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.
Definition
A Program Letter of Agreement (PLA) is an ACGME-required written agreement between a residency or fellowship program and each participating site — any location other than the primary training site where residents receive a required educational experience. PLAs must specify the responsibilities of the participating site, the nature of the educational experience, supervision requirements, and the mechanism for evaluating the site's contribution to resident education. PLAs must be reviewed and renewed periodically.
Why it matters for your program
Missing, outdated, or inadequate PLAs are a common citation in ACGME site visits. Programs often have PLAs on file that are years out of date, don't reflect the current rotation structure, or lack required elements. Managing PLAs across multiple participating sites requires systematic tracking — something many programs handle poorly until it becomes a compliance issue.
Related terms
ACGME Accreditation
The formal process by which the Accreditation Council for Graduate Medical Education evaluates and recognizes residency and fellowship programs.
Sponsoring Institution
The organization — typically a hospital or health system — that takes ultimate responsibility for all ACGME-accredited programs it sponsors.
Affiliation Agreement
A formal legal agreement between a sponsoring institution and a participating site governing the overall relationship for graduate medical education.
Related Service
GME Operations Review
Ashley Wood, PhD helps programs navigate program letter of agreement (pla) requirements with director-level expertise from HCA Healthcare and Vanderbilt.
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