HCPro.com - Residency - DO NOT USE Top Stories

Tip of the Week: Treat faculty orientation like resident orientation

Tue, 07 Feb 2012 19:33:00 GMT

Residents should not be the only in-coming program members to have a thorough and detail-driven start to entering a program.

Set a tone for the program with consistency in orientation. Program directors must discuss and reiterate the educational mission of the program during the interview to help drive home how important personnel take medical education.

Program directors should meet with new hires to re-emphasize their role in relation to the program and director’s expectations. Other topics to cover should also include:

· Relationship between education and service

· Importance of feedback

· Timely completion of resident evaluations

· Compliance with duty hour regulations

· Program policies and procedures

· Program curriculum

Program directors should follow up with face-to-face discussions on many items articulated in the program’s faculty handbook, including the use of the program’s tracking/evaluation system.

This week’s tip is from The Residency Coordinator’s Handbook, Second Edition by Ruth Nawotniak, MS, C-TAGME.

News and briefs: UA study links lack of empathy in residents to long shifts

Tue, 07 Feb 2012 19:31:00 GMT

Approximately 68% of surveyed residents indicated a “significant decline” in empathy during “long-call” shifts, according to findings in a recently published University of Arizona report.

Researchers at the University of Arizona surveyed nearly 100 medical residents at different hospital settings. For the survey, empathy was officially defined as the compassion and concern demonstrated to a patient, and a long-call shift as a continuous 24- or 30-hour period of time. The study measured medical resident burnout and stress to compare the data.

The report, which was published three months after the new ACGME duty hour restrictions went into place, emphasizes a need for more attention on the emotional and mental well-being with all healthcare providers.

For more, click here.

News and briefs: GA may increase residency number s across state, but cut main hospital?s budget

Tue, 07 Feb 2012 19:27:00 GMT

Georgia Governor Nathan Deal is proposing cuts to the state’s largest teaching hospital, but additions to the number of medical residency slots throughout the state.

According to a recent article in the online publication, The Republic, Deal proposes a $583,000 reduction in state funding to the hospital and affiliated clinics of Georgia Health Sciences University (formerly medical College of Georgia) in Augusta as part of his midyear budget proposal. In a separate budget proposal, the governor also wants to allot $1.2 million to expand the number of residency slots by 400, spread out to smaller programs across the state to encourage more physicians to stay in-state.

Members of the teaching hospital say the continual cutting of state funding to the teaching hospital is troublesome, stating cuts are at about $8.5 million, or 23%, – since 2002, and the proposed cuts could eliminate seven or eight residency spots at the institution.

For more, click here.

Tip of the week: Getting involved is getting prepared

Tue, 31 Jan 2012 15:58:00 GMT

Internal reviews require a dedication to organization. No matter how organized an individual or program may be, keeping up with internal review best practices should not be limited to prior routine.

Program directors and program coordinators should participate as members of internal review committees for other programs. The opportunity will provide quality learning experiences as well as a chance to network with peers in other programs on the review process. It provides a chance to discuss and analyze best practices from multiple angles.

As an added bonus, residents who participate on another program’s internal review committee can become more involved in their own program and have better insight as to the evaluation and teaching that is involved.

It is impossible to teach internal review experience without getting involved.

This week’s tip is from Insider’s Guide to the ACGME Site Visit, Second Edition by Kathryn Andolsek, MD, MPH, and Shepard Cohen.

News and briefs: Teaching hospitals receive $2 million in Medicare overpayments

Tue, 31 Jan 2012 15:55:00 GMT

Fifty teaching hospitals in Mid-Atlantic states such as Pennsylvania, Delaware, and Maryland received $1.9 million in Medicare overpayments during FY2006 and FY2007, according to a recent report from the Office of the Inspector General (OIG).

As reported by Becker’s Hospital Review, multiple hospitals mistakenly claimed the same resident in these cases, leading to extra payments. Highmark, a CMS contractor for the Mid-Atlantic district where the discrepancies occurred, states in a letter in the report it will review the Intern and Resident Information System program, even if there is no federal mandate in place requiring such action.

In the report, OIG recommends Highmark recover the money and consider developing procedures to make sure the double counting of residents ends.

To read more, click here.

News and briefs: Bob Barker urges university to stop using cats to train medical students

Tue, 31 Jan 2012 15:51:00 GMT

Game show icon Bob Barker is asking the University of Virginia to stop the practice of using cats to teach the proper way to insert breathing tubes into patients. The practice seeks to teach medical students on the proper method of inserting the tubes into premature newborns.

Barker, the longtime “The Price is Right” host, says in a letter to university president Teresa Sullivan the technique is harmful to felines and even “shortchanges” pediatrics medical students on their learning. Barker is an animal rights advocate, who donated $1 million to the university in 2009 to help develop an animal law program. He urges the medical school to switch to simulators.

According to an article on nbcwashington.com, university officials state that the use of simulators does not do as good a job in educating residents on the practice.

To read more, click here.

Tip of the week: Chart stimulated recall improves medical knowledge

Tue, 24 Jan 2012 15:13:00 GMT

Residents are given a number of different exams to increase their medical knowledge – one of the necessary ACGME core competencies. Mix up the exam from time to time using the chart stimulated recall (CSR) model.

Review chart record notes on specific patient cases with a resident. Allow the resident an opportunity to explain his or her thinking on how things were noted. It is important to read the chart notes verbatim, as there are often discrepancies between physician actions and self-noted actions.

A CSR exam will allow the resident to reflect upon his or her own practice decisions and talk out any best practice issues that surfaced while providing care.

This week’s tip is from A Practical Guide to Teaching and Assessing the ACGME Core Competencies, Second Edition by Elizabeth Rider, MSW, MD, FAAP and Ruth Nawotniak, MS, C-TAGME.

Featured blog post: Consider me PGY1: An introduction to the new residency editor

Tue, 24 Jan 2012 15:06:00 GMT

It was a week before Christmas and my family and friends gathered for our annual December yuletide day o’ fun at my parents’ home. As everyone mingled and caught up with each other, I was subject to the same inquisition over a glass of egg nog:

So, Josh, what do you do again?

Good question.

The HCPro residency blog is back. To read more of this blog post and more, click here.

News and briefs: Senators call for GME funding review

Tue, 24 Jan 2012 15:02:00 GMT

Seven U.S. senators urged the Institute of Medicine (IOM) to conduct an independent review of GME funding and governance.

In a December 21 letter written to IOM President Harvey Fineberg, MD, PhD, the senators stated the current GME system is “under increasing stress” and projects to a future in healthcare with many concerns. The letter asks for IOM personnel to address several issues, including potential GME reforms, uneven distribution in funding across states, and accreditation.

The senators hope to receive recommendations on statutory, regulatory, and accreditation changes by this year’s third quarter.

To read the letter, click here.

News and briefs: IRS to reimburse former medical residents

Tue, 24 Jan 2012 14:58:00 GMT

According to an article in the Cleveland Plain Dealer, residents, fellows, and the hospitals they practiced at from January 1, 1997 to March 31, 2005 will receive a tax refund from the IRS. Residents paid Federal Insurance Contribution Act (FICA) taxes as employees, instead of being classified as students, who are exempt from such taxation.

The IRS changed its definition of “student” in 2005, which returned them to “employee” status, but has promised to deliver a refund to qualifying individuals and hospitals who filed FICA return claims. The U.S. Supreme Court recently upheld a pair of appeals court decisions that residents are currently defined as employees and subject to FICA taxes.

An IRS spokesperson says in the article that the majority of the FICA claims will be paid out by September 30, ending a 20-year battle on the issue.

To read more, click here.

Tip of the week: Stay organized in preparation of ranking meeting

Tue, 17 Jan 2012 16:58:00 GMT

Recruiting quality residents into your program can hit a snag if ranking practices are taken lightly. Programs must preach preparation and organization for ranking candidates prior to Match Day.

Program coordinators should create a report summarizing interview recommendations complete with their own interview rankings. Distribute recommendation forms of all candidates to the program director, assistant program director, department chair, and interviewer.

In the room the meeting is conducted:

· Set out all applications

· Make additional copies of candidate pictures separate from application

· Order pictures according to your ranking

This week’s tip is from The Residency Coordinator’s Handbook, Second Edition by Ruth Nawotniak, MS, C-TAGME.

News and briefs: Report focuses more attention on social/behavioral sciences in medical education

Tue, 17 Jan 2012 16:55:00 GMT

A new AAMC report stresses the importance of medical education focusing on the impact of lifestyle, economic status, and behavior on patient care. “Behavioral and Social Science Foundations for Future Physicians” maps out a framework to educate the next wave of physicians on how societal issues can impact health and disease.

The report addresses specific pedagogy, current socio-economic challenges, and calls for medical educators to "renew approaches used to educate physicians while remaining mindful of the complex journey of becoming a physician."

According to an article on AAMC’s website, the report promotes itself as an outcomes-based model to help medical institutions improve their curricula and physicians become well-rounded.

Click here to read the report or here to view the AAMC article on the report.

News and briefs: ACGME to test four-year family medicine residency model

Tue, 17 Jan 2012 16:50:00 GMT

Will it be three or four years? A new ACGME pilot program will determine the appropriate length for family medicine residencies.

According to an article in Annals of Family Medicine, 20-30 three-year programs will be selected to be simultaneously monitored and analyzed with 20-30 four-year programs by The Review Committee for Family Medicine (RC-FM). The pilot will begin with the 2013 academic year and continue through 2019. The ACGME, in conjunction with RC-FM will determine if a four-year program should be the new requirement.

Reasons cited in the article for extending family medicine residencies a fourth year include diminished teaching time created by the recent duty hour restrictions.

To read more, click here.

News and briefs: First Lady lauds AAMC, AACOM commitment to PTSD, brain injury research

Tue, 17 Jan 2012 16:42:00 GMT

With a presidential seal of approval from First Lady Michelle Obama, AAMC and American Association of Colleges of Osteopathic Medicine (AACOM) committed to focusing on developing new research and clinical trials for treating post traumatic stress disorder (PTSD) and brain injuries.

According to a January 12 USA Today article, there is no additional allocation of federal funds for the initiative. Development and teaching of updated PTSD and brain injury curricula will be established by the two medical college associations. Both the AAMC and AACOM pledged their support of the program and the sharing of information to better assist veterans.

The initiative is part of Obama and Jill Biden’s Joint Forces campaign to aid military personnel and their families.

To read more, click here.

News and briefs: CMS selects first wave of 'innovation advisors'

Tue, 10 Jan 2012 17:55:00 GMT

CMS selected 73 medical professionals to the Innovation Advisors Program. These individuals are charged with studying solutions and making suggestions on the Medicare, Medicaid, and Children’s Health Insurance Program delivery systems.

According to a press release from CMS.gov, the program fielded applications from 920 individuals. Selection criterion includes:

· Individual’s career achievements

· Pre-existing skillset

· Quality of their proposed innovation project

CMS’s website states the program plans to open up the next round of applicants this spring. The 73 recently selected individuals begin their six-month orientation and research period this month.

To read more, click here.

Tip of the Week: Celebrate site visit notification

Tue, 10 Jan 2012 17:48:00 GMT

On the fateful day the official ACGME letter arrives in your inbox, pass out high fives instead of passing out from fear.

Resist the urge to panic and view the impending site visit as a chance to celebrate your program. The site visit presents the program with a platform to show it is one of the institution’s strengths. As long as proper preparation for the site visit date has been thorough and on-going, speak positively about the opportunity made possible though hard work.

Consider making plans at this time for a post-site visit celebration. Reward the people devoting much time to this endeavor. There is still work to be done prior to the site visit, but do not fear. Take great joy in this day and your program.

This week’s tip is from Insider’s Guide to the ACGME Site Visit, Second Edition by Kathryn Andolsek, MD, MPH and Shepard Cohen.

News and briefs: New requirements concern DO transfers

Tue, 10 Jan 2012 17:40:00 GMT

The DO Advisory Board is looking to amend proposed changes to the ACGME’s Common Program Requirements regarding transfer residents.

According to a recent story in AOA’s online publication, The DO, new requirements seek to restrict the transfer of residents from AOA-approved institutions to ACGME-accredited residency and fellowship programs. Under the proposed language, by 2014, residents completing a required osteopathic internship year must re-take the internship to transfer to an ACGME program. The same applies to fellows beginning in 2015.

Four states--Florida, Michigan, Oklahoma, and Pennsylvania-- require an osteopathic internship for licensure.

The ACGME accepted comments on the proposed changes and will hold a meeting on its findings in February. A rule change would not affect the 20% of residents enrolled in AOA programs that have dual accreditation with the ACGME.

To read more, click here.

Ask the expert: How can we distribute and review goals and objectives with residents?

Fri, 30 Dec 2011 14:42:00 GMT

One approach is to designate a faculty member assigned to the rotation to be responsible for this duty. This can lead to a loss of enthusiasm overtime, however. The faculty member may initially fulfill the assignment, but eventually he or she forgets or loses interest in reviewing the goals and objectives with residents.

Another method is to post the goals and objectives on a website that the residents can access before each rotation. As adult learners, residents need to be responsible for their own education. You can nudge them along by asking your resident coordinator to send residents an e-mail reminding them to review the goals and objectives before each new assignment. Hopefully, with this reminder and faculty reinforcement, the residents will seek out and understand the learning objectives for each rotation.

This week’s question and answer are from The Residency Program Director’s Handbook, by Robert V. Higgins, MD.

News and briefs: Bill could direct some GME funding to nonhospital settings

Fri, 30 Dec 2011 14:39:00 GMT

A newly proposed House bill would create a pilot program to test GME funding models for offering primary care training in a community setting. Currently, Medicare GME money only goes to hospitals.

According to a press release from the American Academy of Family Physicians, if approved, the proposed Primary Care Workforce Access Improvement Act of 2011 establishes a five-year program testing four models for educating and training primary care physicians. A portion of GME funding would go to community-based, nonhospital settings.

“More than 90 percent of care delivered by primary care physicians is in the community and the vast majority of patients get their care in community settings. So this is where much of the training for primary care doctors should occur,” says Glen Stream, MD, MBI, president of AAFP.