Fellowship Program Policy and Procedure Manual

About AOTA 

The American Occupational Therapy Association (AOTA) is a national professional association established in 1917 to represent the interests and concerns of occupational therapy practitioners and students and to improve the quality of occupational therapy services. 

Current AOTA membership includes occupational therapists, occupational therapy assistants, and occupational therapy students. Members reside in all 50 states, the District of Columbia, Puerto Rico, and internationally. 

AOTA represents 230,000 occupational therapy practitioners and students in the United States. AOTA’s major programs and activities are directed toward assuring the quality of occupational therapy services, improving consumer access to health care services, and promoting the professional development of members. 

AOTA educates the public and advances the profession by providing resources, setting standards, and serving as an advocate to improve health care. AOTA is a 501(c)(6) entity based in Bethesda, MD. 

The purpose of the AOTA Fellowship Program is to cultivate and accredit post-professional training programs that advance the knowledge and skills of licensed occupational therapists in focused areas of practice. 

The Fellowship Program provides a comprehensive framework within which sponsoring organizations can build or tailor fellowships around significant occupational therapy (OT) service delivery areas. Every affiliated Fellowship Program incorporates the Fellowship Program Learning Objectives (FPLOs) into its curriculum. Based on the AOTA Standards for Continuing Competence, (hereinafter referred to as “Standards”) developed by the AOTA Commission on Continuing Competence and Professional Development (CCCPD), the FPLOs cover the acquisition of knowledge, skills, and attributes in the following five categories: (1) Knowledge, (2) Professional Reasoning and Performance Skills, (3) Ethical Practice, (4) Interpersonal Skills, and (5) Scholarly and/or Professional Activities. Fellowship Programs accompany their FPLO-centered curricula with intensive mentorship, and clinical caseloads in their specific focused area(s) of practice. 

This approach to specialty training maximizes fellow exposure to targeted evidence-based research and clinical practice. It also produces unique opportunities for occupational therapists to improve and advance their clinical skills in a salient area of OT practice, and to increase their professional marketability as specialized therapists. 

Sites seeking AOTA Accreditation of an existing or developing fellowship program must successfully complete a three-step initial Accreditation process and adhere to additional program requirements to maintain that Accreditation. The three-step process allows AOTA to ensure that all programs—associated with the Fellowship Program—meet its standard for quality advanced practice education and professional development. To be Accredited by AOTA, the program must supply documentation that highlights the program’s resource allocation, budget, and ability to sustain a fellowship program. This, and candidate status, must occur before the admission of fellows. The additional Fellowship Program requirements provide AOTA the ability to continue to monitor the efficacy of its programs. 

Roster of Fellowship Reviewers (RFR) 

The Roster of Fellowship Reviewers (RFR) is a volunteer body of occupational therapy practitioners who evaluate the compliance of AOTA Fellowship Programs (formerly known as AOTA Residency Programs) using the AOTA Fellowship Program Criteria and Interpretative Guidelines. Their work provides the Fellowship Program Review Committee (FPRC) with the necessary information to make accreditation decisions and helps to ensure the quality and effectiveness of programs designed to advance practitioner expertise. 

Members of the RFR are responsible for conducting the Candidacy Application reviews, site visits, and making recommendations to the FPRC regarding program compliance with the AOTA Fellowship Program Criteria and Interpretive Guidelines.  

Fellowship Program Review Committee 

The FPRC is composed of select members of the RFR. The FPRC is responsible for the Accreditation of fellowship programs. The AOTA Fellowship Program is administered by the FPRC, which serves as the decision-making body for the Program. 

The FPRC is composed of members representing diverse practice areas, occupational therapy education, and expert knowledge of the field. Committee members may serve two consecutive 3-year terms with the option of an extension. The FPRC is responsible for: 

1. The initial accreditation and re-accreditation of fellowship programs. 
2. Ongoing monitoring to ensure continued compliance of accredited fellowship programs using the AOTA Fellowship Program Criteria and Interpretative Guidelines as its guiding principles. 
3. Making final program decisions that consider recommendations made by the RFR. 
4. Participating in the program review process. 
5. Conducting periodic reviews of the policies, procedures, and AOTA Fellowship Program Criteria and Interpretive Guidelines, to ensure the quality of the Fellowship Program and affiliated fellowship programs, and 
6. Hearing and adjudicating complaints from sponsoring institutions or fellows. 

Fellowship Program Review Cycles 

The FPRC holds three to four general review cycles and voting sessions each year.  

The Fellowship Program is supported by AOTA staff who develop procedures and guidelines to support the FPRC in their administration and oversight of the fellowship programs. Questions concerning the AOTA Fellowship Program should be directed to email: fellowship@aota.org 

Program Eligibility 

To be eligible for AOTA accreditation, a program must be designed to provide advanced practice knowledge and skills, in an accredited area of occupational therapy practice, in an appropriate practice setting. Additional guidelines for eligibility are listed below. 

Sponsoring Organization 

Potential fellowships must be sponsored either by an appropriate accredited or licensed clinical facility or by an organization or academic institution that is partnered with an accredited or licensed facility. 

The clinical facility or facilities used by the Fellowship Program must offer continuous client services in the accredited area of occupational therapy practice. The setting must be appropriate to the focused area(s) of practice of the program. Accepted practice settings include, but are not limited to: 

• Community 
• Early Intervention 
• Freestanding Outpatient 
• Home Health 
• Hospital (Non-Mental Health) 
• Long-Term Care/Skilled Nursing Facilities 
• Mental Health 
• School System 
• A setting sponsored jointly by a practice setting and an academic program  

AOTA Membership 

The sponsoring organization must hold valid AOTA membership in one of the following ways: as (1) organizational membership, or (2) through the individual membership of the Fellowship Coordinator. Membership guarantees that each program has full access to all AOTA content and offerings. 

Focused Area of Practice 

A Fellowship Program must be designed to provide advanced practice knowledge and skills, in an Accredited and focused area of occupational therapy practice. Currently, areas of practice may include, but are not restricted to: 

• Acute and critical care 
• Assistive Technology 
• Burns 
• Dysphagia (Feeding, Eating, and Swallowing) 
• Gerontology 
• Hand Therapy 
• Lymphedema 
• Mental Health 
• Neurology 
• Pediatrics 
• Physical Rehabilitation 

Initial Accreditation Process 

A sponsoring organization seeking AOTA Accreditation of an existing or developing post-professional training program must successfully complete the 3-step initial Accreditation process outlined below. Successful progression through the process is evidenced by the sequential granting of Applicant, Candidate, and Accredited Status. 

Step 1: Applicant Phase-Initiating the Accreditation Process 

Sponsoring organizations seeking AOTA Accreditation of a developing Fellowship Program or an existing post-professional training program may initiate the process by submitting an Intent to Seek Accreditation Form and a non-refundable deposit fee for each program (see fees).  

The Intent to Seek Accreditation Form addresses “Section A: Program Eligibility" of the AOTA Fellowship Program Criteria and Interpretive Guidelines and allows a site to select a preferred Candidacy Application submission date. AOTA staff reviews the program to determine whether it meets the AOTA Fellowship Program eligibility requirements. If the program meets the eligibility requirements, it is granted “Applicant Status” and allowed to proceed to the next step: Submission of a Candidacy Application. 

Step 2: Candidacy Phase-Application and Review 

After a program is granted Applicant Status, it may begin to complete the Candidacy Application. The Candidacy Application is designed to collect key information on the program’s structure, supports/resources, and curriculum design. Each Candidacy Application is reviewed by two members of the RFR and voted on for approval, deferment, or denial of Candidate Status by the FPRC. 

Candidacy Application Completion and Submission 

Fellowship program staff completing the Candidacy Application must thoroughly review the AOTA Fellowship Program Criteria and Interpretative Guidelines and related documents, before beginning the Candidacy Application process. 

In most cases, an applicant program will be granted the requested Candidacy Application submission date. If a program fails to submit its Candidacy Application and application fee within 7 days of the original due date, the scheduled review of the program’s application may be moved to the next application review cycle. 

If an applicant program needs to change its scheduled application submission date, it should notify AOTA Fellowship Program staff as soon as possible by emailing fellowship@aota.org, at least 2 months prior to the scheduled application submission date. A program may opt to delay submission of the Candidacy Application only once; and by no more than 18 months past the date it was granted Applicant Status. 

All candidacy application submissions and application fees must adhere to the general Fellowship Program Review Cycles schedule. 

Candidacy Application Review Process 

A completed candidacy application is assigned to a review team that consists of two members of the RFR in accordance with the Conflict of Interest Policy. The RFR members conduct independent reviews of the candidacy application responses and all supporting documentation to assess and ensure the program’s compliance with the AOTA Fellowship Program Criteria and Interpretive Guidelines. 

The FPRC is responsible for determining if the Fellowship Program is in full compliance with the AOTA Fellowship Program Criteria and Interpretive Guidelines. Program materials—received by the submission dates below—are reviewed during the given cycle, and the FPRC decisions are sent to programs within 30 days of the decision meeting. 

 FPRC Actions on Candidate Status 

Grant Candidacy Status 

Candidate Status is granted if the FPRC determines that the fellowship program has the appropriate resource allocation, and program development plans (i.e., curriculum design that reflects the fellowship program learning objectives and evaluations) and demonstrates the ability of the prospective fellowship to be in substantial compliance with the AOTA Fellowship Program Criteria and Interpretive Guidelines. 

A program may be granted Candidate Status based on an application with (1) no request for revisions or for additional information, or (2) a request for minor revisions or additional information. 

A program granted Candidate Status—with or without a request for revisions or additional information—may accept fellows. The program must disclose to prospective fellows the status of candidate, and not fully Accredited. The program must notify AOTA within 2 weeks of accepting fellows by submitting a Fellow Acceptance Notification Form. 

All AOTA Candidate Fellowship Programs must use the following statement in all publications.   

• The [Name of Fellowship Program] has been granted candidate status by the American Occupational Therapy Association. AOTA’s email address is fellowship@aota.org. 

In circumstances of an unforeseen or emerging issue that would cause a program to (1) not be able to accept a fellow within the 12-month period, or (2) lose a fellow for any reason before the initial site visit, the fellowship program would submit a Securing a Fellow Extension Form.  

A program may hold Candidate Status: 

• Unless it fails to accept a fellow within 12 months of being granted Candidate Status, or 24 months if granted an extension.  
• Until it is granted Accreditation Status by the FPRC, 
• Unless it is denied Accreditation Status by the FRPC,  
• Unless it requests voluntary withdrawal of Candidate Status or is involuntarily withdrawn.  

Organizations with candidate status for AOTA accreditation must formally notify all fellows in writing of their candidacy status at the outset of the fellowship program. This notification must include the following language: 

"This program is currently in candidacy status for accreditation through the American Occupational Therapy Association (AOTA). While we are pursuing accreditation, please be advised that if the program does not receive AOTA accreditation by the time you complete your fellowship, you will not receive a certificate of completion from an AOTA-accredited fellowship program." 

It is the responsibility of the organization to ensure that fellows fully understand the implications of candidate status and the potential outcomes related to accreditation. Failure to provide this notification may result in actions from AOTA that could impact the organization's candidate or accreditation status. 

Defer Action on Candidate Status 

Action may be deferred on a Candidacy Application if the FPRC determines that the information provided in the Candidacy Application is incomplete or insufficient; and/or will not achieve substantial compliance, based on the requirements of the AOTA Fellowship Program Criteria and Interpretive Guidelines. In such cases, the FPRC will request that additional information be submitted for consideration at a subsequent FPRC meeting. 

If a program fails to submit the requested information in accordance with the documented timeframe, its application for candidacy may be suspended. 

The FPRC may defer action on a Candidacy Application no more than two times. If, during a third review, the FPRC determines that a program has not provided complete or sufficient information, the program will be denied candidate status. 

Deny Candidate Status 

A program may be denied Candidate Status if the FPRC determines that the resource allocation or program development plans (or both), as presented in the Candidacy Application, do not support the ability of the fellowship program to meet the AOTA Fellowship Program Criteria and Interpretative Guidelines. 

A program denied Candidate Status may re-apply for accreditation by submitting a new Intent to Seek Accreditation Form. All applicable fees will be assessed and due according to the fees policy. 

Fellowship programs can appeal a Denial of Candidate Status. The guidelines are outlined under Rules of Procedure for Appeals. 

All programs will be sent Action Letters detailing the FPRC’s decision, in addition to any subsequent requests or requirements they may have of the program. 

Step 3: Site Visit and Review 

The final phase of the Accreditation process requires an on-site evaluation of the fellowship program by two members of the RFR and/or FPRC. This on-site evaluation must be conducted prior to a fellow graduating. The site visit provides an opportunity for the site visit reviewers to observe how a program is being implemented in relation to the plans presented in the Candidacy Application. It establishes compliance based on the criteria required for accreditation as a credentialing AOTA Fellowship Program. The site visit is also an opportunity for RFR members and program staff to collaboratively identify program strengths and areas for improvement. A comprehensive assessment of the program is established through observation of the practice environment and interaction with the staff, fellow(s), mentor(s), and administrator(s). 

AOTA Fellowship Program staff will only schedule a site visit after a program with Candidacy Status has admitted a fellow. 

Site Visit Preparation 

After a program with Candidate Status notifies AOTA Fellowship Program Staff it has accepted a fellow—through the submission of a Fellow Acceptance Notification Form—AOTA staff will coordinate with the organization’s program staff and the two assigned RFR members to determine potential dates to conduct the site visit. AOTA staff will schedule a site visit no sooner than 6 months into the first fellowship cycle, and no later than 30 days prior to the anticipated completion date of the first fellow. Most site visits are conducted between months 7 and 9 of a 12-month Fellowship Program. 

AOTA Fellowship Program staff will identify two RFR or FPRC members to conduct the site visit. If possible, AOTA staff will attempt to assign the same RFR members who conducted the Candidacy Application review. In the event a second site reviewer is required and no RFR or FPRC member is available, an AOTA staff member who is a licensed occupational therapy practitioner may be assigned to the site. 

AOTA Fellowship Program staff or the RFR lead reviewer will provide the Fellowship Program Coordinator potential dates, names of the site visit team members as well as any additional instructions needed to prepare for the site visit.  AOTA Fellowship Program staff may also request assistance from the Fellowship Program Coordinator, to help with the site visit team’s travel arrangements, in addition to any of the other tasks listed below. 

• Dates of the visit 
• Names and contact information of the site visit team members 
• Sample schedule 
• List of documents—supplemental to those previously submitted, updated documents requested 
• Request for support in making travel arrangements. 

The site visit team may address or seek information on any specific area outlined in the AOTA Fellowship Program Criteria through interviews, documentation review, and/or any other observations. 

Structure of a Site Visit 

A standard site visit is conducted over one and a half days and consists of a series of meetings that include administrative officials, staff, mentors, and/or fellows. Additional meetings with affiliated umbrella organizations may also be requested. 

The site visit may be structured to allow the site visit team the opportunity to: (1) verify information submitted in a program’s Candidacy Application, (2) assess the strengths and weaknesses of the fellowship program, and (3) collect any additional data as needed for clarification or requested by the FPRC. Potential activities during the site visit may include but are not limited to: 

• Observation of actual training (classroom, lab, or clinical), 
• Review of organizational or program policies and curriculum, 
• Review or observation of facility resources, 
• Review of fellow and program evaluation plans, 
• Interviews with the program administrators, clinical faculty, and current fellows, and/or 
• Overview of site visit findings with program administrators. 

AOTA Fellowship Program staff will provide the organization with a sample schedule, but a final schedule will be agreed to and scheduled collectively by the Site Visit Team Lead and the Fellowship Coordinator. 

Site Visit Report 

The site visit team will prepare a Site Visit Report summarizing its findings and submit a recommendation to the FPRC. The FPRC holds the sole authority to make the final decision regarding a program’s compliance. At the conclusion of the site visit, the site will receive a verbal summary of the Site Visit Report. Written feedback, including the FPRC’s decision, will be provided to the site within 30 days of the FPRC decision meeting.  

Following the site visit, the Fellowship Coordinator and any other staff members will be asked to complete the Fellowship Program Post Site-Visit Questionnaire (PSQ). 

The FPRC will review the Site Visit Report for any corrections and/or comments in advance of its spring, summer, or fall meeting. The Committee decides based on the information they receive, using one of the following three actions listed below. 

• Grant Accredited Status 

A program will be granted initial Accredited Status for a period of 10 years if the FPRC determines that the program is in substantial compliance with the AOTA Fellowship Program Criteria and Interpretative Guidelines.  

• Grant Conditional Accredited Status 

A program will be granted Conditional Accreditation Status if the Fellowship Program Review Committee (FPRC) determines that the program is in compliance with the Fellowship Program Criteria and Interpretive Guidelines and received a score that falls below the threshold required for Full Accreditation and above the threshold for Denial. 

Programs granted Conditional Accreditation Status will be required to participate in a virtual site visit one year after the initial decision. Following the virtual site visit, the FPRC will vote to: 

• Grant Accreditation Status, 
• Defer action on Accreditation Status, or 
• Involuntarily withdraw the program from the Fellowship Program. 

If a program is granted Accredited Status or Conditional Accreditation Status, it shall receive a notification that includes a digital certificate of Accreditation or Conditional Accreditation. Fellows will then be deemed as having graduated from an AOTA-Accredited Fellowship Program. 

• Defer Action on Accredited Status 

If the FPRC decides that the findings of the site visit were incomplete or insufficient to determine if the program is in substantial compliance with the AOTA Fellowship Program Criteria, Accredited Status will be deferred. In such cases, the FPRC may request the submission of additional supporting documentation or a second site visit. 

If action is deferred on an Accredited Status decision, the program shall receive (1) a notification of deferral, (2) a complete list of concerns identified by the FPRC, and (3) details for submitting additional supporting documentation or for scheduling a second site visit (fees may apply). The FPRC will review the additional materials or second Site Visit Report and vote on Accreditation Status at the next FPRC meeting. 

• Deny Accredited Status 

A program may be denied Accredited Status if the FPRC determines that the program—as implemented—does not meet the AOTA Fellowship Program Criteria and Interpretive Guidelines and does not demonstrate the ability to come into substantial compliance. 

If a program is denied Accredited Status, it shall receive a Notification of Denial Status and will be sent a complete list of concerns the FPRC identified and used in making their decision.  Procedures for appealing a denial of Accredited Status are outlined in the Rules of Procedure for Appeals. In addition, all Fellowship Programs will receive Action Letters outlining the FPRC’s decision and any subsequent requests or requirements they may have of the program. 

An organization denied accreditation may submit an Intent to Seek application no sooner than 180 days from the date of denial. 

Programs are granted Accredited Status for a period of 10 years. To maintain Accredited Status for the duration of the term, fellowship program(s) must remain in compliance with the requirements outlined below. Accredited Status may be involuntarily withdrawn at any time if the FPRC determines the fellowship program is unable to come into substantial compliance with Fellowship Program Policies and Procedures or the Fellowship Program Criteria and Interpretative Guidelines. 

Below is a list of requirements to maintain Accredited Status. 

• Secure fellows during the accredited period.  
• Inform the FPRC of all program changes via the Annual Data Report Form.  
• Provide AOTA with up-to-date information on fellow admissions, term dates, and completions. Fellow information should be submitted using the Fellow Acceptance Notification Form and Request for Certificate of Completion Form. 
• Timely payment of Fellowship Program fees (See Fees). 
• Submit scheduled program reports (i.e., Annual Data Report Form, Interim Data Report Form) and unscheduled requests for additional program information, within the period designated by the FPRC. 
• Submit a Fellowship Program re-accreditation Application at the end of an accreditation term. 
• Remain in compliance with the AOTA Fellowship Program Criteria and Interpretative Guidelines, updating the program to reflect revisions to the criteria when necessary. 

Securing a Fellow for Accredited Programs 

Accredited fellowship programs are expected to secure a fellow for each enrollment period unless they have opted not to. Regardless of the reason, all programs must report the absence of a fellow on the Annual Data Report (ADR). After 3 consecutive years without a fellow, a member of the FPRC will meet with the program to discuss and, if possible, assist in resolving issues related to securing a fellow. 

Annual Data Report Form 

The Annual Data Report Form is designed to provide the FPRC with key information on the status of an accredited Fellowship Program. The data requested on the Annual Data Report Form consists of key indicators, expectations, and quality outcomes of a program including, but not limited to: 

• General program information, 
• Applicants, fellow enrollment or lack thereof, and fellow completion, 
• Fellowship program resources, 
• Program operations including any changes within the past year, 
• Outcomes 

Fellowship Programs are required to complete an Annual Data Report Form each calendar year while maintaining accredited status, including the year in which the Fellowship Program Re-accreditation Application is scheduled to occur. 

Fellowship Programs are required to submit an Annual Data Report Form in January of each year. The reporting period for the Annual Data Report Form coincides with the calendar year (January 1–December 31).  Annual Fees are submitted in July of each year.  

Interim Data Report Form 

Programs with a 10-year accreditation period must submit an Interim Data Report Form midway (i.e., 5th year) through their accreditation term. The purpose of the Interim Data Report Form is to facilitate continued monitoring of accredited fellowship programs before the full review is conducted at the end of their term.  Questions are designed to elicit self-evaluation of continuing compliance with the AOTA Fellowship Program Criteria and Interpretative Guidelines. Interim Data Report Forms are due April 30th of the program’s 5th accreditation year and can be submitted up to 6 months in advance. 

Each Interim Data Report Form will be reviewed by an FPRC and an RFR member, with the FPRC acting on each report based on the completed review. Actions that may be taken by the FPRC include: 

• Accept Annual and Interim Data Report Form 

The FPRC may accept the Annual or Interim Data Report Form in written format or may note areas of concern that require further monitoring, correction, or follow-up. 

• Defer Action on Annual and Interim Data Report Form 

The FPRC may defer action on an Annual or Interim Data Report Form and request clarification of one or more areas if the data submitted is inconsistent or does not meet the Criteria and Interpretative Guidelines. The program will respond by submitting a Plan of Correction Form. It is the program’s responsibility to supply all requested information in the required timeframe. 

• Reject Interim Data Report Form 

The FPRC may reject a program’s Interim Data Report Form if it identifies significant areas of concern or noncompliance. Rejection may result in a request for additional information or a fact-finding site visit. 

The re-accreditation process includes a re-accreditation application and an onsite visit to determine the program’s continued compliance with the AOTA Fellowship Program Criteria and Interpretative Guidelines. A program is required to submit a Fellowship Program Re-accreditation Application in the 4th year of a 5-year accreditation term and in the 9th year of a 10-year accreditation term. The completed Re-accreditation Application is assigned to a review team that consists of two members of the RFR in accordance with the Conflict of Interest Policy. The RFR members conduct independent reviews of the application responses and all supporting documentation to assess and ensure the program’s compliance with the AOTA Fellowship Program Criteria and Interpretive Guidelines. The FPRC will review the RFR’s feedback and provide recommendations. The Fellowship Program will receive the FPRC’s recommendations prior to and in preparation for the onsite visit.   

The site visit team will prepare a Site Visit Report summarizing its findings and submit a recommendation to the FPRC. The FPRC holds the sole authority to make the final decision regarding a program’s compliance. At the conclusion of the site visit, the site will receive a verbal summary of the Site Visit Report. Written feedback, including the FPRC’s decision, will be provided to the site within 30 days of the FPRC decision meeting.  

Following the site visit, the Fellowship Coordinator and any other staff members will be asked to complete the Fellowship Program Post Site-Visit Questionnaire (PSQ). 

FPRC Actions on Fellowship Program Re-accreditation Application 

The FPRC will review the Fellowship Program Re-accreditation Application and Site Visit Report. Based on the information received, the FPRC grants one of the following three actions: 

Grant Re-accreditation Status 

A program shall be granted Re-Accreditation Status for a period of 10 years if the FPRC determines that the program is in substantial compliance with the AOTA Fellowship Program Criteria. 

Defer Action on Re-accreditation Status 

An action shall be deferred on a re-accreditation application review if the FPRC concludes that the findings of the re-accreditation application review/site visit were incomplete or insufficient to determine if the program is in substantial compliance with the AOTA Fellowship Program Criteria and Interpretative Guidelines. In such cases, the FPRC shall request the submission of additional supporting documentation or another site visit. The program will submit a Plan of Correction Form.  

Deny Re-accreditation Status 

A program shall be denied Accreditation status if the FPRC determines that the Fellowship Program is no longer in substantial compliance with the AOTA Fellowship Program Criteria and Interpretative Guidelines. Procedures for appealing a denial of Accreditation Status are outlined in the Rules of Procedure for Appeals. 

The Fellowship Program will receive an Action Letter detailing the FPRC decision, and any subsequent requests or requirements they may have for the program. 

An organization denied re-accreditation may submit an Intent to Seek application no sooner than 180 days from the date of denial. 

Fellowship Program Re-accreditation Site Visit 

A program must secure a fellow for the re-accreditation site visit. 

In circumstances of an unforeseen or emerging issue that would cause a program to (1) not be able to accept a fellow within the 12-month period, or (2) lose a fellow for any reason before the re-accreditation site visit, the fellowship program would submit a Securing a Fellow Extension Form to request a 1-year grace period. If granted the 1-year grace period, the program will maintain accreditation status. If unable to secure a fellow within that year, they may be involuntarily withdrawn. 

A re-accreditation site visit shall be conducted by two members of the RFR or FPRC, who are assigned to the program in accordance with the Conflict of Interest Policy. In the event a second site reviewer is required and no RFR or FPRC member is available, an AOTA staff member who is a licensed occupational therapy practitioner may be assigned to the site. 

The site visit team will prepare a Site Visit Report summarizing its findings and submit a recommendation to the FPRC. The FPRC holds the sole authority to make the final decision regarding a program’s compliance. At the conclusion of the site visit, the site will receive a verbal summary of the Site Visit Report. Written feedback, including the FPRC’s decision, will be provided to the site within 30 days of the FPRC decision meeting.  

Following the site visit, the Fellowship Coordinator and any other staff members will be asked to complete the Fellowship Program Post Site-Visit Questionnaire (PSQ). 

A program may continue to hold accreditation status unless it: 

• Is denied re-accreditation status by the FPRC 
• Requests voluntary withdrawal of accreditation status 
• Is involuntarily withdrawn.

Defer Action of Plan of Correction 

If a plan of correction is not accepted, the following process will be implemented 

First Deferral for Plan of Correction (POC) Review: 

• Optional meeting with a member of the AOTA Fellowship Program staff. 

Second Deferral for POC: 

• Requires a support meeting with:  
• A member of the Fellowship Program Review Committee (FPRC). 
• A member of the AOTA Fellowship Program staff. 

A Plan of Correction not receiving a decision of Accepted after the second deferral may result in involuntary withdrawal. 

Reporting Program Changes 

Candidate or Accredited Programs must report all program changes.  Candidate programs can report changes during a site visit, and accredited programs on the annual data report (ADR), Interim Report, or re-accreditation application. Please note, the Change in Fellowship Coordinator Form must be completed as soon as possible to ensure accurate communication to the program. 

Common examples of program changes are listed below. This list is not exhaustive and should serve as a guide to determining how Fellowship Programs should respond to requested changes and modifications not explicitly listed or mentioned. 

• Sponsorship: Routine changes to the sponsorship of the program, including transfer of program sponsorship, changes to an existing partnership agreement, or the implementation of a new partnership agreement. 
• Name Change(s): Official changes to the sponsoring organization or program’s name. 
• Fellowship Cycle: Change in the scheduled start or end date of a Fellowship Program for a single fellow, a fellow’s voluntary discontinuation of a fellowship, and/or dismissal of a fellow from a fellowship. 
• Curricular sequencing: Changes in the order of the delivery of modules or clinical experience. 
• Curriculum: Changes to the curriculum delivery model or content for more than one-third of the modules. 
• Program Duration: Increase or reduction in the length of the Fellowship Program. 
• Securing a fellow: Decision not to accept applications from prospective fellows or admit new fellow(s) for one or more fellowship cycles.  
• Licensing or accreditation: Loss of the sponsoring organization or clinical facility’s license or accreditation. (Inform the FPRC within 30 days of receipt of notification of an adverse decision from the licensing or accrediting body.) 
• Resources: 30% or more reduction in the resources between reporting cycles (e.g., financial, personnel, physical) allocated to the program. 
• Admission requirements or selection criteria: Any change made to the admission requirements or selection criteria. 
• Fellowship Coordinator: The appointment of a new or interim Fellowship Coordinator. If the position is vacant, written notification should include the plan for filling the position, and the name, credentials, and contact information of the interim individual who will serve as the primary point of contact for the program. 
• Primary Mentors: Changes to the primary mentor(s) are reported on the Annual Data Report. 

The FPRC will review the submitted information during regular review cycles. The Fellowship Program will receive notification of acceptance, denial, or deferral (request for additional information and supporting documents). When considering program changes, the FPRC will consider any outstanding areas of non-compliance, and may also elect to conduct an abbreviated site visit evaluation to assess the change, and its impact on the program. The FPRC retains the right to deny the addition or change if, upon review, the FPRC feels that it would adversely impact current and/or prospective fellows. 

Fees 

AOTA is committed to administering a quality program cost-effectively and efficiently. Fees paid by the Fellowship Programs help to support costs attributed to the entire accreditation process. Each Fellowship Program is subject to the fee schedule outlined online. All fee increases will be posted on the website, and AOTA Fellowship Program staff will notify all Fellowship Coordinators within 5 business days after the increase is announced. All fees may be paid online or by check.  

Types of Fees 

All fees are non-refundable.  

Application Fee Deposit 

A non-refundable deposit is due upon submission of an Intent to Seek Accreditation Form. The deposit is applied toward the full Candidacy Application fee, for an application submitted within 1 year of the submission of the Intent to Seek Accreditation Form. 

Application Fee 

Payment of the full application fee (less the deposit if submitted within one year) is due upon submission of the Candidacy Application. 

Initial Site Visit Fee 

AOTA Fellowship Program staff shall invoice a candidate program for the initial site visit fee at the time the site visit is scheduled. Payment of the fee must be received by AOTA 90 days prior to the actual site visit. In the event AOTA has not received payment by this time, AOTA Fellowship Program staff will inform the Fellowship Coordinator and the site visit will be rescheduled pending receipt of payment. 

Annual Fee 

Annual fees are due each year in July, including the year in which a re-accreditation application is due. AOTA staff shall invoice accredited programs for the annual fee by June 1. Annual fees are prorated for the first year a program is accredited.  

Re-Accreditation Site Visit Fee 

In a re-accreditation year, the Fellowship Program is required to pay both the annual fee and the site visit fee.  

Organizations with Multiple Fellowship Programs 

Organizations that sponsor more than one AOTA accredited fellowship program must pay the following fees for each fellowship program: (1) an application deposit and fee; (2) an initial site visit fee; and (3) annual and re-accreditation site visit fees. 

A sponsoring organization seeking AOTA accreditation of its Fellowship Program(s) may seek reconsideration or repeal of a FPRC’s decision. An organization may also seek reconsideration or repeal of a decision by the FPRC to remove accreditation of a Fellowship Program. 

An initial decision becomes final when a request for reconsideration or repeal is not initiated within the period noted in the policy below. 

A Fellowship Program subjected to an adverse decision taken or made by the FPRC may appeal that decision if (1) it has reason to believe that the decision was arbitrary, capricious, in substantial disregard of the AOTA Fellowship Program Criteria and Interpretative Guidelines, policies or procedures of the AOTA Fellowship Program, or (2) was not supported by substantial evidence in the record upon which the FPRC relied in making the decision. 

The Fellowship Program has the burden of proof on appeal. 

The record on appeal shall include—as applicable (1) the program’s written appeal and supporting documentation; (2) reports, decision letters, and other correspondence between the FPRC and the site; and (3) the program’s responses to the FPRC’s inquiries and actions. 

The Fellowship Program may not present any data, information, documents, or other evidence to the Appeal Panel that was not part of the original record used by the FPRC to determine and make the appeal. 

Reconsideration of a Denial of Candidate Status 

A sponsoring organization may request that the FPRC re-visit its initial decision to deny its Fellowship Program Candidate Status if it believes the program was in substantial compliance with the AOTA Fellowship Program Criteria, and that it was reflected in the organization’s initial Candidacy Application. 

Procedures for Request for Further Consideration 

A request for a Further Consideration Review shall be submitted in writing to fellowship@aota.org addressed to the AOTA FPRC—and must be received within 30 calendar days of the date that the initial decision was received. The Request for Further Consideration may include written information, documentation, and/or correspondence to demonstrate compliance, in response to the issues cited as deficient and outlined in the FPRC’s initial decision letter. 

An organization cannot appeal the Denial of Candidate Status beyond the Request for Further Consideration process. 

General Principles for Denial or Involuntary Withdrawal of Accreditation   

The first level of appeal is a Request for Further Consideration by the FPRC. If the FPRC sustains its previous decision, the organization may pursue a second and final level of appeal to the Appeal Panel (see Appeal Panel section) appointed by the AOTA Fellowship Program staff. 

Denial or involuntary withdrawal of accreditation status shall become effective when the decision has become final (i.e., after further consideration and appeal). 

The decision made by the Appeal Panel shall be final and cannot be appealed. 

An initial denial or involuntary withdrawal of accreditation shall not preclude an organization from pursuing a subsequent application for accreditation. Removal of accreditation requires that the program pay a new application deposit and fee and submit a new application.  

Rules of Procedure for Further Consideration 

Involuntary Withdrawal of Accreditation Status 

• The FPRC reserves the right to monitor compliance with the AOTA Fellowship Program Criteria and to investigate complaints of possible violations. In addition to documentation and records review, an investigation may include a site visit audit at the expense of the fellowship program. 
• AOTA’s Fellowship Program may involuntarily withdraw programs secondary to: 
• substantial and sustained noncompliance with the AOTA Fellowship Program Criteria, 
• persistently failing to respond to AOTA Fellowship Program staff or FPRC correspondence and requests,  
• failing to pay Fellowship Program fees, 
• failing to submit annual reports, interim reports, and re-accreditation applications.  
• failing to secure a fellow during the reaccreditation process, extension or grace period. 

Programs are required to submit Annual Reports, Interim Reports, and Reaccreditation Applications by the designated due dates to maintain accreditation status. The following process applies to all required submissions: 

• Two Months Before the Due Date:
  An initial reminder email is sent to all individuals listed on file for the program.
• 30 Days Past the Due Date:
  An email notification of non-compliance is sent to all individuals on file.
• 60 Days Past the Due Date:
  An official letter is mailed, notifying the program that it is "In Danger" of withdrawal.
• 90 Days Past the Due Date:
  A final letter is sent via certified mail informing the program that it may be involuntarily withdrawn from accreditation.
• Six Months Past the Due Date:
  If the required submission has not been received and no major extenuating circumstances have been approved by AOTA staff, the program may be involuntarily withdrawn.

Notice of denial or involuntary withdrawal shall be sent to the Fellowship Program by certified mail, return receipt requested, and describe the basis for the denial or withdrawal, specifically addressing the requirements that were not met. 

If the FPRC does not receive a request for a Further Consideration Review within 30 calendar days of the date the initial decision was received (as indicated by the return receipt), the initial decision shall become final and there shall be no right of further consideration or appeal. 

Notice of Decision after Further Consideration Review 

Sites shall receive written notice of the decision following further review by the FPRC. This notice shall be sent by certified mail and return receipt, within 30 calendar days of the committee’s decision. If the Decision Following Further Review is not in the applicant’s favor, the notice shall reference the AOTA Fellowship Program Manual of Policies and Procedures to emphasize the appropriate procedures required for final appeal consideration. 

The decision following the Request for Further Consideration shall describe the basis for the FPRC’s decision. 

The Program may choose to formally appeal the decision at this point, at which time a Request for Appeal is submitted. If the AOTA FPRC does not receive a Request for Appeal of an adverse decision following further review within 30 calendar days, the decision following further review shall become final and there shall be no further right of appeal. 

Rules of Procedure for Appeals

General Principles 

A site subject to an adverse decision taken by the FPRC may appeal that decision if it has reason to believe that the decision was arbitrary, capricious, in substantial disregard of the criteria or procedures of the AOTA Fellowship Program, or not supported by substantial evidence in the record upon which the FPRC relied in making the decision. 

The Fellowship Program has the burden of proof on appeal. 

The record on appeal shall include the program’s appeal document and supporting documentation, reports, decision letters and other correspondence between the FPRC and the site, and the program’s responses to the FPRC inquiries and actions. 

Data, information, documents, or other evidence that was not part of the record when the FPRC made their decision will be disregarded by the Appeal Panel.  

Appeal Panel 

Selection of the Appeal Panel Members 

In the event of a timely and duly filed appeal from a program, AOTA Fellowship Program staff shall select three individuals to serve on an Appeal Panel. The Appeal Panel shall consist of members of AOTA in good standing with expertise in the education and/or practice area(s) identified in the site application. 

No individual may be selected to serve on an Appeal Panel if he or she has had any prior involvement with the appealing program or had any involvement with the AOTA Fellowship Program Review that gave rise to the decision that the organization is appealing. 

AOTA staff shall advise the appealing program 15 calendar days prior to the scheduled appeal hearing date of the names and affiliations of the three individuals selected to serve on the Appeal Panel. 

If the program has good cause to believe that any member(s) of the Appeal Panel should not hear the organization’s appeal, it must immediately notify AOTA Fellowship Program staff in writing that it objects to the panelist(s) and state with specificity the grounds for the objection. AOTA Fellowship Program staff will consider the objections and decide whether to replace the member(s) of the Appeal Panel with another individual(s). The decision of AOTA Fellowship Program staff with respect to the members of the Appeal Panel is final and may not be appealed. 

Appeal Procedures 

Notice of Intent to Appeal: An organization shall commence an appeal by submitting a Request for Appeal to AOTA FPRC within 30 calendar days after the date that the decision was received. 

Request for Appeal: The organization must submit a Request for Appeal with supporting documentation, along with a written statement to the AOTA Fellowship Program, within 30 calendar days after receiving notice of AOTA’s FPRC adverse decision. The document must outline the organization’s argument(s) in support of its contention that the decision was arbitrary or capricious; in disregard of AOTA’s Fellowship requirements or procedures; or not supported by substantial evidence in the record on which the FPRC predicated its decision. 

Materials Submitted with Request for Appeal: An organization may not submit any documents, data, evidence, or other supporting documentation with its appeal unless such materials were in the original record at the time the FPRC rendered its adverse decision. 

Personal Appearance and Representation by Legal Counsel: The program has the right to a hearing before the Appeal Panel and may select a qualified individual(s) and/or legal counsel to represent the organization at the hearing. The Fellowship Program shall provide AOTA staff with the names, titles, and contact information for all representatives who will be participating in the appeal hearing on the organization’s behalf, no later than 10 calendar days before the scheduled hearing date. The program shall also furnish the AOTA Fellowship Program staff with the names and contact information of all legal counsel who will be representing the organization during the appeal proceedings and hearing. 

Transcript of Hearing: The organization has the right to a written transcript of the appeal hearing and may exercise this right by providing notice to the AOTA staff at the time of filing the appeal. AOTA staff will provide the transcription services, but the organization will be solely responsible for all the associated costs of these services. AOTA staff will inform the program coordinator of the transcription cost at least 45 calendar days before the scheduled hearing and will need to be received by AOTA before the hearing. Videotaping of the appeal hearing is strictly prohibited. 

Timing of Appeal Hearing: The appeal hearing will be conducted no later than 60 calendar days after receipt of the organization’s Notice of Intent to Appeal. AOTA has the right to extend this time for good cause. After consultation with the Chief Executive Officer of the appealing organization, the date, time, and location of the appeal hearing shall be set by the AOTA staff and provided to the organization no later than 15 calendar days prior to the hearing date. 

Hearing Format: The following process shall be observed during the appeal hearing: 

The Chairperson of the Appeal Panel shall make an opening statement that includes: (1) identifying the participants in the hearing; (2) briefly describing the issues of the appeal; (3) stating the standard of review that will be used by the Appeal Panel in deciding the appeal; and, (4) summarizing the process and procedures to be followed during the hearing. 

Following the Chairperson’s opening statement, a representative of the AOTA staff will make a brief statement describing AOTA’s decision and the justification for that decision. 

The appealing side will be afforded 30 minutes to present arguments as to why its appeal of AOTA’s adverse decision should be granted. The presentation may be made by one or more Fellowship Program’s representatives and shall be limited to issues relevant only to AOTA’s adverse decision. 

After the program has concluded its presentation, members of the Appeal Panel can then ask any questions of the representatives of the organization about its appeal, or any of the issues raised by the Fellowship Program during the hearing. 

Following the question-and-answer period, the Chairperson of the Appeal Panel shall permit the Fellowship Program to make a brief concluding statement. 

After the Fellowship Program makes its concluding statement, the appeal hearing will conclude, and the record closed. 

Appeal Panel Decision 

Written Decision: After the hearing, the Appeal Panel shall prepare a written decision that clearly outlines its decision in detail, specifies the reasons for its decision, and describes with specificity the action it is taking to affirm, remand, or reverse the decision. 

Transmittal of Decision: The Chairperson of the Appeal Panel shall transmit the written decision of the panel to AOTA staff within 30 calendar days of the conclusion of the appeal hearing. 

AOTA Action: The FPRC will act consistent with the appeal decision as promptly as possible after receipt of the Appeal Panel’s written decision. Pursuant to these rules if the decision is upheld no further action is required. 

Notice of Decision: AOTA shall notify the appealing organization, in writing, of the FPRC’s decision following the review of the findings of the Appeal Panel to affirm the FPRC's decision, or to carry out the Appeal Panel’s decision to remand or reverse the decision. AOTA staff shall notify the appealing organization in writing of the final FPRC decision. 

Appeal Expenses 

Expenses of Appealing Organization: An appealing organization is fully responsible for all costs associated with its appeal.  

Expenses of the Appeal Panel: The appealing organization shall also be fully responsible for all the reasonable costs associated with the appeal hearing, including the hearing room, transcription services, travel, meals, and lodging for all members of the panel. 

Voluntary Withdrawal of Intent to Seek Accreditation 

• A sponsoring organization may withdraw its Intent to Seek Accreditation Form at any time, before submission of the Candidacy Application, however the deposit is non-refundable. The withdrawal request should be provided to AOTA in writing to fellowship@aota.org by the Fellowship Coordinator or program representative.  
• If a sponsoring organization(s) chooses to re-apply for initial Accreditation, all originally paid fellowship fees will be forfeited, and the sponsoring organization(s) will be responsible for paying any future fees associated with the application process. 

Voluntary Withdrawal During Candidacy Application Review 

A Fellowship Program may withdraw its request for initial Accreditation of a Fellowship Program from the Candidacy Application review process at any time before final action by the FPRC. The program must submit a Voluntary Withdrawal Notification form. If the withdrawal notification occurs within 30 calendar days of the application submission the applicable candidacy application fees will be refunded. 

Voluntary Withdrawal During Candidate Status  

A Fellowship Program may withdraw from the Accreditation process during Candidate Status—without penalty—up to 90 days before a scheduled site visit. If a Fellowship Program chooses to withdraw from the Accreditation process less than 90 days before the scheduled site visit date, all fees are non-refundable.  The program must submit a Voluntary Withdrawal Notification form. The program may rescind the voluntary withdrawal without penalty within 30 days, If the program wishes to pursue accreditation within two years, they may begin the process with the Candidacy Application and associated fee. If pursuing Accreditation more than two years from the date of the withdrawal the program will begin the process with the Intent to Seek Accreditation Form and associated fee. 

Voluntary Withdrawal of Accreditation Status 

Accredited programs wishing to voluntarily withdraw Accredited status with the AOTA Fellowship Program must submit a Voluntary Withdrawal Notification form. All previously paid fees are non-refundable. The program may rescind voluntary withdrawal without penalty within 30 days, If the program wishes to pursue Accreditation within two years, they may begin the process with the Candidacy Application and associated fee. If pursuing Accreditation more than two years from the date of the withdrawal the program will begin the process with the Intent to Seek Application and associated fee. 

Policy for Complaints Against a Fellowship Program 

AOTA Fellowship Programs must follow the AOTA Fellowship Program Criteria and Interpretive Guidelines and the AOTA Fellowship Program Manual of Policies and Procedures. If AOTA staff receive a complaint regarding an AOTA Fellowship Program’s compliance with these documents the program will be notified and an investigation initiated. Actions taken by other outside organizational entities do not preclude the AOTA FPRC from investigating a complaint against the same institution or identified Fellowship Program. 

The AOTA’s FPRC will not intervene—or act as a court of appeal—on behalf of the organization/institution or staff.  

Accreditation Procedures for Complaints Against a Fellowship Program 

To be given formal consideration complaints must be submitted to the AOTA Fellowship Program. The complaint must be submitted via a Complaint Against a Fellowship Program Form. The identity of the complainant is concealed. If the complaint is found to relate to the AOTA Fellowship Program Criteria and Interpretive Guidelines and the AOTA Fellowship Program Manual of Policies and Procedure the following procedures shall be followed: 

1. AOTA Fellowship Program staff will acknowledge receipt of the complaint and share with the filing party a description of the process for handling such complaints. 

2. AOTA Fellowship Program staff will notify the Chair/co-chair and FPRC members who support the fellowship program. 

3. AOTA Fellowship Program staff will notify the Fellowship Coordinator of the substance of the complaint. The Fellowship Coordinator will be responsible for conducting a preliminary investigation and providing a report on the findings within 30 days.  The identity of the complaining party is not revealed unless the release of identity has been authorized by the complainant or disclosure is required by legal action. 

4. At the request of the AOTA FPRC, AOTA Fellowship Program staff may request further information or documentation related to the complaint from the complaining party, the institution, or other relevant sources. 

5. The FPRC member assigned to the program in question will consider the complaint and all relevant information obtained during the investigation. They shall recommend an appropriate action/decision to present to the FPRC at its next scheduled meeting according to the following guidelines: 

• If the complaint is determined to be unsubstantiated or unrelated to the AOTA Fellowship Program Criteria and Interpretive Guidelines and the AOTA Fellowship Program Manual of Policies and Procedure, the complaining party, officials of the program in question, and the appropriate official of the sponsoring institution, will so be notified. 
• If the investigation reveals that the Fellowship Program may not have followed AOTA Fellowship Program Criteria and Interpretive Guidelines, and the AOTA Fellowship Program Manual of Policies and Procedure the Fellowship Program may be requested to submit a Substantiated Complaint Response Form detailing the correction of the substantiated complaint. Should the AOTA FPRC be satisfied with this response, the program and the party filing the complaint will be notified of AOTA’s FPRC satisfaction with the resolution of the matter and notice that the program’s Accreditation status remains unaffected by the complaint. 

6. If the AOTA’s FPRC determines that the Fellowship Program’s response to the complaint was inadequate and lacking in evidence of the program’s continuing compliance with the AOTA Fellowship Program Criteria and Interpretive Guidelines and the AOTA Fellowship Program Manual of Policies and Procedure, the FPRC may request that the program submit additional information or may arrange for a fact-finding site visit to the Fellowship Program. AOTA Fellowship Program staff will inform the program of the cost of this additional FPRC-required site visit, which will be paid for by the Fellowship Program. The rate will be equal to the cost of a current initial site visit and will need to be received by AOTA 45 days before the scheduled site visit. The AOTA Fellowship Program maintains a file of all the complaints they receive. All complaints received and acknowledged by the AOTA FPRC against a Fellowship Program related to program compliance since the last onsite evaluation will be made available for review by the on-site team scheduled to visit that Fellowship Program. 

• If AOTA, based on the evidence before it, determines that the Fellowship Program is following the Fellowship Program Criteria and Interpretive Guidelines, and is adhering to Fellowship Program policies and procedures, the Fellowship Program, its sponsoring organization/institution, and the complaining party, will be notified of this assessment, and the fact that the program’s current Fellowship Program status remains unaffected by the complaint. 
• If AOTA, based on the evidence before it, determines that the program is not in substantial compliance with the Criteria and Interpretive Guidelines, policies or procedures areas of noncompliance will be cited, and the Fellowship Program’s status may be involuntarily withdrawn.  

Confidentiality and Disclosure 

AOTA’s FPRC has delineated policies regarding confidentiality and disclosure, in keeping with its obligation and responsibility to the public. 

Statement on Confidentiality 

The FPRC maintains the confidentiality of information collected during the Accreditation process. Documentation such as Candidacy Applications, Annual Data Report Forms, Interim Data Report Forms, and any other supporting documentation are considered confidential and are only accessible by the AOTA staff, the FPRC, and those members of the RFR assigned to review the Fellowship Programs. Written permission must be secured from the administrators of a sponsoring organization or Fellowship Program, before the release of any confidential materials or documentation on any other individual or group, except when the released materials or information does not disclose the identity of the sponsoring organization or Fellowship Program. 

Strict safeguards of confidentiality shall be enforced during meetings where the review and evaluation of specific Fellowship Programs are being discussed. Only required attendees may be present, and meeting minutes shall be kept confidential. 

The AOTA Fellowship Program staff may release aggregate annual report data—obtained directly from Fellowship Programs and statistical summaries—that do not reveal any identifying program information. Staff shall ensure that the information is both accurate and current before it is made available to the public. AOTA staff and the FPRC will not be held responsible for any attempts by external parties to use general information disclosed to the public to identify specific Fellowship Programs. 

Statement on Disclosure 

Policies and Procedures 

The AOTA Fellowship Program scope, policies, and procedures are available to the public through the AOTA website. It is the responsibility of AOTA staff to notify Fellowship Programs of all revisions made to any policies and procedures. 

Fellowship Program Information 

Fellowship Programs are listed in the Fellowship Directory on the AOTA website. Each Fellowship Program listing contains the program’s Accreditation status and web link when available. 

The following status definitions are presented in the introduction to the Fellowship Directory as follows: 

• Accredited: Accredited Fellowship Programs have met all accreditation steps and comply substantially with the AOTA Fellowship Program and Interpretive Guidelines. 
• Candidate: Fellowship Programs holding Candidacy Status have been determined, through their applications, to have met all requirements for candidacy. Upon official notice of Candidacy Status, the Fellowship Programs will be eligible to accept fellows.  
• Applicant: Fellowship Programs with Applicant Status have filed an Intent to Seek Accreditation Form and have been admitted into the Accreditation process. They are in the process of completing a Candidacy Application, or are awaiting a candidacy decision, and are therefore not eligible to accept fellows as they have yet to be Accredited by AOTA. 

Public Notice of Change in Fellowship Program Accreditation Criteria and Interpretive Guidelines  

If the FPRC determines at any point during its systematic review process that it needs to make changes to the AOTA Fellowship Program Criteria, the FPRC will initiate that action. AOTA staff is required to provide adequate advance public notice in the event they need to make any mandatory criteria changes. AOTA staff will notify all Fellowship Programs directly of any change.  

Statement of Ethical Responsibilities and Conflict of Interest Guidelines 

The role of the FPRC and the RFR is to both ensure the quality of the Fellowship Program and to advance practitioner expertise in occupational therapy. The committees must also demonstrate that regular reviews are conducted and that decisions are rendered under conditions of an impartial and objective judgment. 

The following guidelines apply to AOTA staff, the FPRC, and the RFR and Appeal Panel in making decisions regarding potential conflicts of interest. 

Statement of Ethical Responsibilities 

FPRC members: 

May not serve as a paid or unpaid consultant to a Fellowship Program unless such consultations are performed under the auspices of the FPRC, other official body, and/or committee of AOTA. 

FPRC, RFR, and Appeal Panel: 

1. shall abide by AOTA’s Code of Ethics; 
2. shall act in ways to preserve the confidentiality of the personnel, fellowship programs, and organizations that are evaluated; 
3. shall expeditiously handle all matters pertaining to Accreditation  
4. shall not advertise, publicly promote, or permit others to act in a similar manner as it relates to their membership on the FPRC or the RFR, for any purpose unrelated to official business of FPRC, RFR, or AOTA, with the exception of curriculum vitae (CV) (includes public virtual CV), professional publications, and/or manuscripts, 
5. shall not provide any service—whether paid or unpaid—to any institution or program in litigation with the FPRC, or having an appeal of a FPRC action or decision under active consideration; and, 
6. shall not disclose to any person, organization, or fellowship, any information related to FPRC decisions that has not been made public. 

Conflict of Interest Resulting from Membership in Other Bodies 

Fellowship Program reviewers and members of any Fellowship Program committees with decision-making authority (FPRC, and Appeals Panel), must not hold concurrent voting positions on any AOTA policy or decision-making body for occupational therapy.  

Conflict of Interest with Individual Institutions 

Responsibility for identifying a conflict of interest with any given Fellowship Program lies with the individual staff member or reviewer. The FPRC has the final authority to determine when a conflict of interest exists. In deciding a conflict of interest, a staff member or reviewer must consider the possibility of perceived conflicts of interest, as well as actual conflicts of interest as defined below: 

1. A close personal, professional, educational, or financial interest, or other special relationship (including those of a negative nature), in any organization in question. 
2. An employee or consultant to an entity other than the organization under review or other consideration that provides all or a significant portion of the organization’s or fellowship’s funding. 
3. A current or former fellow, graduate or student, or parent of a current or former fellow, graduate, or student of the organization, or Fellowship Program in question. 
4. A current or former candidate for a paid position within the past 5 years with the entity in question. 
5. A position, whether paid or voluntary, current or within the past 5 years, to or for the organization in question. This includes positions as a consultant, advisor, staff, or faculty member (including clinical or adjunct). 
6. A position, whether paid or voluntary, current or within the past 5 years, in an organization that is generally viewed by occupational therapy peers as a major competitor to the organization in question. This includes positions as a consultant, advisor, staff, or faculty member (including clinical or adjunct). 

Withdrawing or Absentia from FPRC Deliberations 

Members of the FPRC—except paid staff—shall refrain from the FPRC’s deliberation on the organization in question if the conditions above are applicable. If any of these conditions apply—or if a member has any doubt or discomfort as to their applicability, the member must leave the meeting (virtual or onsite) during any formal or informal discussion of the organization in question. When the discussion of the program in question is completed, the FPRC member may rejoin the meeting. The minutes of the official proceedings of the FPRC will reflect the absence. 

Absentia from a Vote During FPRC Meetings 

Abstaining (or abstention) is a parliamentary term that means that a voting member chooses not to cast a vote. An abstention in no way implies or indicates that a conflict of interest exists. Abstentions are to be used only when a voting member of the FPRC cannot make an informed decision based on the information presented. The minutes of the official proceedings of the FPRC will record all abstentions as a part of the vote count on all action items. 

When a motion has been discussed to the satisfaction of the FPRC, and the question has been called, the chair (or assigned co-chair) of the committee will ask for a vote from those in favor of the motion, those against the motion, and those abstaining from the vote. 

Non-Discrimination Policy 

The Fellowship Program must foster an environment that values and amplifies the the perspectives and experiences of all individuals. A clear and comprehensive non-discrimination policy—aligned with that of the sponsoring organization—must be established, upheld, and readily accessible to both prospective and accepted fellows throughout the entire fellowship experience. The selection process should reflect a commitment to holistic evaluation, applicant's experiences, personal attributes, and potential contributions. By prioritizing a well-rounded approach, the program ensures a cohort that embodies its mission and values. 

Disclosure of Program Conflicts 

Upon notification of appointment to the FPRC, RFR, or Appeal Panel, the appointed member shall submit to AOTA Fellowship staff a listing of all fellowships or organizations with which a conflict exists, as determined by the criteria above. AOTA staff shall maintain a record of these conflicts of interest. 

During tenure as a member, a member shall disclose in writing to fellowship@aota.org the commencement of any new affiliation with a program that creates an additional conflict. 

Disclosure of Program Conflicts Related to Consultation  

At any time during an individual’s tenure on the FPRC, RFR, or Appeal Panel, if the individual accepts or performs a service that creates a conflict of interest, the individual shall notify the organization for which the services are to be provided that a conflict of interest exists. The notification shall consist of the following statement: 

“My services to [ORGANIZATION/FELLOWSHIP] are strictly independent in nature and cannot be construed in any way, by any party, to be related to the FPRC or the fellowship Accreditation process. Further, I hereby declare myself in conflict of interest with any AOTA Fellowship Program Accreditation activities related to [ORGANIZATION/FELLOWSHIP].”  

In addition, members of the FPRC, RFR or Appeal Panel must notify the AOTA Fellowship Program, of any consulting activity. This written notification must include the following information: 

1. The fellowship at which consultation is being provided and subsequent declaration of a conflict of interest with that fellowship; 
2. The nature of the consultation (e.g., consultant, advisory board, council); 
3. The frequency and duration of the consultation; 
4. Whether financial remuneration is being provided for the consultation, and 

Whether the appropriate persons at the organization(s) were provided with the FPRC disclaimer statement. 

For 2 years following the conclusion of their service to the FPRC, RFR, and any former member(s) who agree to serve as a consultant to an institution or program must notify the Fellowship Coordinator or other appropriate fellowship representative stating that the advice provided is personal advice and does not represent the opinion of AOTA’s FPRC.   

Disclosing Accreditation Status 

All AOTA Accredited Fellowship Programs must use the following statement in all publications.   

• The [Name of Fellowship Program] is accredited by the American Occupational Therapy Association. AOTA’s email address is fellowship@aota.org. 

Use of the AOTA Fellowship Program Logo 

If a program is granted Accredited Status or Conditional Accreditation Status, it shall receive the AOTA-Accredited Fellowship Program logo for its official use, on its website and other program materials. Accredited Fellowship Programs are required to use the current AOTA Fellowship Program logo when reflecting their affiliation status in written or Web-based publications. In addition, the use of the logo is governed by the following guidelines: 

The AOTA Fellowship Program logo may only be used by current Accredited Fellowship Programs. The logo may not be used by programs that have not yet received Accreditation including programs granted Candidate Status. 

If the AOTA Fellowship Program logo is used in a publication or Web page that lists multiple programs with varying statuses, the accompanying text must clearly indicate which programs are Accredited by AOTA. 

1. Use of the AOTA Fellowship Program logo is subject to revocation and withdrawal by the AOTA Fellowship Program staff when, in its sole judgment, its continued use would not serve the best interests of the AOTA Fellowship Program or the public. 

The definitions provided below are for the purposes of this document and other AOTA Fellowship Program documents only.