Ron, Dr. Triana and I enjoyed a great PDW the last few days. We'll be coming home with some new ideas, some renewed and some new connections with our colleagues across the country and with renewed energy.
I especially enjoyed the opening plenary by our STFM president, Terry Steyer. It included a quote from President Obama that went in part like this... "we are the change we seek." That charge came through in many of the sessions I attended and particularly resonated with me because of our ongoing recovery efforts post hurricane Ike. If we don't take advantage of the opportunity within this challenge, we will have done ourselves and our program a great disservice.
This is an exciting time for Family Medicine nationally and that topic was central to the conference this year. It has been a long time since I've seen such energy and enthusiasm about the future of Family Medicine. The upcoming years are really going to be exciting times to be part of the Family Medicine family.
Other highlights from the conference for me...
A couple of great sessions on Leadership and a poster that inspired some thoughts the Residency leadership team will be discussing and implementing in the coming weeks and months. I'm also thinking about developing a FM Leadership/Advocacy elective to offer for our residents. That could also easily be an Area of Concentration, but I'll start with the elective as a good first step! Email me if that interests you.
PGY1 --> PGY2 promotion - saw a great example of some evaluation tools and a formal specifically targeted process for assessing readiness to promote. We will be doing something with a version of this modified for our program as well.
Electives: we need an elective database that includes info on electives that our residents have done. No need to completely re-invent the wheel every time and we could simplify the "who to contact to begin the process" part with a database. Also, Dr. Triana and I attended a curriculum session that included as one part an innovation that has a lot of potential for our program, so be looking forward to upcoming discussions about this. The innovation was moving all six electives to the second half of PGY3. I can think of many potential advantages and a few challenges we would have to work through to make it work. But there are enough advantages that we're at least going to seriously consider it. (Except for our DO residents, because the AOA requires one elective in PGY1, so the DO PGY3 residents would have a 5 block stretch of electives.)
Another curriculum innovation by this program is to structure the second month of emergency medicine longitudinally in PGY2 and PGY3, requiring 6 shifts in each year, done on Friday nights on rotations where the duty hours will allow. This frees up a whole additional rotation block for some other content.
From the ABFM... the ITE will be offered as a computer based exam ONLY by 2013.
From the RRC... a major revision of the program requirements is about to commence. This is especially exciting because required rotations will be critically evaluated and I believe the opportunity for restructuring our required experiences is truly coming. Dr. Ed Bope suggested his version during his plenary... there were a total of SIX program requirements (!!! for reference, I think the current program requirements are about 35 - 45 pages!) and I'll look up his slides to post these later!
One plenary session was devoted to the Patient Centered Medical Home. I learned that "cycle time" (when the patient walks in the door to when the patient walks out the door) is good proxy for practice organization and should be <60 href="http://www.aafp.org">AAFP just posted a PCMH checklist. I plan to use this checklist as a survey for our residents and faculty and use it as information and evidence for obtaining the resources we need in our clinic. Go ahead and print it off, fill it out and drop by my office if you'd like. Please put your name on it, only so I can keep track of who has done it and who hasn't. You won't hurt my feelings with your answers!
I attended a great session on the PD-Program Coordinator team and relationship. I think Linda and I are generally doing pretty well with this, but I will review the content with her and check my own perceptions to be sure she feels the same way. There are a few things from that session that we can work on too.
One session I attended was about Leadership and Life Balance. The speaker (Lee Lipsenthal) is really great and gave us a CD that I believe contains one of his talks. Residents can look forward to hearing this at an upcoming didactic session.
Overall, this year's PDW was very beneficial and we'll be bringing home some exciting ideas!
Tuesday, June 09, 2009
Saturday, May 23, 2009
Thanks, Dr. Triana!
...for a great party honoring the graduates of 2009.
Check our FaceBook page for photos!
Check our FaceBook page for photos!
Tuesday, May 12, 2009
STFM 09 - Denver
Who recognizes this UTMB FMRP alum? See comments for the answer!
And congratulations to Dr. Rene Melendez and his faculty mentor Dr. Burch for their successful poster presentation. A great deal of interest was shown in their project. Excellent work, Rene!Friday, April 24, 2009
interesting quote...
I'm attending the AODME conference this week in Seattle.
Here is one of my favorite quotes from a session...
"You don't need a double-blind placebo controlled study on the efficacy of parachutes when jumping out of airplanes... some things just make sense."
Here is one of my favorite quotes from a session...
"You don't need a double-blind placebo controlled study on the efficacy of parachutes when jumping out of airplanes... some things just make sense."
I also like this... Background - I frequently get "offers" for our residents to participate in this or that activity, which unfortunately often centers more around some work that needs to be done rather than what it might contribute to the educational program. I've struggled with formulating politically correct responses at times, but this was a good one, to simply ask... "what is the educational objective of that experience?"
Thursday, April 23, 2009
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Thursday, April 16, 2009
What does our interview day look like?
Group 1
8:00 – 8:30 Applicants meet with Dr. Nash as a group
8:30 – 9:00 Individual Interviews with Fac/Res
9:00 – 9:30 Individual Interviews with Fac/Res
9:30 – 10:00 Individual Interviews with Fac/Res
10:00 – 10:30 Applicants meet with Behavioral Medicine faculty as a group
Groups 1 & 2
10:30 – 11:30 Applicants tour the university with Louis Johnston
11:30 – 11:45 Break
11:45 – 12:00 Applicants meet with Dr. Thompson as a group
12:00 – 1:00 Applicants have lunch with the Interns
1:00 – 1:30 Applicants meet with Residency Staff as a group
Group 2
1:30 – 2:00 Applicants meet with Dr. Nash as a group
2:00 – 2:30 Individual Interviews with Fac/Res
2:30 – 3:00 Individual Interviews with Fac/Res
3:00 – 3:30 Individual Interviews with Fac/Res
3:30 – 4:00 Applicants meet with Behavioral Medicine faculty as a group
8:00 – 8:30 Applicants meet with Dr. Nash as a group
8:30 – 9:00 Individual Interviews with Fac/Res
9:00 – 9:30 Individual Interviews with Fac/Res
9:30 – 10:00 Individual Interviews with Fac/Res
10:00 – 10:30 Applicants meet with Behavioral Medicine faculty as a group
Groups 1 & 2
10:30 – 11:30 Applicants tour the university with Louis Johnston
11:30 – 11:45 Break
11:45 – 12:00 Applicants meet with Dr. Thompson as a group
12:00 – 1:00 Applicants have lunch with the Interns
1:00 – 1:30 Applicants meet with Residency Staff as a group
Group 2
1:30 – 2:00 Applicants meet with Dr. Nash as a group
2:00 – 2:30 Individual Interviews with Fac/Res
2:30 – 3:00 Individual Interviews with Fac/Res
3:00 – 3:30 Individual Interviews with Fac/Res
3:30 – 4:00 Applicants meet with Behavioral Medicine faculty as a group
Special Info for DOs re: the Match Process
UTMB Family Medicine Residency will be participating in BOTH the ACGME and AOA Matches in 2010.
We will offer two positions in the AOA Match. These are the “dual-certified” positions that will allow you to sit for both the American Osteopathic Board of Family Medicine (AOA) and the American Board of Family Medicine (ACGME) exams upon successful completion of the 3 year program.
We will also be offering six positions in the ACGME Match. We welcome applications from Osteopathic students for these positions, in addition to the two positions we will offer in the AOA Match. However, if we fill our two positions in the AOA Match and you subsequently match with our program through the ACGME Match, you will not be in a “dual certified” position. You will be eligible to sit only for the American Board of Family Medicine exam and not the AOBFM exam.
You may apply to our program through either or both Matches. The AOA Match essentially offers you an “early decision” and also guarantees you the “dual certified” position. If you participate in both Matches, in the event you do not match in the AOA Match, you will then have a second opportunity to match with our program through the ACGME Match.
Not matching with us in the AOA Match does not mean we didn’t value you highly as an applicant. We simply have a very limited number of positions in the AOA Match. As Program Director, I am happy to match you through either Match process. I do want you to understand the differences however, thus the purpose of this information.
We’re looking forward to two great Matches in 2010!
We will offer two positions in the AOA Match. These are the “dual-certified” positions that will allow you to sit for both the American Osteopathic Board of Family Medicine (AOA) and the American Board of Family Medicine (ACGME) exams upon successful completion of the 3 year program.
We will also be offering six positions in the ACGME Match. We welcome applications from Osteopathic students for these positions, in addition to the two positions we will offer in the AOA Match. However, if we fill our two positions in the AOA Match and you subsequently match with our program through the ACGME Match, you will not be in a “dual certified” position. You will be eligible to sit only for the American Board of Family Medicine exam and not the AOBFM exam.
You may apply to our program through either or both Matches. The AOA Match essentially offers you an “early decision” and also guarantees you the “dual certified” position. If you participate in both Matches, in the event you do not match in the AOA Match, you will then have a second opportunity to match with our program through the ACGME Match.
Not matching with us in the AOA Match does not mean we didn’t value you highly as an applicant. We simply have a very limited number of positions in the AOA Match. As Program Director, I am happy to match you through either Match process. I do want you to understand the differences however, thus the purpose of this information.
We’re looking forward to two great Matches in 2010!
Areas of Concentration
The Task Force on Medical Education of the Future of Family Medicine project calls for residency programs to be individualized to learners’ needs and to offer expanded educational opportunities in areas needed by graduates. (1)
The Residency Assistance Program’s guidelines for excellence also encourage that “an individualized educational plan should be developed for residents as they matriculate into the residency program.” (2)
Traditional approaches to meeting individual residents’ needs include elective rotations and post-residency fellowships. Unfortunately, the number of residents who desire fellowship training greatly exceeds the number of available positions. Individual electives are generally available and effective in meeting residents’ needs for brief clinical experiences. However, many residents desire a more structured and focused curriculum with greater depth, breadth and evaluation methodology, as well as some form of recognition for their advanced training in a particular area within the traditional structure of the Family Medicine Residency.
The Association of Family Medicine Residency Directors Board of Directors has recommended that the Area of Concentration concept be offered as a tool for individual programs to use as an aid in designing individual education plans for residents.
Guidelines for Individual Areas of Concentration
A. Written program of study including competency-based goals and objectives. Evaluation measures should be included.
B. Faculty mentor is to be identified and the resident will review their progress periodically with their faculty mentor.
C. Suggested time frame is 4 to 8 months duration. Focused blocks of time (4 week block electives) and/or longitudinal components are possible formats. Specific time frames will vary based on goals and objectives as chosen by the resident.
D. Scholarly Project – must be presented at least locally, although presentation at the state or national level is encouraged. (Resident is responsible for funding travel and other related expenses. Use of discretionary funds is allowed.)
E. Resident will attend a CME meeting in the AOC. (Resident is responsible for funding travel and other related expenses. Use of discretionary funds is allowed.)
F. Resident will present a critical appraisal of a current journal article in their AOC.
G. Quality outcomes should be demonstrated and documented in the AOC with case logs, patient outcome data and faculty reviews of resident competency, as appropriate to the AOC goals and objectives.
H. A letter summarizing the training completed will be written by the Program Director for placement in the resident’s portfolio and attached to the final residency completion letter.
Interested residents are encouraged to develop (in consultation with their Faculty Advisor and/or selected AOC mentor) and complete an Area of Concentration during their training.
Some potential topic areas include, but are not limited to:
Advanced Obstetrics*
CAM / Integrative Medicine*
International Health*
Sports Medicine
Academic Family Medicine / Research
Behavioral Medicine
Urgent Care / Emergency Medicine
Geriatrics*
Adolescent Medicine
Sleep Medicine
*draft available
References:
Bucholtz JR, et. al. Task Force Report 2: Report of the Task Force on Medical Education. Ann Fam Med. 2:S51-S64(2004).
RAP Criteria for Excellence, 6th edition p. 21
Frank SH, Smith CK. Areas of Concentration Programs in University-based Family Practice Residency Training. Family Medicine. Vol. 25, April 1993, pp. 242-4.
The Residency Assistance Program’s guidelines for excellence also encourage that “an individualized educational plan should be developed for residents as they matriculate into the residency program.” (2)
Traditional approaches to meeting individual residents’ needs include elective rotations and post-residency fellowships. Unfortunately, the number of residents who desire fellowship training greatly exceeds the number of available positions. Individual electives are generally available and effective in meeting residents’ needs for brief clinical experiences. However, many residents desire a more structured and focused curriculum with greater depth, breadth and evaluation methodology, as well as some form of recognition for their advanced training in a particular area within the traditional structure of the Family Medicine Residency.
The Association of Family Medicine Residency Directors Board of Directors has recommended that the Area of Concentration concept be offered as a tool for individual programs to use as an aid in designing individual education plans for residents.
Guidelines for Individual Areas of Concentration
A. Written program of study including competency-based goals and objectives. Evaluation measures should be included.
B. Faculty mentor is to be identified and the resident will review their progress periodically with their faculty mentor.
C. Suggested time frame is 4 to 8 months duration. Focused blocks of time (4 week block electives) and/or longitudinal components are possible formats. Specific time frames will vary based on goals and objectives as chosen by the resident.
D. Scholarly Project – must be presented at least locally, although presentation at the state or national level is encouraged. (Resident is responsible for funding travel and other related expenses. Use of discretionary funds is allowed.)
E. Resident will attend a CME meeting in the AOC. (Resident is responsible for funding travel and other related expenses. Use of discretionary funds is allowed.)
F. Resident will present a critical appraisal of a current journal article in their AOC.
G. Quality outcomes should be demonstrated and documented in the AOC with case logs, patient outcome data and faculty reviews of resident competency, as appropriate to the AOC goals and objectives.
H. A letter summarizing the training completed will be written by the Program Director for placement in the resident’s portfolio and attached to the final residency completion letter.
Interested residents are encouraged to develop (in consultation with their Faculty Advisor and/or selected AOC mentor) and complete an Area of Concentration during their training.
Some potential topic areas include, but are not limited to:
Advanced Obstetrics*
CAM / Integrative Medicine*
International Health*
Sports Medicine
Academic Family Medicine / Research
Behavioral Medicine
Urgent Care / Emergency Medicine
Geriatrics*
Adolescent Medicine
Sleep Medicine
*draft available
References:
Bucholtz JR, et. al. Task Force Report 2: Report of the Task Force on Medical Education. Ann Fam Med. 2:S51-S64(2004).
RAP Criteria for Excellence, 6th edition p. 21
Frank SH, Smith CK. Areas of Concentration Programs in University-based Family Practice Residency Training. Family Medicine. Vol. 25, April 1993, pp. 242-4.
2009 Match data from AAFP
Preliminary information available from the 2009 National Resident Matching Program (NRMP) indicates that for family medicine residency programs 2,329 positions filled out of 2,555 positions offered (91.2%). This represents a decrease in the number of positions offered and filled but an increase in the percentage of family medicine residency positions filled through the NRMP over 2008. [Included in this category are family medicine-psychiatry, family medicine-emergency medicine, and family medicine-internal medicine programs.] Ninety nine fewer family medicine positions (3.9%) were offered in 2009 compared with 2008. Seventy five fewer positions (3.2%) were filled in 2009 compared with 2008 (2,329/91.2% vs. 2,404/90.6%)
Eighty nine fewer U.S. seniors (1,083 vs. 1,172) chose family medicine in 2009 compared with 2008. Slightly more U.S. seniors participated in NRMP in 2009 compared with 2008 (15,638 vs. 15,242), with a resulting decrease (7.4%) in the percentage of U.S. seniors who chose family medicine. Although 2008 marked the first time in over a decade that more U.S. seniors participating and matching through the NRMP matched into family medicine compared with the preceding year, this year there were fewer US seniors who matched into family medicine than 2007.
Access the full report here.
Eighty nine fewer U.S. seniors (1,083 vs. 1,172) chose family medicine in 2009 compared with 2008. Slightly more U.S. seniors participated in NRMP in 2009 compared with 2008 (15,638 vs. 15,242), with a resulting decrease (7.4%) in the percentage of U.S. seniors who chose family medicine. Although 2008 marked the first time in over a decade that more U.S. seniors participating and matching through the NRMP matched into family medicine compared with the preceding year, this year there were fewer US seniors who matched into family medicine than 2007.
Access the full report here.
Political Action at Work - April 2009
Health plans confusing patients, hospitals playing doctor, and brand new physicians forced to leave Texas. Those are the biggest issues Texas Medical Association is handling as the 2009 Texas Legislature moves into its final six weeks.
This month’s video includes:
- A progress report on our “Patients’ Right to Know” campaign for health insurance reform;
- Our work to protect your clinical autonomy by stopping hospitals’ push to be able to hire physicians directly; and
- Interviews with a panel of medical students on their advocacy to expand graduate medical education slots in Texas and reengineer the state’s student loan repayment program.
Saturday, April 04, 2009
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