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(collectively, the Schools). The clinical training provided is a
prerequisite to the professional licensing of doctors and
dentists in New York State.
The University does not maintain its own medical center. To
provide the necessary clinical training, the University relies on
its affiliation with several teaching hospitals in the Buffalo
area. All clinical programs are conducted at one or more
teaching hospitals.
Prior to 1983, the Schools and the affiliated teaching
hospitals administered their own programs for the clinical
education of medical and dental residents and fellows
(hereinafter residents and fellows will be referred to
collectively as residents). Each hospital employed its own
residents, met its own payroll, and provided its own benefits
packages. No one hospital or school had the resources necessary
to implement a comprehensive program. As a result, the Schools
and the affiliated teaching hospitals had difficulty maintaining
accreditation for their programs.
In 1981, new accreditation standards, effective beginning in
1982, were announced by the Accreditation Council for Graduate
Medical Education (ACGME). These standards required greater
centralization of decision-making where two or more institutions
join together to provide medical education. In such cases, the
standards required the establishment of mechanisms to ensure that
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