• Advanced specialty training programs (ASTPs) offer focused clinical subspecialty experience for physicians who have completed residency, and in some cases, fellowship. These experiences can range from simple apprenticeships to formally structured programs with a defined curriculum. Rather than being a full-time commitment, they allow a portion of time for independent practice consistent with the prior education and experience of the trainee as permitted by his/her delineated medical staff privileges. Training in AST programs is designed, monitored, and successful completion determined by the sponsoring department. 
• ASTPs are appointed as full-time faculty in the School of Medicine at the rank of Assistant or Instructor. As independently licensed physicians, their services are billable, and they are not subject to ACGME work-hour limits. 
• Departments may choose to offer subspecialty training as an ASTP even when ACGME accreditation is possible.
• At Johns Hopkins Hospital and Bayview Medical Center, ASTP is a unique clinical staff category. If a faculty appointment is made specifically for time limited training, the individual must be designated as an Advanced Specialty Trainee and follow the outlined procedures. Costs associated with licensing, credentialing, etc. are covered by agreement with SOM. Other JHHS sites credential ASTP trainees with full privileges. The associated costs for licensing, credentialing, etc. are paid by the SOM department to the entity.

• To designate a program as an ASTP, it must be approved by both the Office of Faculty Information (OFI) and the Executive Committee of the Graduate Medical Education Committee (GMEC). Departments must submit their request to OFI, which will review and, if appropriate, forward it to the GMEC for final approval. The submission must include the following details:
• Name of the program
• Faculty director of the program – must be appointed to the SOM faculty; unpaid part time faculty who are employed as clinical associates are not eligible to be training program directors
• Number of trainees anticipated
• Program start date
• Criteria for acceptance of trainees (medical school graduation, prior GME training, Board certification, prior experience)
• Length of the program
• Description of the activities of trainee participants, including clinical and didactic experiences
• Activities requiring faculty supervision
• Letter of endorsement from the Department Director
• For program directors who are less than FT, the endorsement must specify the program director’s time commitment and also verify that it aligns with their other SOM faculty duties.
• Letter of acknowledgement and endorsement from the director(s) of the core residency and/or subspecialty program(s) in the department
• Funding source (Note: NIH T32 grants cannot provide support for AST programs)
• Approval of the program will be determined based on evidence and assurance that the program provides a valid educational experience and that the program will not interfere with training and education of participants in ACGME-accredited programs or existing non-standard training programs.

• School of Medicine (SOM): Participants are appointed as faculty in the SOM at the rank of Assistant or Instructor. The length of the appointment is generally limited to the length of the program.
• Johns Hopkins Health System (JHHS): Participants must obtain a State of Maryland Medical License and receive a JHHS medical staff appointment before beginning clinical work. The JHHS appointment shall be in a separate category from the Active Staff and shall automatically terminate at the end of the ASTP period; if the department elects to appoint an ASTP trainee to the Active Staff of JHHS following completion of the program, the new appointment must be in place before clinical activity may begin in the new role.

• To request a change to an existing ASTP program (number of trainees, duration of program, change in program director, etc), send a letter signed by the department director to [email protected]. Be sure to include an effective date for the change.
• Changes to the original program description undergo the same review process as a new ASTP program.

• To close a program, a letter signed by the department director is required to be sent to [email protected].
• If the program is being closed to accommodate a new non-standard training program, please indicate so in the letter.

• Programs are asked to review/confirm specific program information on a yearly basis.
• If programs undergo revisions, it is the responsibility of the sponsoring department to submit changes to OFI in a timely fashion.

Please review the policy: Johns Hopkins School of Medicine Policy Against Concurrent Identical Specialty & Sub-specialty Training Programs

• Certificates of training are available for those trainees who successfully complete their training through the Office of Faculty.
• Departments are not authorized to create certificates of training.
• View sample

A Program Letter of Agreement (PLA) must be completed and signed by the ASTP Program Director and the representative at the host institution.  The completed form should be sent to the Office of Faculty Information at [email protected].  If approved, OFI will obtain the Dean's signature and return the form to the program for execution.  Programs are responsible for retaining this documentation in their records.

See draft offer letter.