New Application: Pediatric Rehabilitation Medicine
Review Committee for Physical Medicine and Rehabilitation
ACGME
515 North State Street, Suite 2000 Chicago, Illinois 60654  312.755.5000  www.acgme.org
SPONSORING INSTITUTION
1. Describe how the sponsoring institution provides adequate salary support to the program director.
Include the percentage of the program director’s salary that is provided. [PR.I.A.2.]
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2. Describe the financial resources committed to the program by the sponsoring institution. [PR I.A.3.]
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PROGRAM PERSONNEL AND RESOURCES
Program Director
1. Is there a written supervision policy, developed and implemented by the fellowship program director
in cooperation with the core physical medicine and rehabilitation residency program director, which
specifies the lines of responsibility for faculty members and fellows, as well as residents in the core
program? [PR II.A.3.e)] ................................................................................................ ☐ YES ☐ NO
2. How will the program director ensure that fellows entering at the PRM-2 level achieve the required
PRM-1 competencies by the completion of the PRM-2 year? [PR II.A.3.f)]
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3. What mechanisms does the program director have in place for monitoring fellow stress, including
mental or emotional conditions inhibiting performance or learning? [PR II.A.3.g)]
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Other Program Personnel
Describe the additional professional, technical, and clerical personnel that will support the
administration and educational conduct of the program. [PR II.C.]
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Resources
1. Does the program have access to a service delivery system dedicated to the care of persons with
pediatric rehabilitative disorders? [PR II.D.1.] ............................................................... ☐ YES ☐ NO
2. List the number of pediatric rehabilitation beds at each site. [PR II.D.2.a)]
Total Pediatric Rehabilitation Beds
Site # 1
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Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
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3. Briefly describe the outpatient clinic or examination areas used to assess persons with pediatric
rehabilitative disorders. [PR II.D.2.b)]
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4. Briefly describe the transitional services available to the program for home care, community entry,
and schooling. [PR II.D.2.c)]
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5. Briefly describe the equipment, electrodiagnostic devices, radiology services, laboratory services,
and clinical rehabilitation facilities available to the program. [PR II.D.2.d)]
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6. Briefly describe the teaching facilities available to the program. [PR II.D.2.e)]
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7. Is there a medical records system that allows for efficient case retrieval? [PR II.D.2.f)]
.................................................................................................................................... ☐ YES ☐ NO
8. Indicate with a check mark whether personnel in the following specialties and subspecialties will
interact regularly with fellows at each participating site. [PR II.D.2.g).(1)]
Team Members
Anesthesiology
Diagnostic radiology
Emergency medicine
General Surgery
Medical genetics
Neurological surgery
Neurology
Orthopaedic surgery
Pathology
Pediatrics
Pediatric surgery
Plastic surgery
Psychiatry
Urology
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9. For categories of personnel that are unavailable, describe how that function will be addressed in the
program.
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10. Patient Population
Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 2/2015
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Data should be specific to pediatric rehabilitation patients. Patients should be counted only once.
Provide data the most recent year. [PR II.D.3.]
Patient Type:
Musculoskeletal
disorders and trauma,
including sports
injuries
Inpatient pediatric
rehabilitation admissions
Inpatient consults
Outpatient consults
Cerebral palsy
Inpatient pediatric
rehabilitation admissions
Inpatient consults
Outpatient consults
Spinal dysraphism
Inpatient pediatric
and similar congenital rehabilitation admissions
anomalies
Inpatient consults
Outpatient consults
Spinal cord injury
Inpatient pediatric
rehabilitation admissions
Inpatient consults
Outpatient consults
Traumatic and other Inpatient pediatric
acquired brain injuries rehabilitation admissions
Inpatient consults
Outpatient consults
Limb
Inpatient pediatric
deficiency/amputation rehabilitation admissions
Inpatient consults
Outpatient consults
Neuromuscular
Inpatient pediatric
disorders
rehabilitation admissions
Inpatient consults
Outpatient consults
Peripheral nerve
Inpatient pediatric
injuries
rehabilitation admissions
Inpatient consults
Outpatient consults
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11. Are fellows provided with prompt, reliable systems for communications and interactions with
supervisory faculty members? [PR II.D.4.] ................................................................... ☐ YES ☐ NO
EDUCATIONAL PROGRAM
Are fellows provided with written objectives for each clinical rotation? [PR IV.A.1.a)] ......... ☐ YES ☐ NO
Patient Care
Indicate the settings and activities in which fellows will develop competence in each of the following
areas of patient care. Also indicate the method(s) used to assess competence.
Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 2/2015
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Competency Area
PRM-1 Year
Initial patient evaluation to include
pertinent information relevant to
the patient’s impairments,
medical conditions, functional
limitations, cognition,
psychosocial issues, and
educational or vocational
limitations
[PR IV.A.2.a).(1).(a).(i)]
Implementing general pediatric
rehabilitative therapeutic
management, including early
intervention, age-appropriate
functional training, programs of
therapy, play (avocation),
therapeutic exercise, electrical
stimulation and other modalities,
communication strategies, oral
motor interventions, discharge
planning, educational and
vocational planning, transitional
planning, adjustment to disability
support, and prevention
strategies.
[PR IV.A.2.a).(1).(a).(ii)]
Incorporating psychological,
social and behavioral aspects of
rehabilitation management,
including family-centered care for
pediatric patients
[PR IV.A.2.a).(1).(a).(iii)]
Identifying and managing
common pediatric rehabilitation
medical conditions and
complications, including nutrition,
bowel management, bladder
management, gastroesophageal
reflux, skin protection, pulmonary
hygiene and protection, sensory
impairments, sleep disorders,
spasticity, thromboembolism
prophylaxis, swallowing
dysfunction, seizure
management, and behavioral
problems
[PR IV.A.2.a).(1).(a).(iv)]
Selecting and interpreting
diagnostic studies commonly
ordered in pediatric rehabilitation
Settings/Activities
Assessment Method(s)
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Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 2/2015
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Competency Area
Settings/Activities
Assessment Method(s)
medicine, including radiographic
imaging, laboratory data, genetic
testing, urodynamics and
electrodiagnostic studies
[PR IV.A.2.a).(2).(a)]
PRM-2 Year
Prescribing, age-appropriate
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assistive devices and technology
to assist environmental
accessibility, including orthotics,
prosthetics, wheelchairs and
positioning, ADL aids, interfaces
and environmental controls,
augmentative/alternative
communication, and electrical
stimulation
[PR IV.A.2.a).(1).(b).(i)]
Rehabilitation management of common pediatric problems, including: [PR IV.A.2.a).(1).(b).(ii)]
Musculoskeletal disorders
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and trauma, to include sports
injuries
[PR IV.A.2.a).(1).(b).(ii).(a)]
Cerebral palsy
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[PR IV.A.2.a).(1).(b).(ii).(b)]
Spinal dysraphism, and other Click here to enter text.
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congenital anomalies
[PR IV.A.2.a).(1).(b).(ii).(c)]
Spinal cord injury
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[PR IV.A.2.a).(1).(b).(ii).(d)]
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brain injuries
[PR IV.A.2.a).(1).(b).(ii).(e)]
Limb deficiency/amputation
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[PR IV.A.2.a).(1).(b).(ii).(f)]
Neuromuscular disorders
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[PR IV.A.2.a).(1).(b).( ii).(g)]
Peripheral nerve injuries
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[PR IV.A.2.a.(1).(b).( ii).(h)]
Performing pediatric rehabilitation Click here to enter text.
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management procedures,
including spasticity management
[PR IV.A.2.a).(2).(b)]
Medical Knowledge
1. Indicate the settings and activities, (including lectures, conferences, journal clubs, etc) in which
fellows in the PRM-1 year will develop basic knowledge of each of the following areas. Also indicate
the method(s) used to assess knowledge.
Area of Knowledge
Settings/Activities
Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Assessment Method(s)
Updated 2/2015
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Area of Knowledge
Normal growth and
development, including physical
growth, developmental skillsattainment (language and
communication skills, physical
skills, cognitive skills, emotional
skills and maturity, academic
achievement/learning skills),
transitional issues, metabolic
status, biomechanics, the effects
of musculoskeletal development
on function, sexuality,
avocational interest
development, wellness and
health promotion, and aging
issues for adults with congenital
or childhood onset disabilities
[PR IV.A.2.b).(1).(a)]
Growth and development for
children with congenital and
childhood onset disabilities,
throughout the life course
[PR IV.A.2.b).(1).(b)]
Medicolegal aspects of care,
including child protective
services and guardianship
[PR IV.A.2.b).(1).(c)]
Settings/Activities
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Assessment Method(s)
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2. Indicate the settings and activities (including lectures, conferences, journal clubs, etc.) in which
fellows in the PRM-2 year will develop competence in their knowledge of each of the following
areas. Also indicate the method(s) used to assess competence.
Competency Area
Settings/Activities
The clinical course of, and
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functional prognosis for,
common pediatric rehabilitation
problems, as well as burns and
rheumatologic and connective
tissue disorders that are
common in the pediatric patient
[PR IV.A.2.b).(2).(a)]
Applications, efficacy, and
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selection of pediatric
rehabilitation medicine
assessment tools, including
general health measures,
developmental attainment
measures, general functional
measures, and specific
outcomes measures
[PR IV.A.2.b).(2).(b)]
Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Assessment Method(s)
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Competency Area
Settings/Activities
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organizational behaviors and
leadership, quality assurance,
cost efficiency and regulations
pertaining to systems of care,
including external reviews,
inpatient services, outpatient
services, home care, and school
based programs
[PR IV.A.2.b).(2).(c)]
Assessment Method(s)
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Practice-based Learning and Improvement
Indicate the settings and activities in which residents will develop the skills and habits to meet the
following goals. Also indicate the method(s) that will be used to evaluate competency. [PR IV.A.2.c)]
Competency Area
Settings/Activities
Teaching other hospital
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personnel, including medical
students, residents, and other
fellows, about pediatric
rehabilitation medicine. Including:
developing objectives and
curriculum plans; effectively using
audiovisual aids and other
teaching materials; and,
evaluating teaching outcomes
[PR IV.A.2.c).(3); IV.A.2.c).(3).(a)(c)]
Method(s) Used to Evaluate
Fellow Competency
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Interpersonal and Communication Skills
List the settings/activities in which fellows develop competency in the areas listed below. Also specify
the method(s) used by the program to evaluate fellow competency in each area. [PR IV.A.2.d)]
Competency Area
Settings/Activities
Requesting appropriate
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medical/surgical consultations
from other specialties by the
completion of the PRM-1 year
[PR IV.A.2.d).(1)]
Providing consultation to
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psychiatrists, pediatricians, and
other clinicians regarding pediatric
rehabilitation issues; and eliciting
information from, and providing
counseling to families and
patients in age-appropriate
manner by the completion of the
Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Method(s) Used to Evaluate
Fellow Competency
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Competency Area
PRM-2 year
[PR IV.A.2.d).(2).(a)-(b)]
Settings/Activities
Method(s) Used to Evaluate
Fellow Competency
Systems-based Practice
List the settings and activities in which fellows develop competence in the areas listed below. Also
specify the method(s) used to evaluate fellow competence in this area. [PR IV.A.2.f)]
Competency Area
Demonstrate a management
style compatible with
interdisciplinary team process
[PR IV.A.2.f).(1)]
Settings/Activities
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Method(s) Used to Evaluate
Fellow Competency
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Curriculum Organization and Fellow Experiences
1. Will each fellow be assigned a faculty advisor/mentor for the duration of the fellowship? [PR
IV.A.3.a).(1)] ................................................................................................................ ☐ YES ☐ NO
2. Briefly describe the faculty advisor/mentor’s responsibilities and planned interactions with the fellow.
Also describe how the faculty advisor/mentor and the program director together will provide
monitoring and feedback, and adjustment of the fellow’s written plan as needed. [PR
IV.A.3.a).(1).(a); IV.A.3.a).(1).(b)]
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3. Briefly describe the opportunities for fellows to meet and share experiences with residents in the
core program and in other specialties. [PR IV.A.3.a).(2)]
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4. Briefly describe fellow experience following individual patients longitudinally. Also describe how the
program will ensure that this experience allows fellows to encounter a wide variety of patient
problems? [PR IV.A.3.a).(3)]
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5. Do program conferences include: [PR IV.A.3.d).(1).(a)]
a) Case-oriented multidisciplinary conferences?......................................................... ☐ YES ☐ NO
b) Journal clubs? ........................................................................................................ ☐ YES ☐ NO
c) Quality management seminars relevant to clinical care in pediatric rehabilitation medicine?
............................................................................................................................... ☐ YES ☐ NO
6. Provide a list of conferences, including case-oriented multidisciplinary conferences, journal clubs,
and quality management seminars, relevant to clinical care in pediatric rehabilitation medicine for
the past two years. Include titles, presenting faculty member or fellow names (underline fellow
names), and dates. Add rows as necessary. [PR IV.A.3.d).(1)-IV.A.3.d).(4).(a)]
Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 2/2015
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Title
Presenting Faculty Member
or Fellow Names
Date*
*NOTE: At a minimum, there must be twice-monthly conference time [PR IV.A.3.d).(4).(a)]
7. Briefly describe how the curriculum addresses the fundamentals of managing patients with pediatric
rehabilitation disorders, including pathophysiology, clinical manifestations, and problem
management. [PR IV.A.3.d).(2)]
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8. Briefly describe how fellows will be provided with instruction in the economics of health care and
current health care management issues, including cost-effective patient care, practice
management, preventive care, quality improvement, prevention of medical error, resource
allocation, and clinical outcomes. [PR IV.A.3.d).(5); IV.A.3.d).5.(a)]
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9. Briefly describe how fellows will be provided with instruction in issues related to regional and
national access to care, resources, workforce, and financing appropriate to the field [PR
IV.A.3.d).(6).(a)]
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10. Briefly describe how fellows will be provided with instruction about the organization and
management of the pediatric rehabilitation service within the local delivery system. [PR
IV.A.3.d).(6).(b)-IV.A.3.d).(6).(b).(vi)]
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FACULTY EVALUATION
Will fellows provide confidential evaluation of the members of the faculty annually? [PR V.B.3.]
.......................................................................................................................................... ☐ YES ☐ NO
If no, explain.
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Pediatric Rehabilitation Medicine
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 2/2015
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