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FAQs for Medical Education Institutions of LCME-Accredited, US Osteopathic, and Non-US Medical School Applicants

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FAQs by topic

General FAQs

What is the CPA? What are the organizations involved?

The Coalition for Physician Accountability (Coalition), a cross-organizational group composed of AACOM, AAMC, ABMS, ACCME, ACGME, AMA, AOA, CMSS (OPDA), ECFMG, FSMB, LCME®, NBME, and NBOME, was established in 2009 to promote professional accountability by improving the quality, efficiency, and continuity of the education, training, and assessment of physicians, from medical school through practice. The Coalition shares a strong commitment to protecting the public’s health and safety through the delivery of quality health care.

Why is the Coalition addressing COVID-19 pandemic-related issues?

The Coalition established the Work Group on Medical Students in the Class of 2021 Moving Across Institutions for Post Graduate Training (Coalition WG) to consider the COVID-19 pandemic’s impact on current M3/rising senior students, particularly as applicants prepare for the residency selection process. Limitations on learners’ ability to work in the clinical learning environment, restrictions on individual travel, and the inability to complete assessments and educational requirements will render the traditional residency selection process impossible to replicate this year. Yet, the Coalition WG believes a meaningful and effective selection process can still be achieved for both students and residency programs. This Coalition WG was charged with addressing three major issues facing applicants and training programs as they prepare for the 2020-2021 residency application cycle: (1) away rotations, (2) in-person interviews for residency, and (3) the ERAS timeline.

What approach did the Coalition WG use to address these issues?

The WG established the following guiding principles as a framework for considering those three important issues under its charge:

  • Patient care and the safety of the community, patients, and learners are most important.
  • Medical schools must prioritize meeting core competencies anchored in accreditation and graduation requirements for their own students. Likewise, residency programs must prioritize fulfilling competencies and meeting accreditation and specialty board certification requirements of current residents.
  • The residency selection process should be as equitable as possible for applicants, recognizing the diversity of learners and educational programs and the differing missions and priorities of schools, training programs, and institutions.
  • A concerted effort to reduce anxiety and promote well-being of students, program staff, and institutions (home and host) in an already stressed system is critical.
  • We anticipate stakeholders will commit to policies that prioritize these goals yet recognize the necessity for innovation and flexibility in this new COVID-19 environment.
  • Recommendations at the national level are intended to promote fairness across the country and reinforce our commitment to an equitable process for all.

What feedback was sought in making these recommendations?

Members of the Coalition WG included representatives from the Accreditation Council for Graduate Medical Education (ACGME), American Association of Colleges of Osteopathic Medicine (AACOM), American Medical Association (AMA), Assembly of Osteopathic Graduate Medical Educators (AOGME), Association of American Medical Colleges (AAMC), Council of Medical Specialty Societies/Organization of Program Director Associations (CMSS/OPDA), Education Commission for Foreign Medical Graduates (ECFMG), and National Resident Matching Program (NRMP). ERAS, NBME, and NBOME participated for the ERAS timeline discussions. As the WG deliberated on these important matters, broader feedback on the guiding principles, away rotations, and in-person interviews was sought from across the constituency of each organization and was considered heavily in the WG’s deliberations and recommendations. Subject matter experts were invited to discuss the relevant issues and shared feedback and recommendations as appropriate. As final recommendations were drafted, the Coalition WG shared them with constituents, member organizations, and the Coalition.

How will these recommendations be enforced?

These recommendations are designed to prioritize patient, student, and community safety. Neither the Coalition nor its member organizations intend to police or enforce these guidelines; however, the recommendations reflect the Coalition WG’s collective sense of how to proceed, and we urge each medical school, sponsoring institution, and residency program to carefully consider these recommendations in the context of their local situations and to commit to working together to create a safe, equitable, transparent, and successful residency selection cycle for all involved.

What is the student's responsibility to comply with these recommendations?

Students have a responsibility to the health of individuals in their community and where they do their rotations to follow national, state, local, and medical school guidance for travel and other COVID-19-related restrictions and to follow institutional policies, including personal protective equipment and infection control policies. Students are also encouraged to stay abreast of developments in their specialty relating to these recommendations. For example, emergency medicine and neurosurgery academic professional associations have advised program directors to look unfavorably at applications from students who have completed several away rotations. Students are encouraged to work with their medical school advisors to determine the best approach to complying with these recommendations.

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Away Rotation FAQs

How many away rotation opportunities will exist this year?

The number of available away rotations will vary widely by institution, specialty, and program. Each program will need to decide, based on its own community’s experience with COVID-19 and the changes that experience brings to the clinical learning environments, whether it can offer any rotations to visiting students at all this year. Under some conditions, students from one geographic location who are invited into a facility in another location could increase the likelihood of carrying an infection into the host institution or community, or from the host institution to the student’s home site and community. It is likely that the number of away rotations offered to students this year will be less than in the past. In addition, guidance from several specialty and program director groups is urging limitations for away rotations for this cycle. As medical schools and host institutions establish policy within the context of their own individual elective offerings and with the Coalition WG’s recommendations in mind, students are encouraged to work closely with their medical school advisors to determine how they should proceed.

How many away rotations are recommended?

To prioritize the safety of the community, patients, and learners, the Coalition WG recommends that away rotations be discouraged, except under very narrow circumstances as specified in the final report. Students are encouraged to work closely with their medical school advisors to determine how many, if any, away rotations are recommended for their individual circumstances.

Does this guidance limit the number of weeks per away rotation?

No, it only affects whether a student is approved to do the rotation at all, not how many weeks a student can be or should be permitted to complete an away rotation. The decision about the length, format, and content of the rotation remains with the program offering the rotation.

How will schools verify eligibility?

Each school will develop a policy and plan for communicating to their students and faculty how they will implement the away rotation recommendation, including eligibility, once they have considered the recommendation in the context of their individual elective offerings and graduation requirements.

What are alternatives to away rotations?

Some programs are planning virtual events to allow students to have some of the experiences they may have had during an in-person rotation at their site. Students should work with their medical schools and advisors to make sure their knowledge, skills, and attitudes are well-documented in their application. Applicants and programs should also share information on desires and expectations for program culture and priorities. More information and links to specialty resources are available in the compendium document accompanying the recommendations.

What is available regarding specific specialty guidance related to away rotations?

Many specialty societies have given guidance to residency programs about the use of away rotations this year, and others have been awaiting the release of the Coalition WG’s recommendations to complete their own. ERAS is collecting a list of specialty statements; check back often for updates.

What if a student already has rotations scheduled do I have to cancel them?

On May 11, 2020, the Visiting Students Learning Opportunities (VSLO®) service released guidance for medical schools and students. Review their release and FAQs or, to get your specific questions answered, contact them here or at (202) 478-9878.

Does the Coalition WG’s away rotation recommendations and exceptions pertain to virtual away rotations?

The away rotation recommendation, including the two exceptions, outlined in the Coalition WG’s final report were intended to provide guidance for in-person away rotations only.  No limitations were recommended for virtual rotations.

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Virtual Interview FAQs

My institution does not have the resources to make fancy videos or conduct virtual interviews. How do I comply with this recommendation?

Institutions are encouraged to think creatively about what is most important about their program and why applicants would consider making it their home. Applicants are seeking thoughtful, trustworthy content to aid their decision-making about where they will spend the next few years training. How that information is delivered is far less important than the transparency and authenticity of what is delivered. Programs and institutions are encouraged to work together on what they wish to share as an institution and community, then hone in on specific unique qualities of the individual program. While not all benefits of in-person interviews can be replicated in a virtual environment, a thoughtful and dedicated approach can maximize the value of remote interactions.

If I start out with in-person interviews, what’s the downside of switching over to virtual interviews if COVID-19 resurges?

Forecasts are predicting a resurgence of COVID-19 in the fall or winter, so it seems unlikely that programs will be able to complete an entire interview season with in-person interviews. Interview best practices call for a standardized process where all applicants are interviewed in the same manner. Switching to virtual interviews midcycle may be challenging for the faculty and staff involved in the process, and applicants who are unable to complete an in-person interview could be disadvantaged. Programs are encouraged to consider virtual interviews for the entire residency application cycle.

How will I know if a program is conducting in-person or virtual interviews?

Many specialties have shared COVID-19-related guidance with ERAS for the upcoming cycle; however, applicants may need to consult with individual training programs to get specific details.

There are important aspects of the in-person interview that cannot be captured during a virtual interview, like informal gatherings with residents and faculty. How can programs get the information they need if applicants are unable to travel to the program?

While it is true that all benefits of an in-person interview cannot be replicated virtually, technology does allow for programs and applicants alike to maximize information gathering virtually. Programs can consider developing a virtual tour of the hospital and community. They can create informal, private meet-ups with residents to interact and gather information and ask residents to share five things they most appreciate about the program or institution. Programs can host opportunities for faculty and interviewees to discuss research and scholarly activities or set aside five to 10 minutes during the interview for the program director to greet each interviewee, share an overview of the program/institution/community, and answer questions. Consult the compendium that accompanies these recommendations for other ideas.

What if something goes wrong that could jeopardize my chances with the applicant/program?

Even as we adjust to the inevitability of this new normal of virtual interactions, replacing the benefits applicants and programs derive from in-person interviews will require adjustments on both sides. As more medical schools turn to virtual curricula as stopgap measures to keep advancing the third-year curricula and the clinical environment looks to telemedicine to provide patient care in a COVID-19 environment, we expect that the medical education community will continue to innovate and share best practices for how to prepare and perform during virtual interviews. And just as applicants, faculty, and staff have adapted to these new innovations in the clinical environment, that familiarity coupled with a dose of patience with each other will get them successfully through these extraordinary times.

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ERAS Timeline FAQs

When is ERAS releasing its 2020-2021 timeline?

On May 11, 2020, the Electronic Residency Application Service (ERAS®) released its 2020-2021 application cycle timeline to programs, schools, and applicants. Address specific questions to the ERAS support team.

I live in the snowy Northeast and receive well over 5,000 residency applications annually. How am I to complete my residency selection process with ERAS opening to residency programs so late?

We understand that this application cycle will present many challenges to the program and applicant communities.  One of the guiding principles the Coalition WG discussed as we deliberated about the ERAS timeline was a residency selection process that was as equitable as possible for applicants, recognizing the diversity of learners and educational programs and the differing missions and priorities of schools, training programs, and institutions.  A level playing field for the applicants requires an opportunity to submit the most complete application possible to programs to review and evaluate.  COVID-19 has taken an important portion of the clinical curriculum from most medical students.  The decision to request a delay in ERAS’ opening to programs included input from program directors and schools and was to give students time to complete important clerkships, electives and assessments so that programs might have as complete an application as possible by which to evaluate all applicants.

Of note, the recommendation that all programs commit to virtual interviews and visits was in recognition of both a possible COVID-19 resurgence and the possible negative impact of weather in a shorter interview window.  While we acknowledge that these recommendations cannot address every eventuality and that their impact may be felt more acutely by some, they were offered to provide the best path forward to promote consistency and fairness across the country and to reinforce our commitment to an equitable process for all.

Will there be a change in the NRMP Match timeline to accompany the ERAS change?

The Coalition WG was not charged with addressing changes to the NRMP Main Match timeline. Questions related to the NRMP Main Match timeline for the residency applicants and programs should be directed to the NRMP at support@nrmp.org.

Will there be a change in the Urology Match timeline to accompany the ERAS change?

Since Urology programs receive their applications via ERAS, the changes to the ERAS timeline will apply to Urology programs as well; however, the Coalition WG was not charged with addressing changes to the Urology Match timeline. Questions relating to the Urology Match timeline should be directed to the American Urology Association, which manages that match, customerservice@AUAnet.org.

Will there be a change in the San Francisco Match timelines for Ophthalmology and Plastic Surgery programs?

The Coalition WG was not charged with addressing changes to the San Francisco Match timelines. Guidance from Ophthalmology and Plastic Surgery can be found on the ERAS website; additional information related to the San Francisco Match timeline can be found on their website, www.sfmatch.org.

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FAQs Specific to the Osteopathic Community

What is considered a home institution or system?

The “school system” of a COM is generally understood to include clinical rotations and other clinical experiences at partner institutions where the COM has an agreement for the clinical education being provided, as well as for curricular, educational, and sometimes scheduling support.

What are away rotations? What are audition rotations?

Away rotations are any rotation that is (1) not in the COM’s school system and (2) requires the student to travel from their clinical site. These rotations are often, but not always, in a residency setting. An audition rotation is one in which a student participates at a residency program in a location they are interested in matching to for residency. On this rotation, they can demonstrate their knowledge, skills, and attitudes to a residency program over the course of several weeks or a month, possibly obtain a letter of recommendation, and learn more about the program’s culture. Audition rotations that take place outside a COM’s system are both audition rotations and away rotations, and that sometimes leads to confusion.

In the compendium of resources that accompanies the recommendations, we tried to use “away rotations” to refer to out-of-system rotations that are not audition rotations and “audition rotations” only to describe away rotations that also serve as audition rotations.

How many away rotation opportunities will exist this year?

The number varies widely by program. Each program will need to decide, based on its own community’s experience with COVID-19 and the changes that experience brings to the clinical learning environments, whether it can offer any rotations to visiting students at all this year. Of course, under some conditions, every student from another geographic location who is invited into their facility increases the likelihood that an infection will be carried into the host institution or community, or from the host institution to the student’s home site and community. It is likely that the number of away rotations offered to students this year will be less than in the past. However, COM students may have access ― or even greater access ― to some or all rotations because fewer students are expected to enroll in away rotations this year. In addition, guidance from several specialty and program director groups are urging limitations for away rotations for this cycle.

How many away rotations are recommended?

To prioritize the safety of the community, patients, and learners, the Coalition WG recommends that away rotations be discouraged, except under very narrow circumstances as specified in the final report. Students are encouraged to work closely with their COM advisors to determine how many, if any, away rotations are recommended for each student’s circumstances.

Does this guidance limit the number of weeks per away rotation?

No, it only affects whether a student is approved to do the rotation at all, not how many weeks a student can or should be permitted to do the rotation. The decision about the length, format, and content of the rotation remains with the program offering the rotation.

How was the voice of osteopathic medicine incorporated into the recommendations?

AACOM staff representing AACOM’s member COMs and the AOGME membership participated actively in the Coalition WG, and many of their suggestions were included in the final documents. AACOM also circulated draft documents among its membership to get comments from a broader audience at several points during the process.

How will schools verify eligibility?

The process for verifying eligibility is outlined here. As stated in the compendium document that accompanies the recommendations, “Each school should review the … recommendation in the context of their individual elective offerings and graduation requirements and develop a policy and plan for communicating the school-specific implementation of this recommendation to their students and faculty.”

What is the student's responsibility to comply with these recommendations?

Students have a responsibility to the health of individuals in their community and where they do their rotations to follow national, state, local, and COM guidance for travel and other COVID-19-caused restrictions and to follow institutional policies, including personal protective equipment and infection control policies. AACOM also encourages students to stay abreast of developments in their specialty of interest that may affect their applications for away and audition rotations. For example, academic professional associations for emergency medicine and neurosurgery have advised program directors to look unfavorably at a student who does several away rotations. AACOM is asking students to work with their advisors and deans to determine the best options for away and audition rotations.

What are alternatives to away rotations?

Some programs are planning virtual events to allow students to have some of the experiences they may have had during an in-person rotation at their site. Students should work with their COMs and advisors to make sure their knowledge, skills, and attitudes are well-documented in their application. Students and programs should also share information on desires and expectations for program culture and priorities. More information and links to resources are available in the compendium document accompanying the recommendations.

What is available regarding specific specialty guidance related to away rotations?

Many specialty societies have given guidance to residency programs about the use of audition rotations this year.

What if I need an away rotation to graduate? Will I be able to fulfill requirements for graduation?

Yes. One of the exemptions provided in the recommendations is for learners who need an away rotation to fulfill a graduation or accreditation requirement. As depicted in the vignettes, students who need an away rotation to fulfill a graduation or accreditation requirement qualify for one of the exemptions specifically permitted in the guidance.

What if a student already has rotations scheduled ― do I have to cancel them?

The Visiting Students Learning Opportunities (VSLO®) service has developed guidance for COMs and students. To get your specific questions answered, contact them here or at (202) 478-9878.

What will happen to third-year requirements from the COCA related to training in GME?

The COCA has indicated a willingness to review proposals for changes to curricula or requirements due to the COVID-19 pandemic. COMs with specific proposals should contact the COCA directly.

What OMS level does this recommendation affect?

These recommendations apply to all students applying for away rotations (including audition rotations), which generally are fourth-year students in the 2020-2021 academic year. However, if a COM normally allows third-year students to participate in away rotations, that practice can continue, and these guidelines apply in the same way as for fourth-year students (i.e., exceptions for students who have not had access to a clinical rotation with a residency in their specialty of interest or who need a rotation to complete a requirement for graduation or accreditation).

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