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Updates in Graduate Medical Education. Neil Parker, MD, Sr. Associate Dean for GME Program Directors’ Conference May 14, 2010. Agenda 8:00-9:00 Update on GME / Making Your Life Easier 9:00-9:15 Audience Response System

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Updates in Graduate Medical Education

Neil Parker, MD, Sr. Associate Dean for GME

Program Directors’ Conference

May 14, 2010

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  • 8:00-9:00 Update on GME / Making Your Life Easier

  • 9:00-9:15 Audience Response System

  • 9:15-9:30 Strategies for Establishing Performance Criteria

  • 9:30-10:00 Preparing for Site Visits

  • 10:00-10:15 Break

  • 10:15-10:35 GME Resources

  • 10:35-11:05 Mistreatment of Medical Trainees

  • 11:05-11:10 Teaching Professionalism

  • 11:10-12:00 Welcome from the Dean

  • 12:00-12:50 Lunch 

  • 1:00-2:00 The ‘Challenging’ Resident

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Updates from UCLA

  • UCLA GME receives 5+ year institutional accreditation !!!!!

  • Thanks to all who assisted with this.

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GME Leadership Team

  • Susan Baillie, PhD

  • Lee Miller, MD

  • Lourdes Guerrero, EdD

  • Sharina Kumar

  • Nasim Afsar-Manesh, MD

  • Neil Parker, MD

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What’s coming from the ACGMENasca’s letter (5/4/2010) to the GME Community

ACGME recommended changes in common program requirements will be forthcoming in 6 weeks

Standards for practice will address the following:

Resident Supervision

Resident and faculty Professionalism & Fitness for duty

Patient safety and Quality Improvement expectations

Handover processes

Inter-Professional communications

Duty Hours

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Issues of concern from 2010 ACGME & AAMC GRA Conferences

  • Mismatch of medical school increases in numbers and available residency spots

  • Federal hold-the-line approach for GME funding through Medicare

    • The new health care legislation will redistribute a certain portion of unused, Medicare supported graduate medical education slots—preliminary estimates put the number at 600-700—to health professions shortage areas and regions with low resident-physician-to-population ratios. This represents a fraction of the 15,000 new slots requested by the academic medicine community and other groups.

  • Increased attention to ‘supervision’ issues

    • Academic MedicineThe May issue includes articles on physician competencies, medical education research, surgery education, and more.

  • Focus on patient safety and quality improvement initiatives: What are we doing at UCLA?

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UCLA GME Update: Internal Review Process & Document

  • Internal review documents must be submitted 3 months prior to internal review

  • Program Demographics - expanded

    • Program Director Attestation required for:

      • Accuracy of the Internal Review document

      • Regular monitoring mechanism for duty hours

      • Recent review of Program Requirements (they change at least every 5 yrs)

  • Residents to be interviewed must be Peer selected

  • An internal review “team” (GMEC faculty, GME Administration and resident representative ) will now conduct all interviews on the same day

  • Accreditation Response:

    Using the last LON, Program Director must list each citation/concern and provide specific information as to how this has been addressed or corrected.

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Internal review changes (continued)

  • Program Director Information –

    • Need to identify percent of protected time/salary support (program directors must receive support)

    • Need to identify % of time/ allocated for program coordinator

    • Need to identify adequate support services

  • Addendum internal review information needs to be submitted at the same time as the internal review incl:

    • a copy of last year’s annual report

    • most recent goals and objectives, assessment methods and resident benchmarks

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Internal review changes (continued)

  • Program faculty

    • Need to be board certified with few exceptions

    • Core teaching faculty need to be involved in educationally related faculty development including fatigue

    • PD must meet with core faculty to discuss performance criteria for assessment

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Data for the Site Visit of the Future

  • A streamlined PIF and Program Portfolio including data on resident attainment of learning milestones

  • Allows enhanced Focus on:

    • Outcome data

    • Educational Curriculum

    • Quality and Quantity of faculty interactions with residents and fellows

    • Variety of patient and learning opportunities and the quality of the learning experience

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Current Initiatives Aimed at the Future Model of Accreditation

  • Milestones Project and ACGME Portfolio-Sue will be discussing

  • Extended Review Cycles

    • Under consideration: Up to 10 yr cycles, with focused assessments for suspected problems

  • Efforts to innovate Education

  • ACGME Resident Survey

    • Faculty Survey Planned

  • Enhanced focus on Duty Hour Compliance

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Resident Survey: The Purpose Accreditation

  • Broaden resident input into site visit and accreditation review

  • Monitor residents’ clinical education and compliance with Common Program Requirements and Duty Hours

  • Enhance Site Visitor interview with residents

  • Provide RRC with resident satisfaction on quality of their program

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ACGME Update: Annual Program Evaluation / Improvement Accreditation

  • Program must document review of formal, systematic and confidential evaluation of the curriculum at least annually by faculty and residents/fellows

  • Documented review must identify 5-8 plans for program improvement for next academic year.

  • Program must monitor and track Resident and Faculty Development

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Common Program Requirements Accreditation

Program Eval Con’t

  • Program must use results of residents’ assessment of the program together with other program evaluation results to improve the program (ACGME & GMEC surveys, resident & faculty annual meeting, etc.)

  • The plan for improvement needs to be identified and available for review by faculty and residents

  • Due August 30, 2010