Responding to Residency Review Committee (RRC) Correspondence

Format

• Address the letter to the Executive Director of the RRC.

• Prior to the greeting, include a "Re:" section that states your program name as shown on the RRC letter (including the name of the sponsoring institution) and the program number.

• The first paragraph should reference the RRC letter to which you are responding: the date and the nature of letter (e.g., accreditation letter, request for additional information or for a progress report, etc.).

• Each citation, question, or comment to which you are responding should be included, verbatim and in quotes, followed by your response. Ex: Citation #1: “The RRC judged that resident call rooms are inadequate…” [include the full text of the citation]. Response: “The space for three additional call rooms has been identified. Since the time of the site visit, construction has begun and occupancy is expected on December 1, 2019.”

• In the final paragraph, you should thank the RRC for their careful evaluation of the program and offer to provide any further information that might be helpful. If there is some urgency to their assessment of your response (such as approval for program expansion that may hinge on their review), you can note that.

• Include this text as the last sentence: “The signature of the DIO below serves to attest that the GME Committee has reviewed and approved this report.”

Language and Content

• Responses should be clear and sufficiently detailed.

• Extraneous or irrelevant information should not be included—e.g., room location of conferences, etc. A historic perspective on the program is usually not appropriate, except (a) where you want to demonstrate progress relating to an issue of concern, or (b) where the program is facing a possible adverse outcome and you want to diplomatically include some “PR” (we can help with this).

• It is important to be clear in describing the time course and current status of program initiatives or improvements. For example, in addition to describing a new initiative, state whether it is “under consideration” vs. “planned” vs. “implementation anticipated on [date]” vs. “implemented as of [past date]”.

• It is also important to note when a problem was addressed with respect to the date of the site visit AND the date of the RRC meeting when the site visit information was considered. The RRC may consider more favorably improvements that were undertaken based on the program’s initiative, rather than in response to their concerns. (For example: “The department’s education committee eliminated the XYZ rotation as of June 30, 2019 based on input from residents and faculty, prior to the RRC’s consideration of this program at its meeting on April 15, 2019.”)

• Sometime citations don’t seem to correspond to a written RRC requirement. Please highlight this for us when you submit your draft and we will talk with you about whether to “rebut” the citation on that basis—which on rare occasion is a reasonable strategy.

Supporting Data

• Attachments with detailed documentation addressing the specific issue at hand are helpful, such as: lecture schedules that illustrate coverage of all core curriculum topics; duty hours logs and summary reports documenting compliance; lists of resident-generated lectures and publications to document “scholarly activity”, etc.

• If data addressing the issue at hand was provided previously, such as part of the PIF, that can be politely referenced in the letter and the data can be supplied again as an appendix.

 Tone

• Whether or not the RRC’s concern seems reasonable, the tone of our response must be respectful and even appreciative. Placing blame on the RRC or site visitor, individuals within the program, or unreasonable requirements is counterproductive.

Miscellaneous

• If you absolutely cannot provide a response by the date requested, ask for an extension as soon as the letter is received. It is preferable to seek an extension by e-mail, rather than by phone, so that there is a written record of the extension being requested/granted.

• It is normally required that GMEC (Graduate Medical Education Committee) approve each program response to the RRC. To have your letter placed on the agenda requires advance notice: the GME accreditation manager for your program will coordinate this. Usually, the draft response should be submitted approximately three weeks prior to the BWHEC or MGH GMEC meeting for review and comment by the GME Director for your specialty.

• You may wish to respond to an accreditation letter even if no response is requested—especially if the RRC based any conclusions on incorrect or misinterpreted information. (Please discuss this with the GME Director prior to writing a draft.) Unsolicited responses may not be reviewed by the RRC upon receipt, but would become part of the program’s ACGME file.

This page was reviewed 3/31/21.