Annual review

Residency Program Insider, May 10, 2005

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Dear residency program colleague:

Most of us have multiple opportunities to review our residency programs. Programs conduct such reviews using a variety of formats--faculty meetings, internal curriculum committee meetings, or scheduled retreats. Once you identify the strategy that works best for your program, remember to throughly document the review.

To determine which format to use, you must first know what your residency review committee (RRC) requires in regard to your review of the residency program. For example, most RRCs require the attendance of key faculty, if not all faculty, and at least one resident. It is desirable to have as many residents participate as possible--at a minimum representatives from each of the training years. It is critical to consider the residents' perspective of the daily reality of the programs we design. If they are unable to participate, try to arrange an anonymous survey to identify their key concerns.

A template can be useful when planning and documenting the review meeting. The template provides a roadmap of the material that should be available for review and the areas that should be discussed. At a minimum, this template should include:

Programs may also find it useful to review evidence of patient safety and patient satisfaction, adequacy of clinical experience as measured by number of procedures or certain types of patients, adequacy of required continuity or ambulatory experiences, results from an alumni questionnaire, and resident performance on an in-service examination. In addition, some programs may find it useful to give all attendees a current copy of the program's RRC requirements.

Use the template as a meeting agenda to make sure all areas are discussed. Use it to write the minutes that are distributed to all faculty and residents--even those not in attendance. Keep a copy of the meeting minutes in an easily accessible file for your next RRC accreditation site visit.

Don't forget to close the loop and make this a living document. Plan "follow-up" in perhaps three to six months from the date of the meeting. Evaluate what has happened to any plans your program implemented as a result of its self-study. What have been the successes? What have been the challenges and the strategies to overcome impediments?

In addition, this meeting provides an opportunity for enhancing the collegiality among the faculty and residents. Programs can build in time for social activities, a nice meal, rewards, and recognition.

Most programs discover that with a little advance planning, they can not only fulfill the expectation that they have and document a yearly review, but can also identify opportunities for program enhancements.

That's all for this week!

All the best,

Kathryn M. Andolsek, MD, MPH
Associate Director, Graduate Medical Education Clinical Professor, Family Medicine
Duke University, Medical School

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