PLA MARICOPA COUNTY OFFICE OF MEDICAL EXAMINER REV2JR.PDF

PROGRAM LETTER OF AGREEMENT
between
The University of Arizona College of Medicine - Phoenix
and
Maricopa County Office of the Medical Examiner
This Program Letter of Agreement (“PLA”) is incorporated into and made part of the previously
approved Affiliated Agreement (C-29-09-004-3-01), between The University of Arizona College
of Medicine- Phoenix (“Home Institution”), and Maricopa County Office of the Medical
Examiner (“Host Institution”), with respect to resident/fellowship education for required
assignments and sets forth the terms and conditions of the residents and/or fellows rotation
assignments.
This PLA is effective beginning July 1, 2019 and ending December 31, 2019 (no more than five
(5) years). This PLA may be terminated by either party at any time with prior written notice to
the other party. This Letter of Agreement will automatically expire on the date that the
Affiliation Agreement expires if the Affiliation Agreement is not renewed or a new Affiliation
Agreement approved.
1. Program Rotation
This is an Forensic Medicine rotation for Home Institution’s Pathology Residency
Program residents to rotate at Maricopa County Office of the Medical Examiner.
2. Rotation Description and Length
The rotational assignment for residents and/or fellows shall be such that up to two (2)
fellows may rotate for one (1) month at Host Institution. Home Institution shall
provide Host Institution a listing of the residents and/or fellows who are proposed to
participate in the rotation.
3. Persons Responsible for Education and Supervision
At Home Institution: Program Director Name: Xianfeng Frank Zhao, MD, PhD, MBA
Address: 650 E. Indian School Rd.
City, State, Zip: Phoenix, AZ 85006
Phone: (602) 277-5551 xt. 6346
Email: xfzhao@email.arizona.edu
At Host Institution: Site Director Name: Jeffrey S. Johnston, MD
Address: 701 W. Jefferson Street
City, State, Zip: Phoenix, AZ 85007
Phone: (602) 506-3322
Email: johnstonj004@mail.maricopa.gov
Other Supervising Physicians Amber R. Wang, MD
at Host Institution: Faculty as assigned by the Site Director
The faculty mentioned above are responsible for the education and supervision of the residents
and/or fellows while rotating at the Host Institution.
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4. Responsibilities
a. The site director and other supervising physicians at OME will provide
appropriate supervision and experience for residents and/or fellows in patient care
activities in a private physician practice or clinic environment and maintain a
learning environment conducive to educating the residents and/or fellows in the
Accreditation Council of Graduate Medical Education (“ACGME”) competency
areas. Each resident and fellow shall have the same privileges relative to
educational experience and clinical activity as all other residents and fellows who
rotate through Host Institution’s site, and each shall have access to the facilities,
services and equipment that are essential to his/her training.
b. OME will evaluate resident and/or fellow performance in a timely manner and
document this evaluation at completion of the rotation or similar educational
assignment. OME will be sent an evaluation form at the completion of each
resident rotation. Completion of evaluation forms for each resident and/or fellow
by OME and the completion by the resident and/or fellow of a rotation evaluation
form regarding OME, are required by the Program in order for the resident and/or
fellow to receive credit.
5. Content and Duration of the Educational Experiences
a. The content of the educational experiences has been developed according to
ACGME Residency/Fellowship Program Requirements, and includes the goals
and objectives set forth in the Program/Rotation Goals and Objectives
(“Attachment A”), attached hereto and incorporated by reference.
b. The Home Institution program director, the Host Institution director and the Host
Faculty are responsible for the day-to-day activities of the residents and/or fellows
to ensure that the outlined goals and objectives are met during the course of the
educational experiences at Host Institution. Without limiting the generality of the
foregoing, the Home Institution, with cooperation from the Host Institution, is
responsible for the quality of the residents’ and/or fellows’ educational experience
and retains authority over the residents’ and/or fellows’ activities while on
rotation at Host Institution. Host Institution and Host Faculty are responsible for
supervising the residents and/or fellows at the Host Institution, and assuring that
patients seen by residents and/or fellows are also seen/treated by Host Faculty.
Any problems that may arise during day-to-day activities of a resident and/or
fellow should be brought to the attention of the residents’ and/or fellows’ faculty
advisor at Home Institution.
c. The duration(s) of the assignment(s) to Host Institution is: One (1) month.
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6. Policies and Procedures that Govern Resident and/or Fellow Education
a. Residents and/or fellows will be under the general direction of the Home
Institution’s Graduate Medical Education Committee’s and Program’s Policy and
Procedure Manual, and Host Institution’s policies for staff activities while at Host
Institution during the rotation. Host Institution acknowledges that each resident
will be attending a Home Institution clinic one half (1/2) day per week during
non-call months, which shall be specified to Host Institution prior to the
commencement of each resident’s and/or fellow’s rotation at Host Institution. The
residents and/or fellows are responsible for notifying Host Institution of any
changes or vacations.
b. Host Institution and Host Faculty are participating voluntarily in teaching.
Accordingly, neither Host Institution nor Host Faculty will receive any
compensation, from Home Institution, any governmental entity or otherwise, for
the services provided under this PLA.
c. Host Institution acknowledges and agrees that residents and/or fellows
participating in a clinical education experience are not entitled to receive
compensation, directly or indirectly, from Host Institution, patients or payors for
any services provided while on rotations at Host Institution
Signatures follow on the next page:
Remainder of Page Intentionally Left Blank
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APPROVED:
The University of Arizona College of Maricopa County Board of
Medicine-Phoenix Supervisors
By:__________________________ By:__________________________
Alan I. Leibowitz, MD Chairman
Title: Associate Dean for Graduate Medical
Education & Designated Institutional Official
Dated: ________________________ Dated: _______________________
Maricopa County Board of Supervisors
By: __________________________ Attest to:
Xianfeng Frank Zhao, MD, PhD, MBA By:_________________________
Clerk of the Board of Supervisors
Dated:________________________ Dated________________________
Approved as to form:
By:_______________________ Maricopa County Office of the
Medical Examiner, Phoenix, Arizona
Dated: ____________________ By:___________________________
Jeffrey S. Johnston, MD
Chief Medical Examiner and
Director
Dated:________________________
Approve as to form:
By:________________________
Deputy County Attorney
Dated:_____________________
Attachment A
Program/Rotation Goals and Objectives:
Program/rotation goals and objectives shall be attached separately hereto and incorporated by
reference.
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