Requesting an Increase in Trainee Complement

All requests for complement changes must describe the Educational Rationale, Resources, and an Implementation Plan, as detailed below. Requests should be submitted as a Word document to the GME Director assigned to the specialty and accreditation manager.

•  ACGME Programs: The GME Committee for your hospital must review and approve the proposal before submission to your ACGME Review Committee (RC) or ADS.
• Non-ACGME Programs: The GME Director, assigned to the specialty, will review the proposal.
• Requests for temporary increases of short duration often can address the necessary information in a short paragraph.
• Requests for permanent complement increase must also include a statement of support from the program director(s) of related specialty or subspecialty program(s) that may be impacted by the increase and the approval by the Department Chair(s)/Division Chief(s).

I. Educational Rationale: Provide a detailed explanation of the educational rationale for your request. For example, additional trainee/s would:

•  Support new rotation/s* or other educational experiences to provide:
• training in new technology
• expanded opportunities for training in sub-specialty areas
• added elective time  

  * Be sure to include an explanation of why adding this new rotation/experience requires an expansion in the number of trainees.

• Allow program to meet (new) accreditation requirements (if applicable)
• Enhance recruitment
• For small programs, achieve a “critical mass” of trainees to enhance the learning environment (be specific)
• Provide increased time for didactics and/or research
• Improve the experience on defined rotation/s (be specific about what improvements would result)
• If applicable, comment on physician workforce issues if there is a recognized need for more practitioners in this (sub)specialty Note: Programs often propose a complement increase with the reasoning that clinical service volume has increased. The education committees generally do not view this as a sufficient reason to approve an increase. There must be a clear rationale as to how the proposal improves education.

II. Resources: To justify an increased complement, you must show that you have the resources to support the education of an increased number of trainees without any negative impact on the current trainee/s in your program, or trainee/s in related (sub)specialty GME programs (please submit a statement of support from the program director(s) of a related (sub)specialty program(s) that may be impacted by the increase). Please comment on such factors as: 

• Clinical volume, especially where specific quotas are required by ACGME or ABMS
• Number of faculty (provide current and projected ratio of faculty and trainees)
• Space and facilities (i.e., educational space such as conference rooms, lab and/or clinic space; call rooms and other support space and resources, such as computers)
• Impact on affiliates (if applicable)
• How will the position(s) be funded? Please note that approval of an increase in trainee complement from the hospital’s education committee and/or from the ACGME does not imply that institutional funding is available. The program must ascertain the availability of appropriate funding before recruiting trainees to the additional position(s)**.

III. Implementation Plan: Submit a proposed implementation plan for the total increase in trainee complement, including the following:

• The current number of trainees and the requested total number (both by program year, for multi-year programs)
• A timetable of increased recruitment (e.g., a four-year program might add one trainee per year each of the next four years; a one-year program might add one position at the start of the next academic year)
• Attach block diagrams of the current and proposed trainee rotation schedules for the entire program

** For any additional FTEs to be supported by hospital or departmental funds, please submit documentation of approval by the Department Chair/Division Chief, after discussion with the Clinical Vice-President. If the program is integrated across hospitals, approval of all institutional Department Chairs/Division Chiefs must be submitted.

This page was updated on 8/30/19.