Policy of the Graduate Medical Education Committee
Section: Resident Support/Conditions for Appointment
Subject: Financial Support and Apportionment of Positions
Number: 2.100
Date Developed: 1/96
Last Review/Revision: 12/05
Replaces: policy of same name, dated 2/99
ACGME Requirement: Institutional IIB

Purpose
To determine the procedures for allocation of financial and other resources to support residents (includes fellows) and to determine the apportionment of resident positions among the residency/fellowship programs.

Definition
Residency Position Allocation Committee (RPAC):
The committee, chaired by the Dean of the College of Medicine, includes representatives from the major teaching hospitals with the authority to commit that hospital’s resources, the appropriate dean’s office support staff, and representatives from the faculty who voice the need for educational consideration in allocating positions and resources for the support of graduate medical education.  The committee examines the resident FTE requests submitted by Program Directors and makes determinations concerning allocation of resources and positions when the requests exceed the money available.

 

Policy
All residents are provided with appropriate financial support and benefits to ensure that they are able to fulfill the responsibilities of their program.

 

Financial support, including stipends, benefits and apportionment of positions, is determined by the Residency Position Allocation Committee which considers recommendations from the GMEC Finance Subcommittee. 

The apportionment of positions for residents among programs consonant with the Residency Review Committee policies is determined by balancing funds available for graduate medical education against requests for residency positions. 

Stipends and Benefits
The Associate Dean for GME obtains the report from the Council of Teaching Hospitals (COTH) on Resident Stipends and Benefits for the prior academic year. 

Procedure
1.         Each fall, the GMEC reviews the COTH information and makes recommendations for stipends for all PGY levels and benefits to the RPAC. 
2.         The RPAC reviews the recommendations of the GMEC and makes final decisions based on the financial resources of the
            participating institutions.
3.         Following the decision by the RPAC, the Associate Dean for GME distributes the final written decision to all Program Directors
            and Departmental Chairpersons.
4.         The Director of Housestaff Records prepares a final budget summary for each hospital and submits it to each designated hospital official. 

Allocation of Positions
The Associate Dean for GME and the Director of Housestaff Records must reconcile FTE requests by Program Directors with the support offered by the various hospitals prior to the deadline for the National Residency Matching Program (NRMP) lists.  This reconciliation will occur early enough to influence resident recruitment by the department.  The allocation of positions will be determined according to the following procedure. 

Procedure
1.         Each Fall, the Director of Housestaff Records sends a resident FTE request to each Program Director.  The deadline for the return
            of these requests is the first week in October.  The request must include carefully documented support for any changes in the
            requested positions.  During the same period, the Director of Housestaff Records asks the hospitals for a statement of support.
2.         Between the first week in October and the first week in November, the Director of Housestaff Records and the Associate
            Dean for GME attempt to reconcile the requests within the support budget.
3.         The Residency Position Allocation Committee determines allocation of positions according to the following:

a. The committee meets in early November to examine the requests in light of the hospitals’ budgets

b. The committee makes adjustments to position requests so that the requests are reconciled to the available hospitals’ budgets.

c. In the event the number of positions must be reduced, every effort is made to confine the reductions to unfilled or PGY-1 positions for the subsequent year.

d. Positions for residents currently in the program will not be reduced except under extreme financial conditions. If this occurs, the Program Director will be notified immediately, and the Program Director will assist the residents in identifying programs in which they can continue their education (see GMEC policy on Reduction in Size or Closure of a Training Program). 

e. The number of positions available for each program is communicated to the Program Director, Program Coordinator, Departmental Chairperson and Departmental Business Manager

f. Appeals are made to the Dean, College of Medicine, who may reconvene the committee at his discretion. 

g. Following this process, the Director of Housestaff Records communicates the final number of funded positions to the Program Director, Program Coordinator, Departmental Chairperson and Departmental Business Manager in time to make adjustments in the NRMP quotas. 

4.         Positions not filled in the Early Match or in the NRMP are retained by the departments and may be filled until July 1 of each year.  Likewise, positions that are filled and then vacated may be refilled by the departments until July 1 of each year.  However, in the event of decreased financial conditions, the decision to fill unfilled or vacated positions will require written approval of the Dean. On July 1, all unfilled positions will return to the Housestaff Office (the positions will no longer be designated to the department).

5.         By January of each year the Director of Housestaff Records provides to each hospital a summary of the number of positions, benefits and administrative budget (including liability insurance and counseling services). 

6.         At any time during the academic year, requests to add a resident position can be made by the Program Director to the Director of Housestaff Records.  A letter must accompany the request from the appropriate hospital(s) guaranteeing a funding source to cover the salary and fringe benefits of the resident.  This letter must be signed by the appropriate hospital member(s) of the RPAC.

Residency Position Allocation Committee
This committee is defined above and its membership is as follows:

a. Dean of the College of Medicine, Chairman

b. Medical Director of University Hospital or designee with authority to commit resources

c. Medical Director, Arkansas Children’s Hospital or designee with authority to commit resources

d. Medical Director, Central Arkansas Veteran Healthcare System or designee with authority to commit resources

e. Three clinical Departmental Chairpersons, elected from and by their peers, who serve staggered 3-year terms. These Chairpersons may designate a program director to serve as their proxy.

f. Chair, Graduate Medical Education Committee

g. Executive Associate Dean for Academic Affairs, ex-officio without vote

h. Associate Dean for Graduate Medical Education, ex-officio without vote

i. Director, Office of Housestaff Records, ex-officio without vote

j. One resident representative to be selected annually by the Resident Council.