing Don’ts

As part of preparing for interviews, make sure all faculty interviewers know what types of questions and topics or behaviors are illegal, inappropriate, and/or prohibited by NRMP.  At the start of each interview season, all interviewers should see the list below as well as read the NRMP Communication Code of Conduct:  

Interviewers must NOT discuss or ask questions regarding:

• Age
• Gender
• Marital Status
• Religion or Creed
• Sexual Orientation
• Immigration Status
• Veteran Status
• Disability (it is permissible to ask about the applicant’s ability to perform the duties and responsibilities described). 
• Family Status (it is permissible to ask whether there are any activities, commitments, or responsibilities which might prevent the meeting of work schedule/attendance requirements, but only if asked of all applicants – both male and female). 
• National Origin (it is permissible to ask about an applicant’s ability to read, write, or speak English or another language when required for a specific job). 

Professional Development: It is stated in the background and intent portion of ACGME’s July 1, 2019 Requirements: “Programs, in partnership with their Sponsoring Institutions, should encourage the professional development of their program coordinators and avail them of opportunities for both professional and personal growth.”  

1. The annual ACGME conference, held at the beginning part of each calendar year is an excellent resource.  (https://www.acgme.org/Meetings-and-Educational-Activities/Annual-Educational-Conference/Program-Coordinator)  In addition to the meeting, there is pre-conference course geared towards PC’s that is invaluable.  

2. The Association of Residency Administrators in Surgery (ARAS) is another great resource. www.arasurgery.org “ARAS is an organization established as an educational resource, a method for encouraging the exchange of ideas, and a support network for persons in the position of managing surgery residency program”.  ARAS meets each year at Surgical Education Week (SEW).  They have a new administrator workshop at the beginning of each conference.  This is an excellent way for new coordinators/administrators/managers to network and be assigned with a mentor.  Dates/places/times to be determined by the Executive Committees with the APDS/ARAS and will be posted on www.apds.org  

3. The National Board for Certification Training Administrators of Graduate Medical Education (TAGME) is an excellent source for professional growth and anyone interested in demonstrating their competence and expertise in managing GME.  To sit for the exam, the applicant must meet certain eligibility requirements, pay the initial application fee and pass an assessment testing the applicants’ knowledge of the day to day GME program management. Once initial certification has been established the applicant will be required to keep up with maintenance certifications.  For more information on eligibility requirements and the assessments, visit: www.tagme.org   

4. It may also be helpful for a new coordinator/administrator/manager to attend their institutions’ residency management software (RMS) conference.  Each individual RMS (for example New Innovations or Med Hub) have conferences each year for their GME customers to show them new software functions, shortcuts, etc.  They generally have workshops customized for new coordinators, intermediate coordinators as well as advanced coordinators.  This is also another helpful resource that can be utilized. 

Also, don’t forget that each time the coordinator/administrator/manager meets someone new at a meeting or conference, is another networking opportunity that also allows healthy ideas and information to be exchanged.