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Clinical Agreements


Clinical Agreements for Healthcare Colleges include several types of agreements: Affiliation Agreements, Clinical Exchange Agreements, Educational Site Agreements, and Graduate Medical Education Program Letter of Agreements.

The following describes the process for developing a new Clinical Agreement:

  1. Approvals  All proposed agreements must be approved by the cognizant department chairperson and dean, the Manager for Clinical Contracting, the Vice President for Clinical Academic Affairs, and the Associate Provost for International Programs.  If the proposed program would fall under the supervision of the Graduate Medical Education (GME) Office, it requires review and approval of the program by the appropriate GME official.
  2. Review Criteria  Criteria for all reviews include those listed in the general criteria.  Additional review criteria include:
    • Educational objectives of the affiliation
    • Faculty / staff / student population to be involved in the affiliation
    • Anticipated frequency an duration of contacts
    • Quality of supervision and training for UK students and/or house staff
    • Scope of work for students at UK and for UK students and/or house staff at the international site, including whether direct patient contact is anticipated
    • Housing arrangements for UK students and/or house staff, and for visiting students
    • Identification of supervisors and available resources for UK students and/or house staff at the international site
    • Identification of supervisors and available resources for visiting students while at UK
    • Safety of UK students and/or house staff at the international site
    • Costs and proposed funding model
    • Issue of reciprocity
  3. Preliminary Approvals to Proceed  Before beginning specific discussion with a prospective partner institution about the placement of students, the faculty sponsor completes a “Notification of Affiliation Conversations and Preliminary Approval to Negotiate International Clinical Agreements” form (preliminary approval form), obtains the approval and signature of the cognizant dean(s), and submits the form to the Office of Clinical Contracting. 

    The Office of Clinical Contracting will review the preliminary approval form, and, if it approves, will forward it to the Assistant Provost for Global Health Initiatives, who will submit the form to the Assistant Provost for International Partnerships for the Provost’s review and approval.  The Provost has assigned responsibility for this review to the Associate Provost for International Programs.  The Associate Provost’s review will be completed in one week.

    If the program is under the supervision of the Graduate Medical Education (GME) office, additional review and approval of the program is required by the appropriate official.

    Once approved by the Associate Provost for International Programs, the form will be returned to the Office of Clinical Contracting, which will notify the faculty sponsor of approval to begin negotiations. 

    A non-binding memorandum of understanding (MOU) is not required to enter into an Affiliation Agreement, Clinical Exchange Agreement, Educational Site Agreement, or Graduate Medical Education Program Letter of Agreement.  However, an MOU may be executed if circumstances warrant.

  4. Preliminary Discussions with the Partner Institution: The faculty sponsor discusses specific arrangements with the partner institution.  Considerations to be discussed include the criteria listed in I.B and on the following:
    • Quality of supervision and training for UK students and/or house staff.
    • Scope of work for students at UK and for UK students and/or house staff at the international site
    • Housing arrangements for students and/or house staff.
    • Supervision of UK students and/or house staff at the international site
    • Supervision of visiting students while at UK
    • Financial arrangements for an exchange in the event that a reciprocal exchange is agreed to.
  5. Negotiation of the Agreement  The Office of Clinical Contracting and the UK International Center have adopted an approved template for department use. Faculty sponsors will complete the template draft, using specifics listed above in "Preliminary Discussions with the Partner Institution."  The draft agreement will then be submitted to the Office of Clinical Contracting. The Office of Clinical Contracting and the Assistant Provost for International Partnerships will review the final draft of the agreement. Upon approval by the Office of Clinical Contracting and the Assistant Provost for International Partnerships, the faculty sponsor will submit the draft agreement to the proposed partner institution for review. If the proposed partner requests changes to the agreement, the Office of Clinical Contracting will negotiate specific wording.
  6. Provost’s Review  Once final language has been approved by the Office of Clinical Contracting, the Assistant Provost for International Partnerships, and the proposed partner institution, the final agreement will be processed for signature.  The Assistant Provost for International Partnerships will review the final text of the proposed agreement in consultation with the Director of Education Abroad or designee, for the purpose of assuring that administrative procedures are in place to manage such matters as registering students with Education Abroad, obtaining travel / evacuation insurance and malpractice insurance, etc.
  7. Execution of the Agreement  The agreement is signed for UK by the Associate Provost for International Programs and the Vice President for Clinical Academic Affairs, and by an authorized institutional representative of the partner institution.  UK may have additional signatories (e.g., faculty sponsor, department chairperson, dean), but none can substitute for the Associate Provost for International Programs and the Vice President for Clinical Academic Affairs.  The Director of Clinical Contracting will prepare six copies for signature.  The agreement may be signed in person or via the electronic or physical exchange of documents.
  8. Archives Two fully executed copies remain with the partner institution.  Five copies are held by UK: one by the Assistant Provost for International Partnerships, one by the Director of Clinical Contracting, one each by the cognizant dean and department chairperson, and one by the Assistant Provost for Global Health Initiatives.