Non-ACGME New Program Request

Please complete this SmartSheet form to request Office of GME approval for a new non-ACGME fellowship program.


If you are completing this application it is because this Non-ACGME program will never accept any trainees who would require a J-1 visa. If you would like to apply for an NST/Non-ACGME program that can accept J-1 visa trainees, please apply here.


Non-ACGME Program Application and supporting documents must first be reviewed and approved by the Vice/Associate Chair for Education.


The following documents are required as part of this application:

  1. Program description – https://ucsf.box.com/s/0awkzq4wzsfmnxdvd14g44jzql8ab7ei
  2. Program director CV – MyCV from Advance https://advance.ucsf.edu/advance/start.jsp
  3. Block diagram – https://meded.ucsf.edu/sites/meded.ucsf.edu/files/inline-files/BlockDiagramInstructions.pdf
  4. Goals and objectives – Must be listed by PGY with rotation and sites referenced
  5. Letter of support for new program - signed by the program director and department chair, division chief, and/or vice chair for education https://meded.ucsf.edu/sites/meded.ucsf.edu/files/inline-files/Letter%20of%20Support%20-%20New%20Non-ACGME%20Program%20Request_0.pdf



The Office of GME will review application and submitted documentation. If edits or additional information is needed, the Office of GME will contact the program director and administrator via email.


Once the process is complete new program approved, you will be contacted via email and the a new program will be created in MedHub and UCMe. Please note review of new program request can take anywhere from 1 - 3 months.



Thank you,


Office of Graduate Medical Education

Contact Information

This must be a full time program administrator. UCSF MC staff cannot be listed as program administrators.

New Program Information

Please enter your program name and include if this program is a residency or a fellowship (i.e. Hospital Medicine, Fellowship)

Please enter your department name (i.e. Pathology )

(optional)

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How many years is the training program?

How many trainees will be in the program?

No positions should be offered until your application for this new program has been approved.

When would the first trainees start in the program?

Please provide information on how trainees will be funded.

Trainee Information

What training is required of applicants prior to starting your program (i.e. pediatric residency, cardiology fellowship, etc.)?

In what PGY level(s) will the trainees be appointed?

Will the fellows function independently and be able to bill (have clinical instructor without salary appointment and privileges)?

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REQUIRED DOCUMENTS

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

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

Please submit as individual Word or PDF documents.

Drag and drop files here or

Please utilize the space below to provide any additional comments you would like the Office of GME to take into consideration when reviewing your application.