Special Review Process

As part of the Next Accreditation System (NAS), the ACGME now requires Institutions to monitor programs’ accreditation status on an annual basic. The Graduate Medical Education Committee (BWHEC or MGH GMEC) demonstrates effective oversight of any underperforming programs through a Special Review process. To assist in meeting these ACGME Institutional and Common Program Requirements, the Annual Review of Programs (ARP) process was introduced. As part of this process, the GME Office, in conjunction with a newly-formed ARP subcommittee of GMEC, determines which programs would most benefit from a Special Review. 

The following materials are reviewed during the ARP process:

• ACGME Accreditation Letter
• Annual ADS Update submitted by the program to the ACGME
• APE Form (including Multi-Year Action Plan) submitted by the program in New Innovations
• ACGME Resident & Faculty Surveys (if available)
• Most recent GME Internal of Special Review report and response
• ACGME Milestones Report
• ACGME Case Log Reports (if available)

Program identified as underperforming will be contacted to schedule the Special Review visit. The Special Review Committee (SRC) will be formed and will consist of 1-2 faculty members from a Partners ACGME-accredited program, 1-2 trainees from a Partners ACGME-accredited program, one of the GME directors, and the GME program manager. As part of the review, the SRC will meet with the trainees, faculty, and program leadership.

The results of the Special Review will be summarized in a report, reviewed and approved by the hospital graduate medical education committee, then shared with the program. The GME Office will then follow up on items  needing improvement and offer suggestions for implementing recommended changes. The ultimate goal of the review is to ensure that the program is of the highest quality possible, and that it maintains continuous accreditation by the ACGME. The report is not shared with the program’s Residency Review Committee, and, therefore, would not directly affect the program’s accreditation

This page was updated on 1/25/18.