Request for Training Extension Request for Training Extension Program contact name * Program contact email * Department name * Program name * Resident/Fellow name * Reason for training extension * e.g. Parental leave If the extension is a result of taking a leave of absence, please ensure the impacts of the extension have been discussed. For more information, visit our Leave resources, here. Current appointment end date * As listed in MedHub. Extension end date * Current R Level * As listed in MedHub. FTE needed for extension (list all applicable hospitals) * Please list amount of additional FTE needed per hospital (Guideline: One month = 0.08 FTE) Will the program need a complement increase? * YesNoUnsure A temporary complement increase is required in circumstances where the total number of trainees exceeds the approved ACGME complement. Any additional information to share with GME After submission you will receive an email confirmation. If you are human, leave this field blank. This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit Hadar Duman, MHI Director of AccreditationPhone: 206.616.2961Email: hadars@uw.edu Shinetra Pryor Appointment ManagerPhone: 206.221.1452Email: snpryor@uw.edu Extensions Quick Links Procedure for Submitting Extension of Training Requests RFPA Amendment to Extend Current Appointment GME Process for ACGME Trainee Complement Increase Quick Links ACGME MedHub Report a Concern Contact Us Hadar Duman, MHI Director of AccreditationPhone: 206.616.2961Email: hadars@uw.edu Shinetra Pryor Appointment ManagerPhone: 206.221.1452Email: snpryor@uw.edu Extensions Quick Links Procedure for Submitting Extension of Training Requests RFPA Amendment to Extend Current Appointment GME Process for ACGME Trainee Complement Increase Quick Links ACGME MedHub Report a Concern