Psychiatry Residency Coordinators

Site Visit Information

When will the site visit be scheduled?
The notification (or accreditation) letter the program receives after the RRC has made an accreditation decision shows the approximate date of the next site visit (stating for example that "the program will be visited after April 1, 2002). Programs routinely are scheduled in a 90- to 120-day (three-month) period following that date. On occasion, site visits may be delayed longer because the ACGME field representatives visit three programs each week, and some programs are held back to allow three programs to be scheduled in a given city.

Programs generally receive at least 90 days advance notice of the scheduled date of the site visit. If the approximate date of the visit is near and you have not yet received a letter from the ACGME, please contact Penny Iverson-Lawrence, Administrative Assistant in the Department of Field Staff Activities at 312-755-5014 to ask if a visit date has been set.

Who will conduct the site visit?
Two types of site visitors are used in accreditation—ACGME field representatives and Specialist Site Visitors (SSVs). Field staff are professional site visitors employed by the ACGME. SSVs are members of the discipline who conduct a small number of visits annually. Each year, approximately 2,000 site visits are conducted by the members of field staff, and between 100 and 200 visits are conducted by SSVs. Biographical sketches for the members of the ACGME field staff, outlining their education and experience, can be found on the ACGME Web Site.

The responsibility of both types of site visitors is the same: "to produce a narrative report that verifies and clarifies the information you have submitted in the PIF." The surveyor is not the decision-maker. Accreditation decisions are made by the RRC. To write the narrative report, the site visitor interviews the program director, faculty, residents, representatives from administration and, for some programs, representatives from other departments the program interacts with.

What do I need to know about preparing the Program Information Form (PIF)?
An important aspect of preparing for a site visit is the preparation of the program information form (PIF). A well-prepared PIF describes the residency program accurately, completely and truthfully. It is comprehensive, specific and concise, and completely answers all questions. An incomplete or inaccurate PIF can be a cause of an unsatisfactory RRC review.

Using the instructions provided in the memorandum that accompanies the scheduling letter (or shown in FAQs, "How do I download the PIF?"), download the PIF for your program from the ACGME's World Wide Web site. Before preparing the PIF, you should review your program requirements and the institutional requirements in the "Essentials of Accredited Residencies." You should also allow sufficient time to gather the data needed for completing the PIF. In completing the PIF, remember that the RRC members will not be familiar with the specifics of your program. Also, you should not rely on the site visitor to relate to the RRC information that is important but was not included in the PIF. If something is important, include it in the PIF.

Call the staff of your RRC if you are unclear about how to answer a question in the PIF. If you have a technical problem with any aspect of the PIF, contact the ACGME Help Desk at 312-755-7464 or via e-mail to helpdesk@acgme.org. Whether you complete the PIF yourself or delegate parts to others, a third party should review the entire document for consistency, accuracy and clarity before it is submitted.

How do I download the program information form (PIF)?
To download the program information form (PIF) you need to prepare for the scheduled visit, on the ACGME's Web Site, access the menu option "Residency Review Committees" to bring up a directory showing all RRCs. Probing the desired RRC's name will bring up a table of contents that includes the option to download the program requirements, the PIFs for the core program and any subspecialties, and the instructions for downloading the document in WordPerfect or Microsoft Word. Programs in Internal Medicine and its subspecialties will have received specific software for completing the program information forms, and their PIFs are not shown on the Web. For an institutional review, the Institutional Review Document (IRD) and the Institutional Requirements can be accessed by probing the option in the main menu entitled "Institutional Review Information" and following the menu options on the left side of the screen.

If you encounter problems in accessing or downloading documents from the web should also contact the Computer Help Desk either by e-mail or at 312-755-7464.

What should be done with the completed PIF?
After completing the PIF, you should print four copies. One copy should be sent to the address of the field representative assigned to your program (shown in the ACGME's letter announcing the site visit date). This copy must be sent to arrive at the field representative's address a minimum of 14 days before the date of the site visit. The three remaining copies are turned over to the site visitor on the day of the visit. The four hard copies of the PIF must be identical and must be final. Draft copies are not acceptable to the field representative or the ACGME. Failure to send the copy to the field representative at least 14 days before the visit can result in cancellation of the site visit at the discretion of the field representative (the program is charged a $2,000 fine for cancellation under these circumstances and the visit is rescheduled). The four copies should not be bound or in a folder (stapling copies or holding them together with a strong rubber band is preferable).

Can I make changes to the PIF after it has been sent to the site visitor?
The program information form (PIF) sent to the site visitor and the three copies provided on the day of the visit must be identical and in final form. Changing the PIF after the site visitor has been sent his or her copy and before the day of the visit should be avoided at all cost. Minor discrepancies can be cleared up on the day of the visit. The rare exception is a major error or omissions in the PIF that profoundly impacts the review. In this case, send the site visitor only the pages that were changed, with the changes clearly highlighted. Do not send an entire new PIF. The three copies of the PIF provided on the day of the visit must be in the new ‘improved' form.

If errors are discovered on the day of the site visit, it is acceptable to make changes to selected pages of the PIF, providing it can be done on the day of the visit before the site visitor departs. Do not ask the site visitor to wait while you make extensive changes. Once pages have been changed, one copy should be given to the site visitor, with the changes highlighted. The revised pages should be replaced in the three copies to be sent to the ACGME before they are packaged for mailing.

Major changes after the day of the visit are strongly discouraged, and this approach should be used only as an approach of last resort for the rare when a PIF has major flaws and requires significant changes. In this case, changes should be provided as a succinct addendum to the PIF, addressed to the RRC team and clearly marked with your program number and name. If you need to send an addendum, contact your RRC team in advance of preparing and sending it. Addenda are accepted at the discretion of the RRC, and not all RRCs accept them. Send the addendum directly to the ACGME's Chicago address (do not send a copy to the field representative). On the day of the visit, the three copies of the PIF, however 'flawed,' are turned over to the site visitor for mailing to the ACGME. Addenda must be sent within 14 days of the site visit date.

How do we set up the schedule for the day of the site visit?
Approximately 30-50 days before the scheduled site visit day, the site visitor assigned to your program will contact you by telephone, letter, fax or electronic mail to set up the schedule for the visit. You may also contact the field representative at the address listed on the scheduling letter to make the necessary arrangements (the best day to call the field representative is Friday). On the day of the visit, the site visitor will need to meet with faculty, residents and administrators. The final determination of the schedule and the individuals with whom to meet is made by the site visitor.

You should remember that the site visitor may not be familiar with the town or your institution's physical facilities, and may appreciate directions to the institution and instructions for parking. You should arrange for a place and an appointed time to meet the site visitor. The entire site visit (with exception of tours of on-call rooms and other facilities, as required) should take place in a well-lighted conference room with a table sufficiently large to allow the site visitor to do his/her work. If lunch is scheduled during the site visit, please keep the menu simple.

How should the residents to meet with the site visitor be selected?
The resident interview is crucial to the site visit. Please follow these guidelines: if the program has ten or fewer residents, the field representative will want to speak with all residents who are on duty on the day of the visit. If the program has more than ten residents, the field representative will want to speak with 10 to 12 residents. Residents must be selected by their peers, with representation from each year of training. If the program has extra-year chief residents, they should not participate in the resident interview (they may be included in the faculty interview). If your program operates a combined program track, such as internal medicine-pediatrics or internal medicine-psychiatry, residents from the combined program should be represented in the interview group.

Residents should be made available for the entire interview period, with their pagers turned off.

Can the date of the site visit be changed?
Because the ACGME site visits approximately 2,100 to 2,200 programs annually, the date of the site visit is set and can generally not be changed. Exceptions may be made in certain circumstances. All requests to change the date of the site visit must be made to Ingrid Philibert, Director of Field Staff Activities, by telephone to 312-755-5003. Requests must be made as soon as possible after receipt of the letter.

The ACGME incurs significant costs in scheduling field representatives to conduct program site visits. Thus, requests for postponements of the survey more than 21 days after the date of this letter must be accompanied by a letter from the institution's Chief Executive Officer (CEO). The letter must indicate that the institution agrees with the request for a change in the site visit date and is aware that it may be charged a fee of $2,000 for late notice of their intent to postpone the visit.

Our program currently has no residents. Will we be site visited?
If a site visit is due, the ACGME will visit your program, even if there currently are no residents in training. However, if your program currently has no residents, and you are not actively recruiting for the next academic year, you may want to take advantage of the ACGME's option of placing the program on "INACTIVE" status. Requests to place the program on inactive status and questions about voluntary withdrawal or inactive status should be directed to the staff of your RRC.

If you have been notified of a site visit and are planning to seek inactive status or voluntarily withdraw the program, notify Ingrid Philibert, Director of Field Staff Activities, as soon as possible of your plans by calling 312-755-5003. Failure to do so may result in the program being fined $1,000 for late notice of seeking inactive status or voluntary withdrawal.

What happens on the day of the survey?
On the day of the survey, be flexible and understand that schedules may be changed or be delayed to accommodate the information collection needs of the site visit. At the conclusion of the visit, do not expect the site visitor to offer an opinion about your program. The RRC evaluates the program and makes the accreditation decision, and the site visitor's role is to verify and clarify the self-study report you provided in the PIF.

What happens during the resident interview?
The resident interview is an important component of the site visit. It generally opens with a brief overview of the accreditation process and the purpose of the site visit. Residents may be asked what instructions were provided about the resident interview. The residents are informed that if an adverse action results the site visit report may be shared with the program. Then the site visitor asks questions based on the information in the program's PIF and concludes with questions about the program's strengths and weaknesses. For the site visit report, answers have to reach consensus level to be reported, or are reported as "a single resident stated" or "the first-year residents as a group indicated." These individual residents are not identified in the report.

Will the program be billed for the site visit?
Programs are not billed for the visit specifically, Since 2000, the ACGME has used an annual accreditation fee for all accredited programs, which eliminates the previous practice of charging site visit fees and annual resident fees. The annual fee is billed in January, separately from the site visit.

What happens after the site visit?
After the visit, the site visitor submits a written report to the ACGME, which is then forwarded to the RRC team and sent to the RRC reviewers. The site visitor does not participate in the accreditation decision. His/her job is completed when the finished site visit report is transmitted to the ACGME. Most RRCs meet twice or three times per year, while some that review a small number of programs may only meet once. The ACGME strives to get each program reviewed in as timely a fashion as possible after the site visit. RRCs close out their agendas 45 to 60 dates before the meeting date. For a program site visited less than four months before a meeting date, there is no guarantee that it will be presented at the next meeting. Also, on occasion an RRC's agenda is very full and programs need to be delayed until the next meeting. The schedule of RRC meetings is published in the ACGME Bulletin each Spring. Contact the RRC team if you want to find out if your program will be reviewed at a given meeting. After the program has been reviewed, you will be notified in writing of the accreditation decision.