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“The THREE Ts of GME” planned by Coordinators for Coordinators

“The THREE Ts of GME” planned by Coordinators for Coordinators. Charles Daschbach, MD MPH Director of Academic Affairs St. Joseph’s Hospital and Medical Center GME Coordinator Conference Apr 8-9, 2004 Westcourt at the Buttes, Phoenix, Arizona. OUR AGENDA (disclaimer first!).

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“The THREE Ts of GME” planned by Coordinators for Coordinators

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  1. “The THREE Ts of GME”planned by Coordinators for Coordinators Charles Daschbach, MD MPH Director of Academic Affairs St. Joseph’s Hospital and Medical Center GME Coordinator Conference Apr 8-9, 2004 Westcourt at the Buttes, Phoenix, Arizona

  2. OUR AGENDA(disclaimer first!) • Review of the GME Coordinator Role • Why would any Sane Person Want This Job ? • What are 4 Formidable Challenges ? • Is There ANY HOPE ? • Suggestions from High in the Bleachers

  3. THE GME COORDINATORS’ “ROLE” • Keep the Program Accredited • Manage the Budget • Document all the Duty Hours • Send the Evaluation Reminders • Track the 80 Hour/ week rule • Complete all the Correspondence • Find those “&+#%$” Affiliation Agreements • Answer the phone in 31 Foreign Languages

  4. Is that all it is…or is it an evolving professional niche ? • Well, what is a “profession” ? • Select body of knowledge • Specialized Training • Certification • Code of Ethics • Sanctions its Members

  5. The GME Coordinators’ Evolving Profession • Select body of knowledge • Specialized Training • Certification • Code of Ethics • Sanctions its Members

  6. The $40,000 Question • Should someone with these skills have to • Type Letters • Take Dictation • Page Residents to do their Records • File Routine Papers • Fix the Call Schedule • Page Residents (AGAIN!) to do their Records • Take Attendance (for Adults) at Noon Conference

  7. The $40,000 Question • Should someone with these skills have to… ( the answer is “NO”…) • But the economics of Hospital based GME dictate that GME Programs will not get more help with these functions unless the Program faces a CRISIS or is the Biggest Money Maker in the Institution…

  8. What Can / Should YOU do ? • We’ll come to this in a few minutes… • But first a few words about the many challenges that you face… • This is very, very difficult.. • Where, oh, where… to begin ?

  9. Challenge # 1 Keeping Quiet in Faculty Meetings • You sit there and you want to • Laugh • Cry • Shout “ YOU IDIOT!” • Explain that we’ve tried that solution 32 times before • Ask if anyone present really got a College Degree • Scream “He’s BLUFFING ! HE NEVER DID THAT !” • Suggest that a Resident being evaluated might be better suited for a career in Forestry far away from civilization and live people…

  10. Challenge # 1 All Faculty are Pretty Much the Same… • one Crusty Curmudgeon • one Dudley Do-Right • one…no, make that make that two Prima Donnas • one Jedi Knight • one “let’s create a policy to fix this” Guy • one deaf mute perfecting the “low profile” • one person whose in love with his palm pilot • one “this is the residents’ fault” Guy

  11. P.S. • Tell the Faculty to stop spending hours on SCREWING AROUND WITH FANCY POWER POINT CRAP… • If we spent Half that time working on the CONTENT and teaching points, we would be much more effective !!!

  12. Challenge # 2 Prioritizing the Urgent ! Email from the Department of Medical Education • You sit there and you want to • Laugh • Cry • Shout “ YOU IDIOTS !” • Explain that we’ve tried that solution 33 times before • Ask if anyone there had formal education…at ANY level • Suggest that the Director of Medical Education might be better suited for a career in Geology in a developing country…far away from people…and live animals…

  13. Challenge # 3 Understanding the Student-Physician • They’ve had 8 years of College • They have people’s Lives in their hands • They get Lunch every day • They get a Book Allowance • They get a Travel Conference Allowance • They make $40,000 / year now… • But will make over $100,000 / year the day they finish • (They do not have to punch the clock) • (and everyone outside of medicine admires them!) • WHO ARE THESE CHOSEN FEW ?

  14. Richie – Rich Ferris Bueller Bart Simpson Mel Gibson Martha Stewart Marcel Marceau Ellen DeGeneres Schwartzenegger Brittany Spears Martin Lawrence Tom Cruise Oprah Cheech and Chong Meadow Soprano Challenge # 3 Understanding the Student-Physician

  15. Challenge # 4 Working in a Larger Bureaucracy • The FY Budget will not be really finally “approved” ever …so stop asking about it • Somewhere it is written that surgeons are better than the rest of us…so get over it • The New Reorganization Chart is going to allow us to work more efficiently…so believe it • The Vice President who’s leaving decided to pursue “other interests” ( so stop laughing ) • We fully support [ INSERT PROGRAM NAME HERE ] because of our historical commitment to this specialty…it has nothing to do with revenue…Cha-ching ! Cha ching !

  16. Are These Challenges Unique to Graduate Medical Education ? • DIFFERENT or the SAME as… • Pilot Training at Luke AFB ? • Journalism at the Arizona Republic ? • Executive Decisions at ENRON or TYCO ? • Leadership in our Churches ? YES…and NO…

  17. WHAT’S SINGULAR ABOUT OUR JOBS IN MEDICAL EDUCATION ? • WE train people to heal other people… • WE directly help care of the sick… • WE directly prevent disease…

  18. WHAT’S SINGULAR ABOUT OUR JOBS IN MEDICAL EDUCATION ? • WE train people to heal other people… • WE directly help care of the sick… • WE directly prevent disease… THEY CANNOT DO IT WITHOUT US !!!

  19. WHAT’S SINGULAR ABOUT OUR JOBS IN MEDICAL EDUCATION ? …not very often…but often enough… A resident stops by your office…maybe an intern…maybe a graduating senior…maybe an alumnus of the program… …and they “thank” us… …and we know we have made a difference…

  20. The GME Coordinators’ Evolving Profession • Select body of knowledge • Specialized Training • Certification • Code of Ethics • Sanctions its Members

  21. What Can / Should YOU do ?some suggestions… THE FACULTY …assess their skill levels  what does the Program need in the skill set of a Faculty Member in the year 2004 ? …what in-house training is available ? …offer keyboarding class one-on-one… …offer Word / Excel / PowerPoint Classes… …work with HR to get them into Relationship Skill Classes …send the evals early and block time on their schedules to do evals

  22. What Can / Should YOU do ?some suggestions… THE GME OFFICE / ADMINISTRATION …communicate in writing …ask for a deadline on a promise …document meetings in a F/U memo or email “thanks for meeting today…as I understand… “…and thanks again for looking into this” …you have a right to respectfully ask how “urgent” something is…but they have a right to say ‘make it so’…

  23. What Can / Should YOU do ?some suggestions… THE RESIDENTS …remind them that they are adults …begin EARLY in July… …remind them that they are adults again …do not engage them in their excuses …you need to be a tougher parent …you DO have some authority

  24. What Can / Should YOU do ?some suggestions… FOR YOU !

  25. What Can / Should YOU do ?some suggestions… FOR YOU ! • RETRAIN …take every training class offered • EXCEED …develop skills BEYOND those currently required for your position (TODAY’S CONFERENCE !!!) • CROSS-TRAIN with other Coordinators / Staff • SHARE BEST PRACTICES with each other • FOCUS…disengage from “personality driven” issues …with the residents …with the faculty …and with each other

  26. OUR AGENDA(disclaimer AGAIN ! ) • Review of the GME Coordinator Role • Why would any Sane Person Want This Job ? • What are FOUR Formidable Challenges ? • Is There ANY HOPE ? • Suggestions from High in the Bleachers

  27. …and If no one thanked you this last few weeks for doing a great job on something, take some solace that while the recognition would be nice, true professionals do our jobs because we know we make a difference

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