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Appointment Principles

The resident's appointment level reflects their progress towards their current educational goal.

Question: At what level should a resident be appointed?

The following are examples of how this principle is applied:

1. As part of a six year surgical program a resident is required to do two years of research. Generally, residents in the Program conduct their research at the University of Michigan in years 4 and 5, returning to clinical activities at an HO 6 level. A resident, with prior full approval of the Program Director, chooses to conduct her required research at the CDC. Upon successful completion of the research, she is given credit for the time spent at the CDC up to 2 full years. Returning to the University of Michigan, she will be appointed as an HO 6. If additional time is spent at the CDC with the Program Directors approval, her returning level will still be as an HO 6.
   Explanation: Two years of research are required as part of the surgical residency. Regardless of where the research is conducted, the resident is fulfilling a requirement towards the educational goal of board eligibility in the discipline. Hence, upon her return, she is given full credit for the experience as if the research had been conducted onsite. Additional research time beyond that required is not credited toward the educational goal of board eligibility and therefore, upon returning, does not result in appointment at a higher level.
   
2. A resident chooses to change specialty careers. He had completed 2 years as a surgical resident at another University and now decides to become a pediatrician. The Pediatrics Board determines that none of his prior training will count toward eligibility for the Pediatrics boards. His appointment at the University of Michigan will be as an HO 1.
   Explanation: The prior experience as a surgical resident does not count towards his current educational goal of becoming board eligible in Pediatrics. Therefore, he is appointed at a level commensurate with his progress towards his current educational goal.
   
3. A resident enters a Gastroenterology fellowship. He had completed his three years of Internal Medicine training and then served one year as a Chief Resident. He will be appointed as an HO 4. Program Directors may recognize a year spent as a Chief Resident in a United States training program.
   Explanation: His experience as Chief Resident was not required for appointment in the Gastroenterology fellowship and did not count towards his goal of board eligibility in GI. Therefore, his appointment level will not reflect the year spent as a Chief Resident.
   
4. A resident is Board Certified in Pediatrics. She has practiced for three years and now decides to enter a Pediatric Nephrology Fellowship Program. She will be appointed as an HO 4.
   Explanation: Her experience in practice was not required for appointment in the Nephrology fellowship and did not count towards her goal of board eligibility in Nephrology. Therefore, her appointment level will not reflect the years spent in practice.

Approved by the GME Review Board on March 23, 1999