Section 4
Date: January 2014, May 2015
Program for Away Rotation (PAR)
4.11 Application: Program for Away
Rotation
Page 1 of 3
Saint Louis University Office of Graduate Medical Education
Program for Away Rotation (PAR) Application
______________________________________________________________________________________
Section I: To be completed by trainee.
Name of Applicant_____________________________________
PGY level__________
Department_________________________________________
Program_________________
SLU Away Rotation Faculty Mentor_____________________________________
Away Rotation Information
Proposed Rotation Dates (maximum 28 days):_______________________________
Country___________________________
City_______________________
Name of School/Organization/Program (if applicable)________________________________
Off-Site Supervisor/Evaluator___________________________________________
___________________________________________________________________________________
Section II: Please respond to each question (to be completed by trainee--max 200 words each).
1. Describe the daily/weekly work on this rotation including specific hospital/clinic sites, didactic
experiences, procedures, and duties that will be performed. Indicate whether observation or active
clinical activities will take place and how supervision will be provided.
2. Describe how this experience will enhance your education in your discipline and why this experience
can’t be obtained locally at Saint Louis University.
3. Describe how this experience will be shared with and benefit your peers and training program upon
your return to Saint Louis University.
4. Describe your qualifications, experiences and strengths which would make you a strong candidate to
receive approval for a GME funded away rotation.
Section 4
Date: January 2014, May 2015
Program for Away Rotation (PAR)
4.11 Application: Program for Away Rotation
Page 2 of 3
Section III: The trainee and PD must initial each statement below, indicating agreement to and
understanding of the following terms of the program.
_____ _____ The GME office will cover the costs of the trainee’s stipend and benefits, and for U.S.-based
rotations the malpractice coverage, for up to 28 days during the rotation through the usual payroll process. No
additional stipend is provided directly to the trainee. Up to $1000 will be reimbursed after the rotation to offset
international airfare expenses and up to $500 will be reimbursed to offset U.S.-based airfare/transit expenses.
_____ _____ The trainee and/or program will be responsible for additional travel costs, lodging, meals,
vaccinations, prophylactic medications, purchasing of SLU international health insurance (required—via website:
http://www.slu.edu/study-abroad-home/health-and-safety/international-health-insurance), fees associated with
processing, licensing or credentialing at the away site, or additive malpractice coverage (optional).
_____ _____ Upon return, the trainee will provide a grand rounds-type educational presentation of the
experience, complete a brief post-rotation report for the GME office, and serve as a resource for other trainees
interested in away rotation experiences.
_____ _____ The trainee’s clinical performance must be evaluated by the away rotation supervisor at the end of
the rotation.
_____ _____ The trainee, faculty advisor, and program director are responsible for completing all paperwork and
travel arrangements related to this rotation including a Program Letter of Agreement between Saint Louis
University and the away site (U.S.-based rotations) at least 1 month prior to the departure date for the rotation.
_____ _____ The trainee must obtain the proper passport, visa, licensure, immunizations, travel medications,
credentialing, and approvals as needed at least 1 month prior to the departure date for the rotation.
_____ _____ The trainee’s absence must not place undo clinical or service stress on other trainees or
compromise patient care.
_____ _____ The trainee must not be required to extend residency training as a result of participation in the
away rotation and that the rotation must provide a certifiable educational experience as outlined by ACGME.
Required signatures: I have read and understood the requirements of the Program for Away Rotation.
___________________________________________________
Trainee
________________
Date
___________________________________________________
Program Director
________________
Date
___________________________________________________
SLU Away Rotation Faculty Mentor (if different from PD)
________________
Date
___________________________________________________
Departmental Chairman
________________
Date
Section 4
Date: January 2014
Program for Away Rotation (PAR)
4.11 Application: Program for Away
Rotation
Page 3 of 3
Saint Louis University Office of Graduate Medical Education Program for Away
Rotation (PAR) Application
Section IV: Supplemental materials to be submitted by Program Director.
Please complete and attach the below items and submit with the application to the GME Office.
Applications will be reviewed twice a year. The deadline for all application materials is May 1
and November 1 and must be at least 60 days prior to the departure date of the rotation.

Rotation description (approximately 1 page) including: goals, competencybased objectives, clinical responsibilities, and the supervision and evaluation
process. This must meet ACGME RRC requirements as a qualifying educational
experience for the trainee’s discipline.

Letter of support from the trainee’s Program Director indicating that:
o The trainee is in good standing with the school and program
o The trainee is qualified to perform the clinical duties of the away rotation
o The away experience will provide an educational benefit to the trainee and program
o The PD has communicated with the off-site supervisor and that supervisor is aware of
the requirements of the away rotation program

A copy of the evaluation form that will be used by the away rotation supervisor
to evaluate the trainee’s performance

A copy of the trainee’s CV

A brief budget outlining expected travel costs of the trainee for this rotation
___________________________________________________________________
Section V: Additional Information
 Prior to any off-site training, the trainee and program director must also complete the
required institutional “Application For Saint Louis University Residents Rotating to Other
Institutions for Electives” forms.
 Trainees holding visas or with immigration-related travel restrictions must get appropriate
authorization prior to off-site rotations.Trainees participating in U.S.-based rotations
rotations must obtain a temporary training license for the state in which the rotation will
take place.
 Trainees participating in U.S.-based rotations must ensure that all paperwork and
affiliation agreements for the accepting hospital/GME Office/University are completed in
advance of the rotation.