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Tip of the week: Create a comprehensive internal review cover letter

Residency Program Connection, September 23, 2008

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During site visits, the ACGME confirms if the institution carried out an adequate and timely internal review. Because in most cases the ACGME never views programs’ internal review reports, the accompanying cover letter serves as documentation that the review actually occurred.

The internal review report cover letter must contain all of the information necessary to demonstrate to the ACGME that the graduate medical education committee carried out an adequate internal review based on the institutional protocol at the midpoint of the accreditation cycle.

Consider creating an internal review cover letter template to provide consistency to all of the institution’s internal reviews. Provide the site visitor with the following information in the cover letter:

• Date of the internal review
• Name of the program reviewed
• Names and titles of all internal review committee members
• List of information and materials reviewed
• List of people interviewed
• Date the GMEC reviewed and approved the internal review report
• Signatures of committee chair and all committee members

This week’s tip comes from Internal Review Made Simple by Robin E. Graham, MD, FACS.

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