Program Ranking: Should I Rank a Program that is on Probation?

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Program Ranking: Should I Rank a Program that is on Probation?

There is a variety of reasons why ACGME may put a program on probation.

“Programs that are not in substantial compliance with program requirements may be given probationary accreditation. All residents must be notified if their program is placed on probation. The program director must also inform all medical student applicants that the program is on probation. Probation is considered an accreditation status. (A list of programs on probation is posted on the ACGME Web site.) The review cycle length for programs with probationary accreditation cannot exceed two years.

Programs with probationary accreditation that fail to demonstrate substantial compliance with requirements may have their accreditation withdrawn. All candidates to the program and residents in the program must be notified in writing of the RRC’s decision to withdraw accreditation.

Regardless of a program’s accreditation status, an RRC following a site visit and review may withdraw a program’s accreditation in an expedited process when there is a catastrophic loss of resources (faculty, facilities, funding) or the RRC determines there is egregious noncompliance with accreditation requirements. “

By the way, did you notice the part referring to "medical student applicants", as if IMGs did not exist?

Most applicants think that a program that is on probation is a bad choice and that residents there are treated badly. This is definitely not the case. A program on probation has ACGME site visit scheduled within a 2-year timeframe. ACGME conducts confidential resident interviews during the visit. So, the program has a real incentive to keep the residents happy.

The biggest risk associated with a program on probation is the closure. Looking back in history (history usually repeats itself) there weren’t many. Program closure by the ACGME is the last resort. If a site visit revealed any non-compliance issues, a program gets a citation and may be put on probation. At this point Program Director is on fire. It is in the program’s best interests to resolve the issues as soon as possible and report the resolution back to ACGME. ACGME is also scheduling a follow up site visit within a year or two. Do programs ever close? Yes, but most closures are not caused by ACGME probation. We have inquired ACGME for a report on programs closed as a result of ACGME actions. Even though we have not received a report yet, we could not find any evidence suggesting this. We are aware of many voluntary closures though. These programs were closed by hospital board decisions due to financial reasons more than anything else. Just to summarize all of the above – yes, a program being on probation is a negative sign, which indicates that teaching process may have some deficiencies. However, it is not a good predictor of program closure. A program is more likely to be closed for financial reasons.

And finally, should you rank a program that is on probation? You may consider giving it a lower rank than the other programs, but you owe to yourself to have it ranked. The worst thing that can happen is that the program closes. Programs do not close in the middle of the year, so you will get at least one year of training. Finding PGY-2 or first year in advanced specialty after successful completion of PGY-1 is a much simpler task than obtaining PGY-1. Yes, you may end up in a situation that requires you to do residency search again. But you will be in a much stronger position then. Besides, the program, as well as ACGME is required to help you in this search.

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