Family Practice Residency Annual Orientation

1. Family Practice ResidencyAnnual Orientation Gail Feinberg, DO, FACOFP, M.Ed Director of Medical Education 2014

2. Objectives • Review program and updates • Brief review of program training manual • Brief description of expectations • Didactics • Clinic hours • Call • Other information regarding the residency

3. Residency Manual • Has now been e-mailed. Should have provided a signed copy of receipt form • OLBH employee handbook • Given at OLBH New Employee Orientation • July 14, 8am-4pm, Bellefonte Center 5th Floor boardroom for Dr. Smith

4. Manual Highlights • Program Director Description – superseded by agreement between OLBH/Feinberg and Howard • Research • Moonlighting • Prescription writing • Even with full license and DEA only preceptor/attending can write for narcotic rx in clinic • Requirements for Promotion/Graduation

5. Professionalism • Cell phone • Dress Code • Attendance • Addressing Preceptors • Parking

6. Other • Wiki • www.olbh.pbworks.com • Quarterly evaluation (by PD/DME) • Clinical Preceptor Evaluation • Evaluation of service by resident • Time sheet • Logs • ACOFP paperwork (done by DME) • SOLE survey (for MSOPTI)

7. Other • OMM eval expectations for hospitalized patient • OMM glossary • OMT coding • Written in admission note • Research information • Resident Job Description • Standards of Practice for Resident

8. Didactics • Journal Club • IM • FIRST Thursday of the month • Residents responsible for selection of articles • Refer to Wiki (and/or printed list in resident lounge) for who is on what month and the topic • MUST have them to DME office 1 week before • Will pull Saturday call if not turned in on time • No peds or OB articles. • Can only use NEJM once during the year • FP • THIRD Thursday of the month • Students responsible for selection of articles

9. Didactics • Attendance expectation • What does 80% mean? • Chief to collect sign in • Unexcused attendance • paper on topic discussed • More than 2 unexcused • Will meet before Medical Education Committee for formal discussion

10. Didactics • Tumor Board • Mandatory • Thursdays, noon • Will be on weekly schedule when planned • Watch for e-mail on Thurs if cancelled • MSOPTI lectures • Mandatory • Although given live Tues noon and Thurs 8am, we watch them taped • Once a quarter live OMT (dinner provided)

11. Didactics • Resident Teaching • Run all Yale one month • Resident will lecture on “bread and butter” ambulatory care topic • Give topic to Chief Resident and/or DME for posting on Wiki • …to avoid duplication • Resident Grand Rounds • Resident lead – in front of room • Presentation of case admitted the night before or interesting case on “days” • Find teaching elements • Not power point format • Attending physicians are in room as proctors/hecklers

12. Didactics • Other Live Lectures • Mandatory attendance • Based on resident requests/wish list • Also include Pulm/Sleep medicine, pharma sponsored speakers, ER lectures, FP lectures, Peds lectures • OK for residents to recruit live lectures • Practice Management Series • Mandatory • 20 total hours during 3 year residency

13. Didactics • Other • M&M • Will be given by resident the month AFTER either ICU or Inpatient Medicine Days • Residents – it’s ok to recruit speakers for live lectures • Just not 1st or 3rd Thursday morning. • Monthly calendar availability

14. Curriculum

15. Elective rotations • 5 electives • OGME 1 – 1 • OGME 2 – 1 • OGME 3 - 3 • If felt more time needed on a specific rotation (eg IM Days), medical education committee may “assign” one of the electives as another month (hence the **)

16. Other rotations required by ACOFP • Behavioral Health • Community Medicine • Hope’s Place • Free clinic • Occupational Medicine

17. Other rotations required by ACOFP • Sports Medicine • Impact Program • School pre-participation physicals • Geriatrics • Longitudinal in years 2 and 3 • Resident is first call

18. Resident Teaching Expectations • Medicine/ICU • Bread and Butter • Grand Rounds • WVSOM education days • Presentation counts as “Statewide” presentation for Residency Project • Table trainers for OMT • Assist with clinical skills labs (August/September)

19. WVSOM education days • Third Friday of each month • At OLBH/SMMC alternately • 3-4x/yr “COILS” – OMM presentation • Will be at SMMC but residents invited and encouraged to be table trainers • Skills labs – can come to teach/update yourselves • If stay entire day – will be asked to review student lecture presentations

20. Other Mandatory Activities • WVSOM midwinter Resident seminar • Hinting at changing that to spring or summer for better weather • WVSOM simulated patients • Once during residency in Lewisburg or Charleston • Residency to pay for mileage/gas whichever is less • KOMA Resident Saturday • DME will give notice if NOT mandatory at least 1 month prior to conference • Residency will pay for registration. CME for hotel if stay more than 1 day.

21. Other Mandatory Activities • Annual Orientation • Residency Graduation • Nursing Home rounds • ACLS/BLS • Morning Didactics if rotation is not linked to another hospital

22. MSOPTI lectures • Telehealth/Youtube • One Thursday/mo 8-9am* • One Tuesday/mo noon* • * will be shown recorded at 7-8am • One OMM session with lab each quarter Thurs 6-8pm • Mandatory • Expected to watch webinar if not present at time of presentation if not excused.

23. MSOPTI • Library facilities • Through WVSOM • Procedures Consult • Chief Resident’s council • Mid Winter Seminar • Research assistance

24. Core competencies • Medical Knowledge • OMM • Patient Care • Professionalism • Interpersonal/communication • Practice based learning/improvement • Systems based practice

25. OSCE (but it’s not) • NOT a PE exam • Clinical skills • Also can look at professionalism, cultural issues, etc. • Part of core competency evaluation • Mandatory in either 1st or 2nd year (repeat in 3rd if poor performance)

26. Requirements for promotion • PGY1 to PGY2 • Must have Kentucky license • Can remain on rotations but will still be considered PGY1 • Once have IP license will get pay increase to PGY2

27. Requirements for promotion • PGY2 to PGY3 • Passage of COMLEX 3 • MUST show proof to DME – copy for your residency file • Will be removed from rotations at conclusion of PGY2 rotations (per AOA requirement) • Leave without pay • Request that you take COMLEX 3 before 6 month mark of 2nd year

28. Requirements for promotion • SOLE survey • Attendance at ACOFP • Once in either 2nd or 3rd year • Something in writing for residency file • Research project • ALL hospital and office work completed

29. Requirements for promotion/graduation • ? Numbers of ambulatory patients seen • May need to take another elective to meet requirements • Receipt of “diploma” does not guarantee completion of program • Still have to file forms with ACOFP • ACOFP has to provide final verification to program

30. Continuity Clinic • OLBH Primary Care FLATWOODS • 2420 Argillite Road • (606) 836-3900 or 836-1900 • Dr. A. Lobach • Dr. Kevin Howard • Lisa Pennington, PA-C

31. Clinic Hours • Flatwoods primary site • Dr. Kevin Howard supervising physician • ½ day a week PGY 1 • 3 separate ½ day sessions PGY 2/3 • AM hours start 8:00am - Noon • PM hours start 1:30-5:30pm

32. Chart Documentation • Every Hospital Admission • OMT eval expected and MUST be in your H&P • FULL H&P • Preventive measures in ROS • epss/USPSTF • Every Office Chart • Must be co-signed by preceptor • Document health maintenance • Assessment in chart must match diagnosis on billing sheet exactly

33. Chart Documentation • MUST let Medicare know that this is a residency clinic • Billing and coding separate lecture…however… • GE modifier – you saw the patient on your own (will NOT apply for the first 6 months of PGY1) • GC modifier – the preceptor saw the patient after you did and performed their own exam • First 6 months of PGY1 year • ANY 99204 or 99214 or greater visit

34. Other Information • Geriatrics • Continuity starts midway through PGY 2 • Derek Jones, DO • Patient panel of 7-8 residents of Trinity Station • Electives • Sooner select the better • Request 2 months in advance or may end up on vacation

35. Other Information • Vacation • Ignore paycheck information re vacation and sick time • 15 days per year plus any days program assigns for conference (e.g., KOMA, WVSOM Doctor Days) • Use it/loose it • Space it out – can’t use all at end of academic year • NO vacation last 2 weeks of June • No more than 5 days consecutively • Not while on Medicine rotations • MUST request 3 months in advance

36. Other Information • CME $$ • Use it/loose it • Licensing • Will pay for KY licensing • WV license fees would come out of your CME allowance • Watch timing for filing information • 1st year under watch of OLBH

37. Program does NOT cover • Licensing other than KY • ACOFP conference • Board fee (for board certification) • Salary over 12/36 months of mandatory rotations

38. Important Numbers • Door codes • Mail Room 24282 • Call room 0710 • Key to Education Classroom • Located at switchboard #61

39. Important Numbers • Feinberg • Cell (606) 922-8598 • ERC office (606) 833-3171 • Fax (606) 833-2280 • gail_feinberg@bshsi.org • SMMC office (304) 399-7592 • Fax (304) 399-7593 • gfeinberg@osteo.wvsom.edu • Flatwoods (606) 836-3900 • Howard • Kevin_howard@bshsi.org