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RESIDENCY REVIEW COMMITTEE FOR NEUROLOGY 515 N State, Ste 2000, Chicago, IL 60610 www.acgme.org VASCULAR NEUROLOGY PROGRAM INFORMATION FORM FOR CONTINUED ACCREDITATION GENERAL INSTRUCTIONS Use this Continued Accreditation PIF in conjunction with the Accreditation Data System (ADS). Follow the provided instructions to create the correct PIF. Go to the Accreditation Data System (ADS) found on the ACGME home page (www.acgme.org ), using your previously assigned username and password, complete the shaded items (as appropriate), print all sections of Part 1 of the PIF and sign the form. If you find items displayed incorrectly change your data using ADS update sections; in some instances you may need to contact your DIO for the entry of updated information. Next, proceed to the section under the RRC for Neurology to retrieve Part 2 of the PIF for continued accreditation in Microsoft Word. Complete Part 2 of the PIF using your preferred word processor (only after Part 1 has been completed). Combine Part 1 and Part 2, number the pages consecutively on the lower center of each page, beginning with Part 1 Section 1 and completing the Table of Contents (found with the Part 2 instructions). After completing the PIF documents, make four (4) copies. They must be identical and final. Draft copies are not acceptable. Mail one (1) set of the completed forms to the site visitor at least 14 working days before the site visit. The remaining three (3) sets should be provided to the site visitor on the day of the visit. The Program Requirements, the Institutional Requirements, and Program Information Form (PIF) may be downloaded from the ACGME Website (www.acgme.org) and should be reviewed carefully. For questions regarding the completion of the form (content), contact the Accreditation Administrator. For Accreditation Data System questions, contact or email [email protected]. For a glossary of terms, use the following link – http://www.acgme.org/acWebsite/GME_info/gme_glossary.asp Program Letters of Agreement (PLA): For new applications, attach at the end of the PIF a program letter of agreement (PLA) for each participating site providing an assignment. Those seeking continued accreditation must have all PLA’s available onsite during the site visit (do not attach to PIF). The program director is responsible for the accuracy of the information supplied in this form and must sign it. It must also be signed by the DIO of the sponsoring institution. document.doc i
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RESIDENCY REVIEW COMMITTEE FOR NEUROLOGY515 N State, Ste 2000, Chicago, IL 60610 www.acgme.org

VASCULAR NEUROLOGY PROGRAM INFORMATION FORM

FOR CONTINUED ACCREDITATION

GENERAL INSTRUCTIONS

Use this Continued Accreditation PIF in conjunction with the Accreditation Data System (ADS). Follow the provided instructions to create the correct PIF. Go to the Accreditation Data System (ADS) found on the ACGME home page (www.acgme.org), using your previously assigned username and password, complete the shaded items (as appropriate), print all sections of Part 1 of the PIF and sign the form. If you find items displayed incorrectly change your data using ADS update sections; in some instances you may need to contact your DIO for the entry of updated information. Next, proceed to the section under the RRC for Neurology to retrieve Part 2 of the PIF for continued accreditation in Microsoft Word. Complete Part 2 of the PIF using your preferred word processor (only after Part 1 has been completed). Combine Part 1 and Part 2, number the pages consecutively on the lower center of each page, beginning with Part 1 Section 1 and completing the Table of Contents (found with the Part 2 instructions). After completing the PIF documents, make four (4) copies. They must be identical and final. Draft copies are not acceptable. Mail one (1) set of the completed forms to the site visitor at least 14 working days before the site visit. The remaining three (3) sets should be provided to the site visitor on the day of the visit.

The Program Requirements, the Institutional Requirements, and Program Information Form (PIF) may be downloaded from the ACGME Website (www.acgme.org) and should be reviewed carefully.

For questions regarding the completion of the form (content), contact the Accreditation Administrator.

For Accreditation Data System questions, contact or email [email protected].

For a glossary of terms, use the following link – http://www.acgme.org/acWebsite/GME_info/gme_glossary.asp

Program Letters of Agreement (PLA): For new applications, attach at the end of the PIF a program letter of agreement (PLA) for each participating site providing an assignment. Those seeking continued accreditation must have all PLA’s available onsite during the site visit (do not attach to PIF).

The program director is responsible for the accuracy of the information supplied in this form and must sign it. It must also be signed by the DIO of the sponsoring institution.

SPECIFIC INSTRUCTIONS

Please read these instructions carefully before work is started on completion of the form.

The following form is designed so that all information regarding multi-hospital programs can be included on one completed form.

A complete set is sent to the Vascular Neurology program director at the sponsoring institution. Completion of the form providing information from all participating sites is the responsibility of the Vascular Neurology program director. One copy should be retained as the institution’s file copy, and three copies of the “master” form should be mailed to the Committee if this is a new application or, upon re-review of the Neurology program. THE VASCULAR NEUROLOGY PROGRAM DIRECTOR IS REQUESTED TO SUBMIT ONLY THREE COPIES, INCLUDING APPENDICIES, OF THE COMPLETE FORM THAT DESCRIBES THE ENTIRE PROGRAM. The Vascular Neurology program director is personally responsible for the content of the completed forms and the information will not be considered complete without his/her signature. The Neurology program director must also co-sign the completed form. All sections of the form applicable to the program must be completed in order to be accepted for review. If any requested information is not available, an explanation should be given and it should be so indicated in the appropriate place on the form.

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GENERAL DIRECTIONS: Many items require a composed response to a specific question. Please respond briefly and concisely. As a rule your response to any individual question should not exceed one page. If you feel that it is imperative to exceed this length please place the response in an addendum at the end of this document identified precisely by page, section and question number.

The form also includes requests for the following additional data, which should be attached as appendices at the end of each copy of the forms and indexed and referenced as the appropriate Appendix:

Appendix A: Explanations, in the event the institution does not hold JCAHO accreditation.Appendix B: Confirming letters from department directors of participating sites (not the full affiliation

agreement).Appendix C: Written statement of supervisory lines of responsibility.Appendix D: Basic and Clinical Sciences Instruction and Lectures

1. Basic Science Curriculum.2. List of lectures, conferences, courses in basic neuroscience.3. List of other Vascular Neurology clinical conferences at each institution.4. List of other courses, conferences, or lectures.

Appendix E: List of other lecturesAppendix F: List of neurological meetings attended by residents.Appendix G: List of resident research projects.Appendix H: List of resident publications.Appendix I: List of Goals and Objectives by year and rotation.

PLEASE DO NOT ATTACH ANY UNNECESSARY MATERIALS SUCH AS REPRINTS, BROCHURES, ANNUAL REPORTS, SCHEDULES, MINUTES OF MEETINGS AND CONFERENCES, ETC. RESIDENCY REVIEW COMMITTEE CONSIDERS ONLY THE INFORMATION REQUESTED ON THE FORM. ANY EXTRA MATERIAL NOT REQUESTED WILL BE DISCARDED. DO NOT SUBMIT ANY MATERIAL LARGER THAN 8.5 X 11 INCHES.

AREAS OF SPECIAL IMPORTANCE IN THE SURVEY OF VASCULAR NEUROLOGY PROGRAMS

PERSONNELA separate conference or meeting room should be set aside for the various interviews that take place during the survey. In addition to the program director, it will be necessary for the site visitor to interview key members of the Vascular Neurology faculty, a member of the administration, neuroradiologists, neurosurgeons and/or vascular surgeons, as well as personnel involved in support services. The resident interview is very important to a successful survey. The site visitor may wish to randomly select certain residents to be interviewed. The surveyor will also want to review any written agreements between the program and the residents, the methodology of resident selection, and the teaching role of the staff involved in the program.

FACILITIESThe site visitor should have the opportunity to see inpatient and outpatient facilities, including support elements in neurosonology, diagnostic neuroradiology, interventional neuroradiology, surgery, and rehabilitation. Library facilities should also be available for inspection.

DATAThe role of the site visitor is that of fact gatherer. The site visitor will, therefore, want to confirm that completed statistical information is available, particularly with regard to the types of admissions, the volume and variety of patient cases, and the procedures performed.

CURRICULUMThe site visitor will want to review the rotation schedule for residents. The site visitor will want to review the role of residents in the teaching of medical students and residents from Neurology and other specialties rotating on the Vascular Neurology service.

OTHERThe site visitor will especially want to gain information concerning the administrative support for the program and the type and extent of involvement in the program by clinical and academic affiliations.

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ACCREDITATION PROCEDURE

Residencies in Vascular Neurology are evaluated by the Residency Review Committee, composed of representatives of the American Academy of Neurology, the American Board of Psychiatry and Neurology and the Council on Medical Education of the American Medical Association, at one of the Committee’s two meetings during the year.The Committee has a cut-off date for preparation of its agenda ten weeks prior to its semi-annual meetings; therefore, there may be a delay of over six months following a survey or submission of materials before notification of the Committee’s action is received by the program, if the report of the surveyor or other materials are received after the cut-off date for the next meeting.

The initial application for a program in Vascular Neurology will not require an on-site survey, but will require submission of all application materials and information, signed by the director of the program in Vascular Neurology and co-signed by the director of the accredited program in Neurology. The Residency Review Committee for Neurology will take initial action based on a “paper review” of the program, namely, a review without survey.

Subsequent review of Vascular Neurology programs will be in conjunction with the survey and review of the core program in Neurology. A separate form still must be completed by the Vascular Neurology program director. In special cases determined by the RRC, a Vascular Neurology program may be surveyed and reviewed separately. The RRC will also entertain interim requests and, on occasion, ask for interim progress reports.

The Residency Review Committee will designate programs as being accredited or not accredited. No further delineation of accreditation categories will be utilized. The accreditation of a program will be directly tied to that of the core. If the core Neurology program is subsequently accredited on a probationary basis, this is simultaneously a warning to the related Vascular Neurology program that accreditation is in jeopardy. Withdrawal of accreditation of the core program will result in a simultaneous loss of accreditation of the Vascular Neurology program.

Programs accredited by the action of the Committee are listed in the annual Graduate Medical Education Directory. It is the policy of the Committee that only those sites providing a significant portion of the program (six months or more) are included in the listing of the program in the Directory. Sites providing brief rotations for residents are to be included in the program description, and their participation in the program is approved even though the name of the site does not appear in the Directory listing.

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RESIDENCY REVIEW COMMITTEE FOR NEUROLOGY515 N State, Ste 2000, Chicago, IL 60610 www.acgme.org

VASCULAR NEUROLOGY PROGRAM INFORMATION FORM

Program Name:

TABLE OF CONTENTS

When you have the completed forms, number each page sequentially in the upper right hand corner. Start on Part 1, Section 1 of the PIF. Report this pagination in the Table of Contents and submit this cover page with the completed PIF.

Part 1 Section Page(s)

General Program Information 1

Participating Institutions 2

Fellow Complement 3

Faculty / Teaching Staff 4

Part 2 Section Page(s)Background Information 5

Residents 6

Personnel 7

Educational Program 8

Research & Scholarly Activity 9

Evaluation 10

Director’s Comments on Plans for Program Development 11Explanation of Non-Accreditation by the Joint Commission on Accreditation of Healthcare Organizations

Appendix A

Participating Site Letters Appendix B

Supervisory Lines Of Responsibility For Residents Appendix C

Basic And Clinical Sciences Instruction And Lectures Appendix C

List of Other Lectures Appendix D

List of Neurological Meetings Attended By Residents Appendix E

List of Resident Research Projects Appendix F

List of Resident Publications Appendix G

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RESIDENCY REVIEW COMMITTEE FOR NEUROLOGY515 N State, Ste 2000, Chicago, IL 60610 www.acgme.org

PROGRAM INFORMATION FORM (Part 2)

FOR CONTINUED ACCREDITATION – VASCULAR NEUROLOGY

SECTION 5. BACKGROUND INFORMATION

A. Previous Citations or Concerns (if applicable)

List the citations from last RRC accreditation if applicable and describe briefly the steps that have been taken to address the citations or suggestions made by the RRC. If documentation is required, provide a specific reference to the information provided in the PIF or append additional support materials. If no citation were listed, inculcate this in the response.

B. Changes (if applicable)

Briefly describe major changes, other than those included in the response to previous citations and/or concerns (above) that have been implemented since the last survey and review. Include changes in sponsoring organization, participating hospitals, required rotations, resident complement, and facility or facilities.

C. Sponsoring Institution/Single or Limited Residency Institution (see ACGME Site Requirements)

For those institutions which are either a single-program institution (e.g. Neurology), or an institution with multiple residencies accredited by the same Residency Review Committee, the Site review will be conducted in conjunction with the review of the program. Only programs in these two categories are to complete the following institutional questions. Complete only if "single/limited site sponsor" field in Part 1, Section 2 is yes.

1. Provide an institutional statement that commits the necessary financial, educational and human resources to support the GME program(s) and provide documentation that the statement has been approved by the governing body, the administration and the teaching staff (Insert 1).

2. Describe the formal method by which a periodic evaluation of the program’s educational quality and compliance with the program requirements occurs. Explain how residents and faculty in the program are involved in the evaluation process.

3. Describe how the institution complies with the Institutional Requirements regarding “Resident Eligibility and Selection” and the development of appropriate criteria for the selection, evaluation, promotion and dismissal of residents in accordance with the Program and Institutional Requirements.

4. Summarize how the institution complies with the ACGME Institutional Requirements regarding resident support, benefits and conditions of employment to include the details of the resident contract or agreement as outlined in the ACGME Institutional Requirements. (Do not append the resident contract/agreement to the PIF but state when it is given to the residents and applicants. Have a copy

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available for verification by the site visitor on the day of the survey with the various items required by the ACGME numbered according to the Institutional Requirements.)

5. Describe in detail the grievance (due process) procedure(s) that is available to residents, including the composition of the grievance committee, and mechanisms for handling complaints and grievances related to actions which could result in dismissal, non-renewal of a resident’s contract, or other actions that could significantly threaten a resident’s intended career development.

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SECTION 6: RESIDENTS

A. Program Outcomes-Scholarly Activity

Based on the last academic year ending June 30,

Number of Nationally Peer-Reviewed Published Articles or Co-Authored by the Residents in the Past Year.Number of Residents Presentations at Regional or National Meetings in the Past Year.

Note: Provide only available information.

B. Other Residents in Training

List the graduate medical education (GME) residents (fellows) from other specialties who rotated through the Vascular Neurology service during the last academic year. Name of Site (Site Identifier): (1) (2) (3)

Specialty & Years of GME (e.g. PGY 2)

Number of these Residents on

Vascular Neurology

Months Each Resident on

Vascular Neurology

Assignment(ward, clinic,

other)Location

(Site #1, 2, or 3)Adult NeurologyPGY-Internal MedicinePGY-Pediatric NeurologyPGY-NeurosurgeryPGY-Physical Medicine & RehabilitationPGY-PsychiatryPGY-TransitionalPGY-Neurocritical CarePGY-NeurorehabilitationPGY-Interventional Endovascular NeurosurgeryPGY-OtherPGY-

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SECTION 7: PERSONNEL

A. Program Director

1. Is the program director ABPN certified with qualifications in Vascular Neurology?...............( ) YES ( ) NO

If not, please indicate appropriate educational qualifications.

2. Is the program director full-time? ......................................................................................... ( ) YES ( ) NO

3. What percentage of time does the program director devote to the leadership, direction and monitoring of the program? % Hours per week

4. Has the program director prepared a written statement of the program’s overall goals and objective and the educational goals and objectives of the program with respect to knowledge, skills and other attributes of residents at each level of training and for each major rotation or other program assignment?.............................................................................................................................................. ( ) YES ( ) NO

If yes, please provide a copy of the goals and objectives in Appendix C1

5. Have these goals and objective been provided to the residents?.........................................( ) YES ( ) NO

6. Give a brief description of the program director’s responsibilities and activities.

B. Other Neurology Staff

List all other Neurology faculty involved in teaching the resident(s), including consultants and basic science teachers. Identify those actually responsible for clinical training with an asterisk.

Name of Site (Site Identifier): (1) (2) (3)

Name and Degree

Title and Position or Role in curriculum

Location of Site Full-Time

If part-time state

CertificationMos/Yr Hrs/wk

*If not certified in Vascular Neurology, note other certification or give statement of education.

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C. Other Non-Neurology Clinical Faculty

Name of Site (Site Identifier): (1) (2) (3)

Discipline/Service

Number who interact with Vascular Neurology Patients

Name of Primary person who interacts with Vascular Neurology residents or division chief or chairman

Site (1, 2,3, etc)

MEDICINE:

Critical Care

Cardiology

Genetics

Hematology/Oncology

Preventative Medicine

Pulmonary

Rheumatology/Immunology

Other (specific)

Neuropathology

Neuroradiology

Neurorehabilitation

SURGICAL:

Neurosurgery

Vascular Surgery

Ophthalmology

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D. Clinical and Educational Facilities and Resources

Facilities

1. Describe the physical facilities at each site for the inpatient and outpatient examination and care of Neurology patients. \

Facilities and Resources for TrainingAre the following clinical resources available: Site 1 Site 2 Site 3

Stroke Stepdown Unit ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Neurocritical Care Unit ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Medical Intensive Care Unit ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Coronary Intensive Care Unit ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Rehabilitation Ward ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Name of Site (Site Identifier): (1) (2) (3)

Facilities and Resources for TrainingAre the following clinical resources available: Site 1 Site 2 Site 3

a. Faculty Offices and Facilities

Vascular Neurology Faculty Offices ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Adult Neurology Faculty Offices ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Secretary Office Space for Vascular Neurology ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Departmental Library ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

b. Resident Offices and Resources

Does each resident have his/her own office? ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Are the only offices for groups of residents? ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NODo the offices have computers and computer internet search capabilities?

( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Do the residents have secretarial support? ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NODo the residents have a designated telephone number for patient to call?

( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Do the residents have access to other office equipment such as copiers, slide projectors, equipment or services to make slides, illustration service?

( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Do the residents have access to major texts in the department?

( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

2. Describe the conference facilities at each site that will be used for Vascular Neurology conferences.

3. Describe the space provided for Vascular Neurology faculty and resident research at each site.

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E. Library Facilities

1. Use the table below to describe the institutional and departmental library holdings and other reference resources at each site.

Name of Site (Site Identifier): (1) (2) (3)

Facilities and Resources for TrainingAre the following clinical resources available: Site 1 Site 2 Site 3

a. Number of journals

Number of Vascular Neurology journals

Access to all Medicine journal articles ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Reference databases ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

b. Computer databases available ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Access in hospital and department ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Access in library ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

24 hour access ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Access to major texts and full text journals ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Computer internet search capabilities ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

c. Library available on site ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOLibrary with major texts in all areas of medicine on site or near by

( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Number of reference books

d. Textbook availability

Major vascular neurology texts on wards ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Major vascular neurology texts in clinic ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

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F. Supporting Facilities

Instruction: Indicate whether the facilities and resources listed below are “AVAILABLE” for all participating hospitals listed in section 2. Write or type the name of each hospital and its identifier. If more than three hospitals participate, duplicate the pages and paste after this page.

Name of Site (Site Identifier): (1) (2) (3)

Facilities and Resources for Training

Are the following clinical resources available: Site 1 Site 2 Site3

a. Neurosonology

Carotid ultrasound ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Transcranial Doppler ultrasound ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

b. Diagnostic Radiological Services ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Conventional MRI and MRA ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

MRS ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Diffusion MRI ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Perfusion MRI ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

SPECT ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

PET ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Conventional CT ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

CTA ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Perfusion or Xenon blood flow ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

c. Cardiodiagnostic services

Transthoracic echocardiography ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Transesophageal echocardiography ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

d. Cytogenetics and genetic testing ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

Related Diagnostic and Therapeutic Services

a. Vascular neurosurgery ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

b. Vascular surgery ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

c. Interventional neuroradiology ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

d. Occupational therapy ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

e. Speech therapy ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

f. Rehabilitation medicine or neurorehabilitation ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

g. Physical therapy ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

h. Neuropsychological ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

i. Critical care medicine or neurocritical care ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

k. Social services ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO

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SECTION 8: EDUCATIONAL PROGRAM

A. Curriculum

Describe in block form the typical curriculum for residents by months, not weeks, including the site (#1,2,3,4) and the experiences on each rotation. Exclude mention of vacation time.

EXAMPLES

Name of Site (Site Identifier): (1) Main Hospital (2) County Hospital (3) City Hospital

Block RotationsJuly Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. April May June

(1)Vascular

IP (1)Vascular

IP (1)Vascular

IP (1)Vascular

IP (1)Vascular

IP (1)Vascular

IP (1)Neuro-

radiology

(1)Neuro

radiology

(1)Neuro

radiology

(3)Neuro-

sonology

(2) Va

scular IP (2) V

ascular

IP

Type of Experience * How Structured Amount of TimeVascular Neurology Inpatient Care (1)

Ward with only 1 day of stroke clinic 6 months

Vascular Neurology Inpatient Care (2)

Ward with only 1 day of stroke clinic 2 months

Neuroradiology (1) Neuroradiology reading daily 3 months

Neuroradiology (1) Endovascular procedures 1 day each week

3 months

Vascular Neurology Outpatient Care

2 half-day Vascular Neurology clinics

2 months (1 day per week x 12 months)

Vascular Neurology Emergency Care

On call for Brian Attack Team Daytime hours 6 months; night call 6 months

Neurosonology Rotation in TCD and carotid duplex lab

1 month

*Describe if inpatient or outpatient and the nature of the experience.

Your Vascular Neurology Program Rotations

Name of Site (Site Identifier): (1) (2) (3)

Block RotationsJuly Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. April May June

Longitudinal Experiences

Type of Experience * How Structured Amount of Time

*Describe if inpatient or outpatient and the nature of the experience.

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B. Seminars and Conferences

1. Attach as Appendix D1 and 2, a basic science lecture schedule. Since clinical and technical lectures in elective rotations such as neurosonology, diagnostic neuroradiology, interventional neuroradiology, etc. do not meet the basic science didactic requirements; identify specific basic science lectures during such rotations. Indicate which lectures are mandatory for Vascular Neurology residents.

2. Attach as Appendix D3, a schedule of clinical conferences for Vascular Neurology residents in each site. Name the faculty member assigned to the conference. Indicate which conferences are mandatory for Vascular Neurology residents.

3. Attach as Appendix D4, a list of the courses, conferences and/or lectures given in each of allied disciplines of Vascular Neurology, including neuropathology, neuro-ophthalmology, neuroradiology, vascular neurosurgery, vascular surgery, vascular medicine, cardiology, critical care medicine, neurocritical care, and rehabilitation. Indicate for each if Vascular Neurology resident attendance is mandatory.

4. Is there a journal club? Specify attendance by resident and faculty, the frequency of meeting, and the organization of the club. If there is no journal club, what substitutes for it?

5. Attach as Appendix E, a list of lectures not already supplied, such as lectures by visiting neuroscientists.

C. Related Services-training experiences

1. Diagnostic Neuroradiology

Nature of interaction with Vascular Neurology residents:

2. Interventional Neuroradiology

Nature of interaction with Vascular Neurology residents:

3. Neurosurgery

Nature of interaction with Vascular Neurology residents:

4. Neurosonology

Nature of interaction with Vascular Neurology residents:

5. Rehabilitation

Nature of interaction with Vascular Neurology residents:

6. Neurocritical care or critical care medicine

Nature of interaction with Vascular Neurology residents:

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D. Clinical Teaching-Inpatient

1. Inpatient Data

Name of Site (Site Identifier): (1) (2) (3)

SITE 1 SITE 2 SITE 3Bed Capacity

Vascular Neurology beds (assigned or available)Admission Data (past year)

Total admissions to Vascular Neurology

Percent male

Percent teaching (with resident participation)

Average daily census/Vascular Neurology

Average Monthly Team Size

Vascular Neurology residents

Rotating residents

Students

E. Teaching Rounds and Inpatient Service

1. Describe how often that teaching rounds are held each week for patients on the Vascular Neurology service and/or the consult service. Describe the complement of the team making attending rounds. Describe the duties of the Vascular Neurology residents and of residents rotating from other services.

2. Describe how Vascular Neurology Faculty participate in the education of residents on the inpatient service.

3. Explain how you ensure that each resident, including those that are not Vascular Neurology residents, is able to take advantage of Vascular Neurology learning opportunities.

4. Describe how therapeutic and diagnostic options including the cost of diagnostic tests, procedures and therapies and the results of the diagnostic tests are discussed on teaching rounds.

5. State whether all patients are examined by the attending and whether the attending is responsible for all patients, some of them or none of them.

Inpatient Attending Staff Site 1 Site 2 Site 3Patient responsibility ( ) All ( ) Some ( ) None ( ) All ( ) Some ( ) None ( ) All ( ) Some ( ) None

Patient examination with resident present ( ) All ( ) Some ( ) None ( ) All ( ) Some ( ) None ( ) All ( ) Some ( ) None

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6. Specify how the Vascular Neurology resident directly manages Vascular Neurology inpatients.

a. Describe the structure for supervision of resident participation in patient care , responsibility for decision-making and teaching, including how residents are afforded progressive responsibility. Who writes orders on inpatients? Does a Vascular Neurology resident write notes on all or only some of the patients? Note differences that may relate to (a) economic status of the patient; (b) status of the responsible physician, either full or part-time, and whether or not hospital-based; (c) exclusion of residents from responsibility in management of any patients. Are all patients of the teaching staff available for resident education?

b. How is continuity of care ensured? E.g. does the Vascular Neurology resident maintain care throughout the hospitalization; does the Vascular Neurology resident see his/her patients on weekends, and, if not, how is the continuity of care maintained? Does the resident see patients admitted to them in clinic follow-up?

F. Patient Statistics

Provide the number of inpatient in each of the following diagnostic categories that were available in the program for the past year. Each patient should be listed only once in the most appropriate category.

Name of Site (Site Identifier): (1) (2) (3)

Diagnostic Category Site 1 Site 2 Site 3Cerebral infarct

Transient ischemic attack

Intracerebral hemorrhage

Subarachnoid hemorrhage

Epidural or subdural hemorrhage

Asymptomatic patient with risk factors for strokeOTHER:

TOTAL

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G. Clinical Teaching-Inpatient and ER Consultations

1. Consultation Data

Name of Site (Site Identifier): (1) (2) (3)

Number of Consultations Per Year Site 1 Site 2 Site 3Inpatient (other than ICU)

Emergency room

ICU

2. Consultation Diagnostic Categories

Provide the number of consults in each of the following diagnostic categories that were available in the program for the past year. Each patient should be listed only once in the most appropriate category.

Name of Site (Site Identifier): (1) (2) (3)

Diagnostic Category Site 1 Site 2 Site 3Cerebral infarct

Transient ischemic attack

Intracerebral hemorrhage

Subarachnoid hemorrhage

Epidural or subdural hemorrhage

Asymptomatic patient with risk factors for stroke

OTHER:

TOTAL

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H. Clinical Teaching-Outpatient

1. Outpatient Data

Name of Site (Site Identifier): (1) (2) (3)

Vascular Neurology Clinics Site 1 Site 2 Site 3Number of resident clinics per month

Average number of visits per month

Average number of new patients per month

Percent visits seen by Vascular Neurology residentsAverage number of Vascular Neurology residents per clinicFrequency of Vascular Neurology residents assignment to clinicAverage number of attendings in Vascular Neurology resident clinicsAverage Vascular Neurology attending/residents ratio

2. Specify how the resident directly manages Vascular Neurology outpatients.

3. Outpatient Diagnostic Categories

Provide the number of outpatients in each of the following diagnostic categories that were available in the program for the past year. Each patient should be listed only once in the most appropriate category.

Name of Site (Site Identifier): (1) (2) (3)

Diagnostic Category Site 1 Site 2 Site 3Cerebral infarct

Transient ischemic attack

Intracerebral hemorrhage

Subarachnoid hemorrhage

Epidural or subdural hemorrhage

Asymptomatic patient with risk factors for stroke

TOTAL

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4. Specialty Clinics*

Name: Site 1 Site 2 Site 3Number of clinics per month

Average number of visits per clinic

Percent visits seen be Vascular Neurology residents

Name: Site 1 Site 2 Site 3Number of clinics per month

Average number of visits per clinic

Percent visits seen be Vascular Neurology residents

Name: Site 1 Site 2 Site 3Number of clinics per month

Average number of visits per clinic

Percent visits seen be Vascular Neurology residents

Name: Site 1 Site 2 Site 3Number of clinics per month

Average number of visits per clinic

Percent visits seen be Vascular Neurology residents

*If more specialty clinics need to be listed, attach as supplemental pages.

I. Educational Program

1. What teaching responsibilities do Vascular Neurology residents have?

2. Outline resident responsibility and frequency on night call at each site.

3. Outline resident responsibility, frequency of service and types of supervision in the emergency room at each site.

4. What provision is there to assure increasing patient responsibility and professional maturation of residents?

5. Additional Curricular Areas

For each of the following areas briefly describe the didactic curriculum, the person responsible for each topic, the number of sessions or hours involved, and how resident attendance is monitored.

a Medical Ethics

b Quality Assurance

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c Health Care Organization, Practice Management

d Financing of Health Care

e Management Information Systems

J. Educational Policies

1. Describe provisions for residents to spend one day out of 7 away from the hospital and for the residents to be on call no more than every 3rd night.

2. Attach as Appendix C, the written statement of the supervisory lines of responsibility for residents involved in patient care.

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SECTION 9: RESEARCH AND SCHOLARLY ACTIVITY

Resident Research Projects

Describe the research projects, supervisors and their specialties, and the nature of resident involvement in departmental research during the past five years. List by name those residents who participated in such research, the duration of their assignment, and whether full-time or part-time as Appendix G.

List the publications of residents from the section/division during the past 36 months as Appendix H.

Resident Meeting Attendance

Comment on resident attendance at local, regional, and national neurological meetings, including the number and frequency of meetings attended. Provide a list of meetings that residents have attended over the past three years, showing the residents by name, as Appendix F.

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SECTION 10: EVALUATION

A. Resident Evaluation

1. Describe the system of formative evaluation of residents. How often does it occur?

a. Does the faculty review a representative sample of residents’ written patient records?........................................................................................................................................ ( ) YES ( ) NO

b. Does the faculty provide feedback to residents on audits of their written patient records?........................................................................................................................................ ( ) YES ( ) NO

c. Does the program perform a formal, observed clinical evaluation exercise (CEX) on residents?........................................................................................................................................ ( ) YES ( ) NO

B. Resident Feedback and Records

Describe how and by whom feedback to residents is provided and what remedial actions are taken in cases of deficiency. What kind of records of resident evaluations does the program maintain?

C. Impaired Residents

How does the program deal with impaired residents?

D. Resident Stress

How does the program monitor resident stress, provide counseling and support services to residents?

E. Moonlighting Policies

Describe the policies on resident moonlighting; explain whether the policies are written and distributed to all residents; and describe how the program director monitors the effects of outside activities, including moonlighting, on the training program. (Be sure to provide documentation to the site visitor.)

F. Final Evaluation

Does the program provide residents with a final written?.............................................................( ) YES ( ) NO

If so please describe how this evaluation is done and what the evaluation covers.

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G. Faculty Evaluation

1. Describe the system by which the program is evaluated.

a. Are written evaluations by residents used in this process?.............................................( ) YES ( ) NO

If not, please explain.

H. Program Evaluation

1. Describe the system by which the program is evaluated.

a. Are written evaluations by residents used in this process?.............................................( ) YES ( ) NO

If not, please explain.

I. Curriculum Evaluation and Development

1. Is there a written curriculum for each major rotation or learning experience?........................( ) YES ( ) NO

2. Describe the process used to develop written goals and objectives for the required experiences and state the time of most recent revision. Explain how often the goals and objectives are reviewed and how they are evaluated.

3. Describe the frequency and the mechanism by which these are distributed to residents and faculty.

4. Describe the process by which the teaching staff is organized and has regular, documented meetings to review program goals and objectives, the program’s effectiveness in achieving them, and the needs of the residents. Include the frequency of such meetings.

5. Describe resident participation in this process. How does the program ensure that written evaluation by the residents is utilized in this process?

6. Describe how the performance by graduates on the certifying examinations is used to evaluate the effectiveness of the program and to modify the goals and objectives?

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SECTION 11: DIRECTOR’S COMMENTS ON PLANS FOR PROGRAM DEVELOPMENT

Photocopies of schedules of staff, program, etc., or brochures or reprints are not acceptable and should not be included. Please furnish only the information asked for, as briefly as is consistent with clarity, and only on the forms provided or as specifically requested.

Information Furnished By:

(Name) (Position) (Date)

If information is furnished by someone other than the Program Director, the latter must verify the accuracy of the above statements by signature:Verified By:Vascular Neurology Program Director

(Signature) (Date)

Neurology Program Director

(Signature) (Date)

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APPENDIX A: EXPLANATION OF NON-ACCREDITATION BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS

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APPENDIX B: PARTICIPATING SITE LETTERS

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APPENDIX C: SUPERVISORY LINES OF RESPONSIBILITY FOR RESIDENTS

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APPENDIX D: BASIC AND CLINICAL SCIENCES INSTRUCTION AND LECTURES

1. Basic Science Curriculum.

2. List of lectures, conferences, courses in basic neuroscience:

3. List of Vascular Neurology clinical conferences:

4. List of clinical courses, conferences and/or lectures given in the subspecialties of Neurology at each Site:

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APPENDIX E: LIST OF OTHER LECTURES

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APPENDIX F: LIST OF NEUROLOGICAL MEETINGS ATTENDED BY RESIDENTS

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APPENDIX G: LIST OF RESIDENT RESEARCH PROJECTS

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APPENDIX H: LIST OF RESIDENT PUBLICATIONS

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