Non-ACGME | NST Application

Non-ACGME | NST Application

Non-Standard Training (NST) Programs provide clinical training to foreign national physicians in advanced subspecialty programs for which there is no ACGME or ABMS accredited/certified program.

Any UCSF Non-ACGME program that plans to sponsor or recruit a trainee with a J-1 visa must apply for Non-Standard Training (NST) Recognition from the ACGME

Additional information on NST Programs can be found on the ACGME website and our NST Resources BOX folder.

As a reminder trainees that hold J-1 visas are not able to moonlight and will never be able to have attending privileges (i.e. bill independently).

INSTRUCTIONS:

Please refer to the following steps and requirements for establishing a clinical NST program at UCSF. This process can take a minimum of 3 to 6 months.

Step 1: Program completes the following documents, which are required as part of this application:

NST Program Description Form*
Attestation and Certification Form*
Supervision Policy Template* Please also review the companion OGME Supervision policy guide
Block Diagram Template*
Program Director CV
ACGME Milestones Document (the milestones from the most closely related ACGME-accredited specialty or subspecialty)

*Please use provided templates linked above. They can also be found here in Box.

Step 2: Program completes this Smartsheet and uploads the six completed required documents (listed above).

Note: Smartsheet will not allow you to save your progress and return at a later time to submit.

Step 3: Office of GME reviews application and submitted documentation. If edits are needed, the Office of GME will contact the program director and administrator via email.

Step 4: When the application is finalized, it will be presented at a monthly GMEC for the committee's review.

Step 5: After receiving GMEC approval, the Office of GME will create and send an approved NST policy document that the program is required to post on their program's website and make available to the trainees at all times.

Thank you,

Office of Graduate Medical Education

Program Information

Name of person completing form:*

Department name:*

ACGME NST focus area*

All NST programs must have a corresponding ACGME-approved focus area.

Select

Is this a new or existing UCSF Non-ACGME program?*

Select or enter value

Select the existing Non-ACGME training program:*

Select or enter value

List the proposed NST Program Director's name and credentials (i.e. MD, MAS, MPH, PhD, etc.):*

Is the NST PD listed as faculty in ADS for the most closely related ACGME accredited program?*

*This NST program cannot be created until the NST PD appears on the ADS roster for the most closely related ACGME-accredited program.

Select or enter value

Program Director email address:*

Program Administrator name:*

Program website:

Optional

Length of training:*

Required length of time in program listed in MONTHS

Select

How many fellowship spots are available each academic year?*

Expected program start date for trainees:

When will you start recruitment for your trainees?

NST recognition status should be in place before any position are offered to J-1 trainees.

Rotation site(s):*

Select all that apply

Select or enter value

Other rotation site(s): please list

What is the most closely related UCSF ACGME-accredited program?:*

Select

ACGME Program Director Name*

Department Chair Name*

Required Documents

Required Documents Checklist:*

Please check off all documents you are including in your application.

Your application will not be reviewed until all required documents are submitted.

Program Description (use template provided and upload as Word Document)

Attestation and Certification Form Signed by NST PD, ACGME PD, and Dept Chair

Supervision Policy (use template provided and upload as a Word Document)

Block Diagram (use template provided)

Program Director CV

Milestones document (the milestones assessment form from the most closely related ACGME-accredited specialty or subspecialty)

UPLOAD Required documents here*

Please submit as individual Word or PDF documents.

Drag and drop files here or

Send me a copy of my responses

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