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Affiliation Agreements

Contact Info

Office of Student Affairs
John Keller
Van Nuys Medical Science
635 N Barnhill Dr. RM 162
Indianapolis, IN 46202
PH: 317-274-2264
msaffil@iupui.edu

A medical education program must have written and signed affiliation agreements in place with its clinical affiliates that define, at a minimum, the responsibilities of each party related to the educational program for medical students.

Why are agreements necessary?

A medical education program must have a written and signed affiliation agreements in place with its clinical affiliates that define, at a minimum, the responsibilities of each party related to the educational program for medical students per standards set forth by the Liaison Committee on Medical Education (LCME) Functions and Structure of a Medical School.

1.4 Affiliation Agreements

In the relationship between a medical school and its clinical affiliates, the educational program for all medical students remains under the control of the medical school’s faculty, as specified in written affiliation agreements that define the responsibilities of each party related to the medical education program. Written agreements are necessary with clinical affiliates that are used regularly for required clinical experiences; such agreements may also be warranted with other clinical facilities that have a significant role in the clinical education program. Such agreements provide for, at a minimum the following:

  • The assurance of medical student and faculty access to appropriate resources for medical student education
  • The primacy of the medical education program’s authority over academic affairs and the education/assessment of medical students
  • The role of the medical school in the appointment and assignment of faculty members with responsibility for medical student teaching
  • Specification of the responsibility for treatment and follow-up when a medical student is exposed to an infectious or environmental hazard or other occupational injury
  • The shared responsibility of the clinical affiliate and the medical school for creating and maintaining an appropriate learning environment


Procedure for New Affiliation Agreements

  1. Campus of Influence Affiliations Site Controller contacts Statewide Affiliations Manager (SAM) at msaffil@iupui.edu to request a new agreement via paper or online request form.
  2. SAM sends request to Medical Education Clerkship Manager for review and approval as qualifying site
  3. Once approved, SAM sends official email with attached documents to Facility Contact.
  4. Facility Contact reviews and approves, sending (2) originals to SAM via regular/priority mail. If changes are necessary SAM brokers negotiations until completed.
  5. SAM routes documents to MSE Dean and then on to Legal Counsel for ED Dean and Counsel signatures. SAM returns original to Facility Contact


Procedure for Renewing Affiliation Agreements

  1. SAM sends request to Medical Education Clerkship Manager to verify site still in use or qualifying six months prior to agreement termination.
  2. Once approved by MSE, SAM sends official email with attached documents to Facility Contact on file using msaffil@iupui.edu account.
  3. Facility Contact reviews and approves, sending (2) originals to SAM via US/Priority mail. If changes are necessary SAM brokers negotiations until completed. SAM routes documents to MSE Dean and then on Legal Counsel for ED Dean and Counsel signatures. SAM returns original to Facility Contact.