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Why Are Agreements Required?

Why are agreements necessary?

According to the LCME Accreditation Standards (http://www.lcme.org/standard.htm updated May 2011)

ER-9.  A medical education program must have written and signed affiliation agreements in place with its clinical affiliates that define, at a minimum, the responsibilities of each party related to the educational program for medical students.

Written agreements are necessary with hospitals that are used regularly as inpatient sites for core clinical clerkships (or, in Canada, clerkship rotations). Additionally, affiliation agreements may be warranted with other instructional sites that have a significant role in the clinical education program.

Affiliation agreements should address, at a minimum, the following topics:

  • The assurance of medical student and faculty access to appropriate resources for medical student education.
  • The primacy of the medical education program over academic affairs and the education/assessment of medical students.
  • The role of the medical education program in the appointment and assignment of faculty members with responsibility for medical student teaching.
  • Specification of the responsibility for treatment and follow-up when a medical student is exposed to an infectious or environmental hazard or other occupational injury.

If department heads of the medical education program are not also the clinical service chiefs at affiliated institutions, the affiliation agreement must confirm the authority of the department head to ensure faculty and medical student access to appropriate resources for medical student education.

The medical education program should advise the LCME and the CACMS, when applicable, of anticipated changes in affiliation status of the program's clinical facilities. 

ER-10.  In the relationship between a medical education program and its clinical affiliates, the educational program for medical students must remain under the control of the program’s faculty at each instructional site.

Regardless of the location in which clinical instruction occurs, department heads and faculty of the medical education program must have authority consistent with their responsibility for the instruction and assessment of medical students.

The responsibility of the clinical facility for patient care should not diminish or preclude opportunities for medical students to undertake patient care duties under the appropriate supervision of the medical education program’s faculty and residents.

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