Form 1 FTE Chart Final

Instructions for completing the Eligible Resident/Fellow FTE Chart (Attachment 1):

NUMBER OF ELIGIBLE RESIDENT/FELLOW FTEs IN PROGRAM
Academic Years	Funding Year	Number of Resident/Fellow FTEs					Aggregate Number of FTEs in the Program	Aggregate Number of THC FTEs
		PGY- 1	PGY-2	PGY-3	PGY-4	PGY- 5
7/1/20xx-6/30/20xx
7/1/20xx-6/30/20xx
7/1/20xx-6/30/20xx
7/1/20xx-6/30/20xx	Baseline Year
7/1/20xx-6/30/20xx	Year 1
7/1/20xx-6/30/20xx	Year 2
7/1/20xx-6/30/20xx	Year 3
7/1/20xx-6/30/20xx	Year 4
7/120xx-6/30/20xx	Year 5

OMB 0915-0367 Expiration Date: XX/XX/20XX

1. Prior & Current Academic Years - In the columns labeled as “Number of Resident/Fellow FTEs,” list the number of Post Graduate Year (PGY)-1, PGY-2, PGY-3, PGY-4 and PGY-5 full-time equivalents (FTEs) enrolled in the resident/fellow program during the indicated academic years, including the number of FTEs supported by the THCGME program for existing THCs. Also include the number of resident/fellow FTEs enrolled during the baseline academic year. The baseline year is the current academic year prior to the academic year (Year 1) that THCGME funding is being requested through this Funding Opportunity Announcement (FOA). If the residency program is three years, input zeros (0) in the PGY-4 and PGY-5 column. If the program is a fellowship, input the fellow FTEs as PGY-4 or PGY-5.

2. Future Academic Years - In the columns labeled as “Number of Resident/Fellow FTEs,” list the number of PGY-1, PGY-2, PGY-3, PGY-4 and PGY-5 FTEs you plan to train over the next five academic years. If the residency program is three years, input zeros (0) in the PGY-4 and PGY-5 column. If the program is a fellowship, input the fellow FTEs as PGY-4 or PGY-5. These columns should include any planned THCGME-supported FTEs during the indicated academic years.

3. In the column labeled as “Aggregate Number of FTEs in the Program” document the aggregate number of resident FTEs that were enrolled, or that you plan to enroll, in the program during each of the listed academic years. This column should be equal to the sum of the numbers listed in the “Number of Resident/Fellow FTEs” PGY columns and should include resident/fellow FTEs supported by all funding sources.

4. In the column labeled as “Aggregate Number of THC FTEs,” document the aggregate number of THCGME-supported resident/fellow FTEs that were enrolled, or that you plan to enroll, in the program during each of the listed academic years. Please note that your projections do not guarantee funding.

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