Affiliation Agreement
A formal legal agreement between a sponsoring institution and a participating site governing the overall relationship for graduate medical education.
Definition
An affiliation agreement is the overarching legal agreement between a sponsoring institution and a participating institution or site. Unlike a Program Letter of Agreement (PLA), which is program-specific, the affiliation agreement governs the broader institutional relationship. ACGME requires that affiliation agreements be in place for all participating sites and that they meet specific requirements. Affiliation agreements must be current and signed by authorized representatives of both institutions.
Why it matters for your program
Lapsed or missing affiliation agreements can immediately jeopardize a program's ability to use a participating site — which can disrupt resident rotations, affect program structure, and create accreditation risk. Managing affiliation agreement renewals across a large GME enterprise is a significant administrative task that is frequently underprioritized until agreements lapse.
Related terms
ACGME Accreditation
The formal process by which the Accreditation Council for Graduate Medical Education evaluates and recognizes residency and fellowship programs.
Designated Institutional Official (DIO)
The individual at a sponsoring institution who has the authority and responsibility for oversight of all ACGME-accredited programs.
Sponsoring Institution
The organization — typically a hospital or health system — that takes ultimate responsibility for all ACGME-accredited programs it sponsors.
Program Letter of Agreement (PLA)
A required agreement between a program and a participating site that defines the training experience, supervision, and educational responsibilities at that site.
Related Service
GME Operations Review
Ashley Wood, PhD helps programs navigate affiliation agreement requirements with director-level expertise from HCA Healthcare and Vanderbilt.
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