A series of interviews must take place with the Program Director, teaching staff, residents, and   with the Residency Program Committee.  Visits to individual sites should take place as appropriate.  All residency education sites and elective experiences should be reviewed by the Internal Review Team.  There should be a careful assessment of the quality of the program based on the general and specific standards of accreditation as outlined by the respective College.

Meeting with the Program Director

The meeting with the Program Director is to ensure that the program structure meets the Accreditation Standards.  For example:

  • Does the program hold regular Residency Training Committee meetings and are minutes kept?
  • Is there appropriate representation on the Committee (i.e., Faculty members, Educators, Teaching Site Representatives, elected Resident Representatives)?
  • Does the Program have a formal Evaluation process?  Are Evaluation forms completed in a timely manner and discussed with residents?
  • Does the program provide opportunities for residents to evaluate the quality of their education?
  • Are residents provided with Educational Objectives, a structured curriculum or is the Curriculum incident-driven?
  • Are residents provided an opportunity for graded responsibility?
  • Are exam Results consistent or is there a significant reduction in performance over the last few years?  Are they consistently below national average?  If so, this may be a sign of a problem in the educational program.
  • How did the program address weaknesses identified during the last review?
  • Have educational initiatives been developed or have they been updated since the last review?
  • How does the program deal with residents in difficulty?  
Meeting with the Department Head & Division Chair

This meeting serves to identify the involvement of the Head in the Postgraduate program. 
Questions to consider include:

  • Where does Postgraduate Education fall within the Department’s mandate? 
  • How much does the Head support the Program Director? 
  • Are adequate resources provided (administrative, financial, physical, material) by the Hospital?

Meeting with the Residents / Chief Residents

The reviewers will meet with all residents in the program.  In large programs it will be customary to meet separately with the junior residents and senior residents.

This meeting is to allow the residents to identify the strengths and weaknesses of the program.  It is important to be positive and give the residents a feeling of openness.  It is suggested that the Review Team Chairperson start the discussion with an opening remark by indicating the purpose of the Internal Review and that residents should feel free to discuss any issue.  It is also important to emphasize that all discussions will remain confidential and anonymous should there be a need to identify issues in the report.  

Question the residents on the following points:

  • Do they think the program is meeting the specialty training requirements?
  • Are residents made aware of their educational objectives and are these being met?
  • Do the senior residents feel that the program provides adequate opportunities to develop their skills necessary to function as a specialist physician?
  • How do residents perceive the service to education balance?  Do they feel there is a good balance between education and service expectations? 
  • Do residents feel there is open communication within the program? 
  • What are the strengths of the program?
In the event that issues of intimidation or harassment are raised, it is important to listen to comments, however it is also important to ensure that this issue does not drive the entire discussion.  

Meetings with Research Director, Teaching Faculty, and Residency Program Committee

These meetings are to obtain feedback on how the members of the program perceive the quality of the education and the structure of the program.   It is also an opportunity to question members of the Residency Program Committee.  Questions to consider include:

  • Is the Committee dealing with issues identified at meetings and is there a follow up mechanism?  
It is recommended that a portion of this meeting should be with the Residency Program Committee without the Program Director, Division Chair, or Department Head present, to allow for frank discussion. 

Preparation for Exit Report

This meeting is to allow the Internal Review Team to come to a consensus on the apparent strengths and weaknesses of the program and to prepare for the Exit meeting with the Program Director. The Internal Review Team should decide what they will report on during the Exit meeting.

Exit Meeting

The exit meeting is simply to outline to the Program Director the findings of the review and to obtain clarification on certain issues.  Be sure to identify the strengths and weaknesses of the Program.  Give an opportunity for the program to provide feedback on the comments you made. This will help the Internal Review Team  to identify whether a specific issue is really a weakness/problem or if it was just a perception.