Graduate Medical Education

Policy on Visiting Residents

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Introduction - The UT Health Science Center at San Antonio is ACGME-accredited as a sponsor of Graduate Medical Education (GME) programs. Under the accreditation standards, as well as the regulations of the Texas State Board of Medical Examiners (TSBME), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and other regulatory bodies, certain rules apply which govern the institution's process for accepting residents from training programs outside the UT Health Science Center at San Antonio who wish to visit this institution and our teaching hospitals for the purpose of medical education. While the primary obligation of the institution is the education of our residents, this policy has been developed to establish some uniformity of experience and to provide guidance to clinical departments that choose to offer observerships to other residents, as well as to the individuals who wish to undertake them. It is assumed that the availability of an observership is at the discretion of individual clinical departments based on that department's availability of resources, and the existence of these guidelines creates no obligation on the part of any clinical department to provide such an experience.

For residents from other training programs desiring clinical experiences within the institution, there are two types of medical experience available. These include:

  1. Observerships
  2. Clinical Rotations

This policy will address Observerships. Observership is defined as the position of observing patient care in a health care setting, without patient contact, for the specific purpose of gaining medical knowledge. (Further description of the position may be found below in Rules for Observership.)

Observerships may be granted on a case-by-case basis to physicians who are graduates of medical school and who are members in good standing of a GME program (hereinafter called "residency"). Applicants for observership whose sponsoring institution is not ACGME-accredited must submit certain information in order to determine eligibility to apply for an observership at UT Health Science Center at San Antonio-sponsored GME programs (see Application Process, below).

Individuals who may be eligible for observership include the following:

  • Residents in good standing in non-ACGME-sponsored programs

Individuals who are not eligible for observership include the following:

  • Residents at ACGME-sponsored programs - they should seek a clinical rotation (see Policy on Visiting Residents 2 - Clinical Rotations).
  • Physicians who are not currently enrolled as residents in graduate medical education programs
  • Individuals who have not yet graduated from medical school (they may qualify for consideration for a Visiting Student Elective -see http://www.uthscsa.edu/som/srselect/Vstudents.html).

Application Process

The following documents (if not originally written in English) must be officially translated into English by a certified translation agency and submitted to the GME Office:

  1. Curriculum vitae
  2. Letter from the Program Director with responsibility for the residency training that addresses the following items:
    1. Authorization and eligibility to pursue international elective experiences, if appropriate
    2. Current level of training
    3. Dates resident began and completed medical school
    4. Date resident began residency training
    5. Anticipated date resident will complete residency training
    6. Statement that the resident is in good standing
    7. Curricular requirements to be met by the observership experience.
  3. Official copy of Medical School transcript with medical school seal
  4. Notarized copy of the Medical School diploma
  5. Evidence of proficiency with the English language
  6. Statement of desired Observerships
  7. Evidence of health insurance to cover accidents, illness, etc. while performing the observership
  8. Nonrefundable application fee of $50.00 (US) - certified check made payable to Office of Graduate Medical Education at UT Health Science Center at San Antonio, to be submitted with above materials.

The application materials should be sent to the program of interest at the following address:

The University of Texas Health Science Center at San Antonio
7703 Floyd Curl Drive
San Antonio, TX 78229-3900

After receipt of all application documents, a determination will be made as to the resident's eligibility to apply for an Observership experience within this institution. Following such determination, the applicant will be referred to the specific program(s) for application. Not all programs accept observers, and programs may require further application documentation, an interview, and/or an additional application fee.

Before beginning an observership, the following items must be completed:

  1. Health screening with documentation of immunization status for measles, mumps, rubella, tetanus, hepatitis B, and polio. Evidence of screening for tuberculosis to include a skin test and chest xray as clinically indicated must be provided. Any lapsed immunizations must be obtained at the observer's expense.
  2. Applicants who do not have United States citizenship or permanent resident status must obtain a visa that will be in force for the entire duration of the observership. The visa holder must comply with all terms of the visa during the observership.
  3. The applicant must complete the UT Health Science Center at San Antonio Selection of Non-Employee ("Volunteer") form and must have a photo identification badge made by the UTHSC Police Office.

Rules for Observership

  1. The observer must obtain prior written authorization from the GME Office. Failure to obtain written authorization will be grounds for immediate escort from the premises of the UT Health Science Center at San Antonio and/or the teaching hospital(s).
  2. The observer must wear appropriate photo identification at all times when on campus or within the teaching hospitals, and must abide by all policies, rules, regulations, and bylaws of UT Health Science Center at San Antonio, the residency department, and the teaching hospitals.
  3. The observer must be supervised by a faculty physician or designee (other faculty from the same department or a senior-level resident) at all times when in the presence of patients. He/she is not allowed unrestricted access to UT Health Science Center at San Antonio, or to the teaching hospitals.
  4. The observer must introduce him/herself to the patient as an observer, and must request the patient's permission to be present at the time of clinical visit, procedure, or other patient services. If the patient declines to allow the observer's presence, he/she must leave the area.
  5. The observer is not allowed any other direct patient contact. Contact is defined as physically touching, talking with, performing a medical history and/or examination, counseling (patient or patient's family/friends), assisting in surgery or any other procedure, or otherwise interacting with patients, either individually or in the presence of others.
  6. The observer cannot make patient chart entries (electronic or hard copy). He/she may not make copies of patient charts (paper or electronic).
  7. There is a maximum of two (2) one-month observerships per individual, which may not be extended.
  8. The observer must complete an evaluation of the rotation upon its completion.
  9. No stipend support, compensation, insurance coverage, benefits, or housing will be provided by the UT Health Science Center at San Antonio or the teaching hospitals.
  10. UT Health Science Center at San Antonio may, at its sole discretion, terminate this observership without recourse to due process or appeal process.
  11. The observership is performed on a voluntary basis, and the resident is not employed by UT Health Science Center at San Antonio or the teaching hospitals or any affiliated entities.
  12. The observer will not receive any academic credit for the experience. The observership does not constitute medical education, graduate medical education, continuing medical education or training leading to licensure or board certification. The observer is not a student, resident, or medical staff member at UT Health Science Center at San Antonio, and must not represent him/herself as such. The experience is properly characterized as an "observership."
  13. The following activities are permissible for observers:
    1. Participation in grand rounds, seminars, or other didactic activities
    2. Participation in case conferences or chart rounds. Observers who are engaged in this activity may be asked to sign a document acknowledging the responsibilities of confidentiality.
    3. May observe walking rounds with the supervising faculty physician or designee.
    4. May view and discuss patient interactions with the supervising faculty physician or designee, if the patient has agreed to permit observation.
    5. May view and discuss videotapes of patient evaluations, if the patient has agreed to permit observation and videotaping.
    6. May utilize software and hard copy educational resources (teaching software, books, journals) of the Briscoe Medical Library. Access to the internet from computers in the Library, or departments will be in accordance with current standard Health Science Center policies.
  14. Upon satisfactory completion of the observership, the sponsoring program will provide the observer with a certificate of completion of the observership.

Acceptance into an Observership position will not constitute a precedent or guarantee acceptance into further residency training in programs sponsored by UT Health Science Center at San Antonio.