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APDIM Survey Committee

APDIM Survey Committee. Fall 2009 Furman S McDonald, MD MPH Chair, APDIM Survey Committee. Michael Adams, MD Betty Aman Vineet Arora, MD Brent Beasley, MD Joanne Connaughton, MD Stephanie Call, MD, Vice-Chair Karen Chacko, MD Saima Chaudhry, MD Kevin Hinchey, MD Robert Hopkins, MD.

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APDIM Survey Committee

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  1. APDIM Survey Committee Fall 2009 Furman S McDonald, MD MPH Chair, APDIM Survey Committee

  2. Michael Adams, MD Betty Aman Vineet Arora, MD Brent Beasley, MD Joanne Connaughton, MD Stephanie Call, MD, Vice-Chair Karen Chacko, MD Saima Chaudhry, MD Kevin Hinchey, MD Robert Hopkins, MD Maria Lucarelli, MD Furman McDonald, MD MPH, Chair Susan Sefcik, MD Debbie Stevens Lisa Willett, MD Ex Officio Eric Holmboe, MD APDIM Support Nicole Baptista Jessica O’Hara APDIM Survey Committee

  3. Goals • Answer Questions Important to APDIM • Consolidate (i.e. decrease) Surveys • Longitudinal Database • Research Network

  4. Publications in Press • Pharmaceutical Industry Support and Residency Education. Loertscher, Halvorsen, Beasley, Holmboe, Kolars, McDonald • Ambulatory Training Since Work-hour Regulations. Zebrack, Fletcher, Beasley, Whittle • Demographic and Work-Life Study of Chief Residents. Singh, McDonald, Beasley • Hospitalists Involvement in Internal Medicine Residencies. Beasley, McBride, McDonald

  5. Survey Development • Shorter • Better Timing • Core Section repeated year to year • Variable Sections based on: • APDIM Membership • Previous Surveys • Listserve/Discussion board calls for input • APDIM Council • Investigator initiated proposals

  6. 2008 Survey • Core Section • Program Director Characteristics • Program Characteristics • Questions only if data not obtainable elsewhere • ACGME, ABIM, FREIDA, US Census • Variable Sections • GME Funding • Remediation • Duty Hours / Work Intensity

  7. 2008 Survey Facts • 268 programs responded • 72.0% of all 372 APDIM members • APDIM members represent 97.1% of all 383 ACGME accredited internal medicine residency programs* *ACGME web site, December 1, 2008

  8. 14% 22% 38% 25%

  9. Program Description(source: FREIDA) Community-based, university hospital affiliated

  10. 2006-2008 Rolling Pass Rates(source: ABIM) Mean = 92.2% Median = 93% Percent

  11. Accreditation Cycle Length(source: ACGME) Mean = 4.2 years Median = 4.5 years Percent

  12. Median = 6 years Percent Program Director Tenure(source: ACGME, as of 12/1/08) Mean = 7.4 years

  13. Gender 1995 – 18%

  14. Career Designation

  15. Academic Ranks

  16. Total Annual Salary Percent

  17. http://www.bls.gov/data/inflation_calculator.htm Average Annual Salary

  18. Hospital(s) → Residency Agree 80% Would like to have input in how DME is disbursed? Have input? Hospital(s) → Department Department → Residency 14% 33%

  19. Which systems of GME funding should APDIM support? All Payer Modify Current Private Insurance No Opinion Discretionary Other

  20. REMEDIATION Residents with Problems Program Prevalence 74% Resident Prevalence 5%

  21. 77% Struggle in Multiple Competencies

  22. Successfully Remediated Competencies

  23. Highest Level of Intervention

  24. Do You Have Any Duty Hour Problems?

  25. Duty Hour Rules:If So, Which?

  26. What have you done to better meet duty hour requirements? Increased Staffing

  27. What have you done to better meet duty hour requirements? Increased Workloads

  28. What have you done to better meet duty hour requirements? Modified Schedules

  29. What have you done to better meet duty hour requirements? Decreased Resident Responsibility

  30. Non-direct Patient Care Tasks “Routinely” Performed by Residents

  31. PLEASE COMPLETE2009 Survey • Core Section • Program Director Characteristics • Program Characteristics • Questions only if data not obtainable elsewhere • Variable Sections • Recruitment • Global Health • Night-Time Supervision • IOM Duty Hour Recommendations

  32. Thank You

  33. Medicare → Hospital(s) Hospital(s) → Department Department → Residency Agree 15% 14% 27% Transparency in the way DME money is flowing?

  34. Direct Medical Education (DME) Attempted to find 59% Successful finding 31% Regularly in Budget 6%

  35. The number of residents with problems has:

  36. Application Materials Helpful?(of 35% who identified “red flags”)

  37. How Were They Identified?

  38. Contributing Personal Factors

  39. Intervention Effectiveness

  40. Intervention Effectiveness continued...

  41. How Do You Track Duty Hours?

  42. Frequency of Duty Hour Monitoring?

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