Va Form 10-0094d - Dental Education Affiliation Agreement Between Department Of Veterans Affairs (Va) And A School Of Dentistry As The Sponsoring Institution - 2015 Page 2

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An affiliation agreement promotes common standards for patient care, resident and student education,
research, and staff appointments. The parties to the affiliation agreement also seek to avoid duplication of
academic assets. The parties enter into this affiliation in a spirit of mutual benefit to be achieved through an
equitable contribution of resources. The affiliation agreement is crucial to the relationship because it forms the
philosophical and, in some cases, the legal basis for specific agreements that may be executed between
components of the affiliate and VA.
In entering into any agreements, VA and the affiliate have a responsibility to comply with federal laws and
VA policies concerning conflicts of interest. The existence of an affiliation agreement does not guarantee that VA
and the affiliate will enter into additional agreements. However, some institutions may have other agreements
including contracts, memoranda of understanding, or other written agreements.
RESPONSIBILITIES
1. The school of dentistry has the following responsibilities:
A. Operate and manage the school of dentistry and its associated residency programs and assume overall
responsibility for the educational programs.
B. Maintain accreditation by the nationally recognized accreditation entity, the Commission on Dental
Accreditation (CODA).
C. Encourage school of dentistry to accept positions as VA dental staff/consultants and assure that academic
standards are met.
D. Enable school of dentistry faculty appointments, appointments to school of dentistry committees, and
administrative positions for VA-based staff.
E. Recommend members for appointment to the VA Affiliation Partnership Council and its subcommittees.
Members will include the dental school dean and senior faculty members from appropriate divisions of the dental
school and affiliated participating institutions.
2. The school of dentistry and their affiliated institutions have the following responsibilities:
A. Maintain accreditation by the Commission on Dental Accreditation (CDOA) for dental students and
residents.
B. Participate in the supervision of integrated academic programs at VA.
C. Select residents for academic programs operated jointly by VA and the school of dentistry and the
affiliated participating institutions. Residents accepted for assignment at VA facilities must have the qualifications
and credentials as agreed upon by the school of dentistry, the affiliated participating institutions, and VA.
D. Develop educational program letters of agreement for each VA healthcare facility that provides a resident
with educational experience that is one month or longer in duration. These agreements must identify faculty who
will teach, supervise, and evaluate resident performance; oversee duty hours; outline resident educational
objectives; specify periods of resident assignment; and establish policies and procedures for maintaining resident
education during the assignment.
VA FORM 10-0094d
June 2015
PAGE 2 OF 6

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