MPPDA 2014 Presidential Address

1. MPPDA 2014Presidential Address Russ Kolarik, MD MPPDA National Meeting April 10, 2014

2. 2013-14 Year in Review • MPPDA.org • 2014 Match Results • 2012 ABIM and ABP Results • Accreditation for Pediatric Hospital Medicine • The first year of the NAS

3. MPPDA.org • First year of new web resource for our organization. • Will briefly review site at the end of the day today. Please review it today and subscribe. • Designed as a comprehensive information hub for everything you should need to access quickly as a Med-Peds PD.

4. MPPDA.org • All feedback about the site, however small is highly welcomed! • info@mppda.org goes directly to me. Please email me. • Please take a moment to send your name, institution and academic rank to me at info@mppda.org

5. 2014 Med-Peds Match Results

6. 2014 Med-Peds Match Results

7. 2014 Med-Peds Match Results

8. 2014 ERAS Data • Applicants that applied to at least 1 Med-Peds program: • US Allopathic applicants was 439 down from 468 total in 2013. • US Osteopathic applicants 65 (14.8%) up from 48 in 2013 (10% of total).

9. Conclusions and Next Steps • The total number of candidates applying to Med-Peds decreased from 603 in 2013 to 582 in 2014, but is still higher than the 560 in 2012. • Local recruiting efforts are needed to promote our specialty. • Get involved with NMPRA and creating Med-Peds Student Interest Groups

10. 2012 ABIM Results

11. 2012 ABP Results

12. Conclusions and Next Steps • We have some breathing room, but still need to pursue board preparation aggressively with our at-risk residents. • Maintaining equivalence with categorical programs is VITAL for our specialty. • To compare favorably at this rate, only 40 MP residents nationwide can fail the ABP, and 56 the ABIM.

13. Board Preparation for at risk residents • At risk residents include those with USMLE I less than 220, or ITE in final year of training of less than 65% • 14 respondents to survey for up to four at-risk residents per program. • Roughly 50% of respondents reported mandating resident-specific study programs for at-risk residents that involve additional board study and questions.

14. Board Preparation for at risk residents • About 50% of respondents also said that they would recommend that they would recommend deferring the ABIM for at risk residents so they could focus on passing the ABP. • About 30% did not counsel either way because the decision is up to the resident. • 20% counseled them to take both exams.

15. From the PD Survey • 43% of programs use the USMLE scores to determine residents at risk for failing the board certification exams, 79% use the ITE’s, and 43% use other or personal reasons. • 72% who were identified at risk passed the ABIM, and 71% passed the ABP.

16. Next Steps • We should know who our high risk residents are. • We should take a personal interest in our at-risk passing their boards, starting as early in training as possible. Reach out to other programs and the MPPDA for assistance.

17. Accreditation for Pediatric Hospital Medicine • JCPHM: Joint Council for Pediatric Hospital Medicine has initiated the application process for acreditation. • Applying for an accredited two-year pediatric hospitalist fellowship that if approved would start in about 6 years time.

18. Intended impact • Standardize care for pediatric inpatient clinical diagnoses. • Focus on specialized clinical services and procedures for hospitalized children. • Emphasis on healthcare systems, quality leadership and advocacy

19. Intended Impact • Develop leaders in pediatric hospital medicine at academic medical centers and community hospital medical directors. • Not intended to restrict ability of general pediatricians or Med-Peds physicians to practice hospital medicine in academic or community settings.

20. Potential unintended effects • Board certification may ultimately become standard for medical staff offices hiring new hospitalists or leaders. • Concern about grandfathering criteria for current Med-Peds hospitalist who see proportionately fewer pediatric patients.

21. Potential unintended effects • Could potentially limit scope of employment opportunities for general pediatrics or Med-Peds graduates wishing to pursue jobs as hospitalists. • Effectively increases training time to 6 years for Med-Peds graduates wishing to work primarily as hospitalists. Medical students are already inquiring about this as a significant concern.

22. Current proposal • I am working to make criteria for grandparenting to sit for boards as encompassing as possible for current Med-Peds hospitalists. • I have also proposed a one-year pediatric fellowship option for Med-Peds trainees that may or may not be combined with adult hospital or transitional care activities.

23. Follow-up • Will share data with JCPHM leadership. • Need for Med-Peds representation on Committees and at society meetings. • Jen O’Toole is conducting a hospitalist workforce survey inquiring about recent graduates. PLEASE complete this survey.

24. Next Accreditation System • First year of using the Milestones, implementing Clinical Competency Committees, and CLER visits. • First reporting of Internal Medicine and Pediatric Milestones to the ACGME in May/June. • Need to share experiences – website and listserve.

25. Next Accreditation System • Need for ongoing Med-Peds representation with national organizations and feedback regarding milestone evaluation process. • Need to share assessment and evaluation tools to help track milestones and other outcomes of training.

26. Just one last thing…. • I invite each of you, think of just ONE thing you can do when you go back home after this meeting is over that will help the specialty of Med-Peds. • Take a moment, write down one thing that you are going to do and the date you plan to do it. When you are successful, let the rest of us know.