Updates in Graduate Medical Education

1. Updates in Graduate Medical Education Neil Parker, MD, Sr. Associate Dean for GME Program Directors’ Conference May 14, 2010

2. Agenda • 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

3. Updates from UCLA • UCLA GME receives 5+ year institutional accreditation !!!!! • Thanks to all who assisted with this.

4. GME Leadership Team • Susan Baillie, PhD • Lee Miller, MD • Lourdes Guerrero, EdD • Sharina Kumar • Nasim Afsar-Manesh, MD • Neil Parker, MD

5. 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

6. 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?

7. 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.

8. 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

9. 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

10. 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

11. 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

12. Resident Survey: The Purpose • 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

13. ACGME Update: Annual Program Evaluation / Improvement • 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

14. Common Program Requirements 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