Appendix S – GME Program for Away Rotation (PAR)

APPENDIX S
Program for Away Rotation (PAR) Description
Saint Louis University, Office of Graduate Medical Education (GME)
Background: The financial structure of Medicare GME training requires residents to work physically
within the hospital system that provides the financial support forthe educational experience. Resident
rotations away for special educational activities, volunteering for underserved populations, and
international experiences are not supported through traditionaGME Cost Report funding. It is difficult
to arrange away rotations, even within the same city, without dedicated financial support. Many Saint
Louis University faculty volunteer clinically outside of the United States and would welcome resident
participation but lack a financial mechanism for such rotations. Prospective residents often ask about
international or away electives during the interview process and indicate that the Saint Louis University
mission of service is a reason for selecting our schooland residencies. Many desire the opportunity to
provide additional care to the underserved, generally outside of the United States, as a part of the
training program. Some residents also desire specialized educational opportunities that are not
available at our School or affiliated training hospitals. These rotations away require external stipend
support not available through the current hospitalor GME training budgets.
Rationale: The GME Office at Saint Louis University will provide support for a limited number of away
electives for resident training. These rotations are intended to enrich the educational experience of a
resident and the residency training program, expand SLU visibility in the community and internationally,
and create unique opportunities for residents to provide care to the underserved.
Program Structure: Each academic year up to 12 residents will be allowed to engage in training outside
of the Saint Louis University affiliated sites for a maximum of four weeks each. This is a competitive
process which requires an application, approval, and supporting documentation. A committee will
review the application and determine if funding and support will be provided by the GME office forthis
experience. Applications must be received at least two months in advance of the expected training
period.
Funding Support: Up to 28 days (approximately $5000) per resident will be covered through the GME
office for stipend, benefits, and malpractice coverage (if U.S.-based rotation) during the away rotation.
An additional travelallowance of up to $1000 will be provided to offset a portion of the cost of
airfare/transit to an international location and up to $500 to a U.S.-based location. Trainees remaining
in Saint Louis will not receive a travel allowance.
When partial existing funds are available for a rotation or travel, partial support may be provided by
GMEto offset unfunded expenses. The resident and/or program will be responsible for lodging, meals,
required vaccinations or prophylactic medications, incidental costs, and fees associated with processing,
licensing, or credentialing at the away site, purchasing of international health insurance (mandatory) or
additive malpractice coverage (optional). The resident’s training program will be responsible for any
programmatic costs associated with the trainee’ sabsence. International health insurance is available
for a minimal cost through Saint Louis University via the SLU Marketplace website:
http://www.slu.edu/study-abroad-home/health-and-safety/international-health-insurance

This program will neither replace established funding mechanisms for resident away rotations, nor fund
experiences that are a required component of the residency training program. This program is intended
to provide support for unique opportunities, resident-initiated experiences, or initial development of
international training partnerships for resident education. This program is not intended to fund
established or annual senior year” away rotations for a department/program. Externalor
departmental support is expected once PAR funding has been provided twice forthe same site.. Denial
of funding through this GME-supported program does not imply denial of approval by the GME Office
for the away experience; other funding mechanisms should be pursued.
Program Requirements: Each training program may submit up to two applications for consideration
during an academic year. Applications and supporting documentation must be completed priorto being
considered by the review committee. Applications must clearly demonstrate the educational benefit to
the trainee and program and the support of the program director and department. Upon return from
the rotation, the trainee will be required to provide an educational presentation of the experience,
complete a post-rotation report for the GME Office (see Appendix 1) and serve as a resource for other
trainees who may be interested in away rotation experiences.
A local faculty advisor and an off-site supervisor must be identified for each away experience. The
advisor will be responsible for assisting the resident with the application process, obtaining necessary
supporting documentation, monitoring the resident’s participation in the away rotation, and ensuring an
evaluation of the resident takes place. The off-site supervisor must complete an end-of-rotation
evaluation and agree to the term established forthe away rotation. The resident, faculty advisor, and
program director are responsible forall planning, paperwork and travel arrangements.
A rotation description including goals and objectives, clinical responsibilities, and supervision and
evaluation process must be created by the program director and an evaluation of the trainee must be
performed at the end of the experience by the supervising clinician. When required, the program
director must submit a program letter of agreement between Saint Louis University and the away site
which outlines the resident responsibilities, educational activities, and supervision structure of the away
rotation. The program director must complete any paperwork required by the away rotation site at
least one month in advance of the start of the rotation. Those trainees holding visas or having travel
restrictions must make arrangements with the GME Office to ensure the travel will not jeopardize
his/hertraining status with the University.
The away rotation must not place undue clinical or service stress on othertrainees or compromise
patient care. Participating residents must not be required to extend residency training by participating in
the away rotation. The away rotation must provide a certifiable educational experience as outlined in
the ACGME Resident Review Committee Program Requirements for the trainee’s specialty.
Selection Process: Applications will be reviewed for merit and priority by the PAR Review Committee
comprised of resident, faculty, and GME members. Applications will be reviewed for approval/funding
twice each year (May 1 and November 1). A resident must be in good standing with the training
program and the Schooland is eligible to participate in a GME supported away rotation only once while
in training at Saint Louis University.
This program is intended primarily to fund experiences outside of the United States. On rare occasions
PAR funding may be provided for U.S.-based rotations. Trainees participating in U.S.-based rotations
must obtain a temporary training license for the state in which the rotation will take place.

Trainees participating in U.S.-based rotations must also ensure that all paperwork and affiliation
agreements forthe accepting hospital/GME Office/University are completed in advance of the rotation.
These agreements can take several months to process. The trainee or program director must contact
the GME Office prior to submitting an application fora U.S.-based rotation.
Priority will be given to those trainees who: are a PGY-2 or higher, utilize the full four-week rotation
period, engage in clinical activities, accompany a Saint Louis University faculty on the rotation, provide
care to an underserved population, work internationally, participate in a well-established governmental,
educationalor philanthropic program/organization, or engage in an educational activity that is not
available at Saint Louis University affiliated training sites. The away rotation cannot take place in a
restricted location, site of military conflict or area which would place the trainee in physical danger.

Saint Louis University Office of Graduate Medical Education
Program for Away Rotation (PAR) Application
Name of Applicant
Department
SLU Away Rotation Faculty Mentor_
PGY level
Program
Away Rotation Information
Proposed Rotation Dates:
Country

• City.
  Name of School/Organization/Program (if applicable)
  Off-Site Supervisor/Evaluator_
  Please respond to each question (to be completed by trainee— max 200 words each)

1. Describe the daily/weekly clinical work on this rotation.
2. Describe how this experience will enhance your education in your discipline and why this
   experience can’t be obtained locally at Saint Louis University.
3. Describe how this experience will be shared with and benefit your peers and training
   program upon your return to Saint Louis University.
4. Describe your qualifications, experiences and strengths which would make you a strong
   candidate to receive approval for a GME funded away rotation.

Saint Louis University Office of Graduate Medical Education
Program for Away Rotation (PAR) Application Checklist
Please attach and complete the below items and submit with the application to the GME Office.
Deadline for all application materials is 90 days prior to the departure date of the rotation.
• Goals, objectives, and description of the clinical rotation (must meet ACME RRC
requirements as a qualifying educational experience for the trainee’s discipline)
• Letter of support from the trainee’s Program Director indicating that:
• The trainee is in good standing with the school and program
• The trainee is qualified to perform the clinical duties of the away rotation
• The away experience will provide an educational benefit to the trainee and program
• The PD has communicated with the off-site supervisor and that supervisor is aware
of the requirements of the away rotation program
• A copy of the evaluation form that will be used by the away rotation supervisor to
evaluate the trainee’s performance
• A copy of the trainee’s CV
• A budget outlining expected travel costs of the trainee for this rotation
The trainee and PD must initial each statement below:
I understand that the GME office will cover the costs of the trainee’s stipend, benefits,
and malpractice coverage (for U.S.-based rotations) for up to 28 days during the rotation. Up to $1000
will be provided to offset international travel expenses and up to $500 will be provided to offset U.S.-
based travelexpenses.
I understand that trainee and/or program will be responsible for additional travel
costs, lodging, meals, required vaccinations or prophylactic medications, incidental costs, and fees
associated with processing, licensing, or credentialing at the away site, purchasing of international
health insurance (required) or additive malpractice coverage.
I understand that trainee will provide an educational report or presentation of the
experience to the Graduate Medical Education Committee and/or the local training program.
_understand that the trainee’s clinical performance must be evaluated by the away
rotation supervisor at the end of the rotation

I understand that the trainee, faculty advisor, and program director are responsible for
completing all paperwork and travel arrangements related to this rotation including a Program Letter of
Agreement between Saint Louis University and the away site (U.S.-based rotations) at least 1 month
prior to the departure date forthe rotation.
I understand that the trainee must obtain the proper passport, visa, licensure,
immunizations, travel medications, credentialing, and approvals as needed at least 1 month prior to the
departure date for the rotation.
I understand that trainee’s absence must not place undo clinical or service stress on
othertrainees or compromise patient care.
I understand that the trainee must not be required to extend residency training as a
result of participation in the away rotation and that the rotation must provide a certifiable educational
experience as outlined by ACME.
Required signatures: I have read and understood the requirements of the Program for Away Rotation
Trainee
Date
Program Director
Date
SLU Away Rotation Faculty Mentor (if different from PD)
Date
Departmental Chairman
Date