Member Change Form
All major changes to member programs must be submitted in writing to the Fellowship Council office via the Member Change Form. Major changes include:
- Change in Program Director
- Significant Change in Faculty Complement
- Change in Number of Positions Available
- Change in Program Designation
- Withdrawal from the Fellowship Council/Program Closure
Fellow Change Form
Programs must complete the Fellow Change Form any time there is a change to either the Matched or Current Fellow.
Change Review Process
The information will be reviewed by the Membership, Communications, Accreditation Committees, and/or Board of Directors as applicable. The form must be signed by BOTH the Program Director and the program’s Designated Institutional Official (DIO).
The completed form must be emailed to firstname.lastname@example.org.
**Potential triggers for a site visit by the Accreditation Committee include but are not limited to: a change in Program Director, a change in the number of fellows, a significant change in the associate faculty, insufficient case logs, program complaints, failure to address previous citations, and conflicts with the residency program. Please also note that a change in program designation may require closure of the existing program and re-application as a new member for the requested new designation.