Update Program Director

Prior to assuming responsibilities for a program, a new program director candidate must receive approval from the College of Medicine Graduate Medical Education Committee (GMEC) and their specialty’s Accreditation Council for Graduate Medical Education (ACGME) Review Committee. Please review your program’s requirements for Program Director Qualifications [II.A.3]

This process begins with the submission of this online program director change form.

For this online form, the following information is needed:

Current Curriculum Vitae for Program Director Candidate
Copy of current board certification in specialty
Copy of current medical licensure
Letter outlining current medical staff/clinical appointment from department chair/section chief

Once the online form has been submitted, the GME office will review the request and verify that the new Program Director candidate’s credentials meet the requirements for the program set forth by the ACGME.

Once the new program director candidate’s qualifications are verified, a member of the GME office will contact the program to schedule a meeting with the program director candidate and the Executive Associate Dean for Graduate Medical Education.

After this meeting, the new program director candidate will be presented to GMEC for review and approval. Once the candidate has GMEC approval, the program can submit the candidate for review by their ACGME Review Committee through the ACGME WebADS system.

Change Program Director Form

Name of Person Filling Out Form*
First Last
Email of Person Filling Out Form*
Program/Specialty Name*
Current Program Director's Name*
First Last
Current PD's Email*
Current PD's Phone*
Current Program Coordinator's Name*
First Last
Current PC's Email*
Current PC's Phone
Program Director Candidate's Name*
First Last
PD Candidate's Email*
PD Candidate's Phone*
PD Candidate's Date of Birth*
needed for NRMP registration
MM slash DD slash YYYY
What date will this change take place?*
MM slash DD slash YYYY
What is the reason for this change?*
Enter ACGME requirement for Program Director minimum dedicated time. [ II.A.2]*
Program Director Candidate has been allocated required FTE to support program.*
- Yes
- No
Date candidate was appointed faculty in this program.*
MM slash DD slash YYYY
Year candidate first started teaching in the specialty.*
Year candidate first started teaching in GME.*
Provide at least three years of documented educational and/or administrative experience. [II.A.3.a)]
Certification Documentation*
Upload documentation of Program Director Candidates’ Current Certification by appropriate specialty board and expiration date of certification. [II.A.3.b)]
Drop files here or

Max. file size: 15 MB.
Medical Licensure*
Upload documentation of current medical license. [II.A.3.c)]
Max. file size: 15 MB.
Medical Staff/Clinical Appointment*
upload letter from department chair/section chief outlining clinical appointment
Max. file size: 15 MB.
If there are additional program specific requirements, please provide documentation in this section.
What is the PD candidates proposed term of appointment as PD?*
- < 6 months
- >= 6 months and < 1 year
- >= 1 year and < 2 years
- >= 2 years and < 3 years
- >= 3 years and < 4 years
- >= 4 years and < 5 years
- >= 5 years and < 6 years
- >= 6 years and < 10 years
- Indefinite
- Interim
Please upload the CV for the PD Candidate*
Drop files here or

Max. file size: 15 MB.
Please upload a professional headshot for the PD Candidate*
Max. file size: 15 MB.

UAMS College of MedicineUniversity of Arkansas for Medical Sciences

Mailing Address: 4301 West Markham Street, Little Rock, AR 72205

Phone: (501) 686-7000

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