UTMB Family Medicine Residency

alumni updates

2010-01-08T10:20:00.002-06:00

Lots of cute photo updates posted to the FaceBook group page... go check it out! Alumni, if we're missing you, please join the group and post to the wall!

How can it be...

2010-01-06T13:20:00.003-06:00

...so long since I last posted?!

Hope everyone had a good holiday. I know I did, but I've had about enough of this ridiculously cold weather!

Some congratulations to shout out - the following residents were top of their class on the annual in-training exams recently: R1 - Rory Bradt, R2 - Rich Donaldson, R3 - Thein-An Nguyen. Scores overall were quite impressive this year, so congratulations to all the residents for the hard work and especially to our three top scorers!

Putting a wrap on recruiting season this month. We have several interview days left to go, but our AOA Rank List goes in in a couple of weeks and shortly thereafter we will also be ready to submit our NRMP list. Can't wait to see who turns up on our Match list!

kudos

2009-11-03T08:07:00.004-06:00

Congratulations to Sashi and Eric on achieving a passing score on the American Board of Integrative & Holistic Medicine exam!!

Description of our program

2009-10-30T09:49:00.002-05:00

The University of Texas Medical Branch (UTMB) is a component of the University of Texas System and is located on beautiful Galveston Island, Texas. The Department of Family Medicine at UTMB was established in 1971. It was the first academic department of Family Medicine in the state of Texas. Since 1998, the Department of Family Medicine has been chaired by Barbara L. Thompson, MD.

The Residency Program was one of the first in the state and has graduated over 250 residents since accepting the first trainees in 1972. The program director is Lisa R. Nash, DO since 2003.

The program is structured as an 8-8-8 program accredited by the ACGME, for a total of 24 residents in training annually. The curriculum includes a diverse blend of campus and community based experiences to meet training requirements and provide a comprehensive view of contemporary Family Medicine.

A Rural Training Track was added to the program in 2000, located in Weimer Texas, a community with a population of 1800. In 2009 the RRC approved an expansion of the RTT curriculum, which will allow residents to spend approximately the first half of their training at the academic medical center in Galveston and the remainder at the RTT site in Weimar.

The UTMB-FMR curriculum also incorporates the “Integrative Medicine in Residency” curriculum. Residents receive over the course of their training an additional 200 hours of instruction in Integrative Medicine. At the completion of training, graduates qualify to sit for the American Board of Integrative Holistic Medicine exam.

Additionally, the program achieved certification by the American Osteopathic Association in 2007, qualifying all DO residents to sit for the American Osteopathic Board of Family Physicians exam.

Other notable features of our program:
• Area of Concentration Programs – an elective written program of individual study
• Maximum number of electives (six) allowed by the RRC for FM
• International Health program and strong history of approved electives for residents
• Behavioral Medicine program – recognized as one of the best examples of an integrated, skills-based curriculum in the nation
• Electronic Resident Portfolio – collection point and tracking mechanism for resident progress through training requirements
• Campus-wide integrated EMR (EPIC)
• Resident Research Program – with 18 national conference presentations and/or publications over the past five years
• Fellowship/Advanced Training – 11 graduates over the past five years have gone on to prestigious fellowships and other advanced training opportunities

For more information about our program, visit us here. Meet residents, alumni, faculty, staff and others on our UTMB Family Medicine Residency group on Facebook!

Loan Repayment info

2009-10-29T16:15:00.000-05:00

Texas Enacts Loan Repayment Program to Entice Primary Care Physicians to Practice in State's Underserved Areas

Participants Could Pay Off Student Loans Within Four Years

Click here to read the details!

message from the Chairman of FM

2009-10-19T13:18:00.000-05:00

I am pleased to announce that we are beginning our search for a new Director for the UTMB Center for International Health and WHO/PAHO Collaborating Center for Training in International health. Dr. Laura Rudkin will chair the search committee and Drs. Catalina Triana, Clinton White, Rebecca Wong, and Lexi Nolen have agreed to serve as search committee members.

The successful candidate for this position will have an MD or DO degree, will be boarded in a primary care discipline and will be eligible for a Texas medical license. He or she will have experience in global health as well as teaching medical, graduate, nursing , health professions, graduate students and/or residents. Rank and salary are commensurate with experience.

I invite you to nominate candidates for this position by providing their names and contact information to Dr. Rudkin or one of the members of the committee. I appreciate their support and yours as we look forward to identifying highly qualified candidates for this important position.

Barbara L. Thompson, M.D.
Professor and Chair
Department of Family Medicine, Campus Route 1123
Primary Care Pavilion, Room 2.208A
Office 409-772-3125
Fax: 409-772-0497

underserved communities rotation - funding available!

2009-10-16T15:55:00.002-05:00

Residents,

East TX AHEC has funding for residents (approx 5) to participate in a multi-disciplinary Community Health rotation in certain MUA/HPSA (underserved) communities. The site list is prioritized roughly in the following order: Community Health Centers, FQHCs, Rural Health Clinics and others. The final approved site list is still being determined. As soon as it is available, I will forward it, but you don’t have to wait on the list if you have an idea about a site you think will qualify. Let me know your idea and we’ll find out.

Anyone interested in potentially practicing after graduation in an underserved area is encouraged to apply. This could be urban underserved in addition to rural. Rural Track residents would certainly qualify for the program but this is not limited to RTT residents.

Please email me if you may be interested.

Recruiting update

2009-10-06T11:16:00.000-05:00

Total Applications = 585

Scheduled to Interview (48)
USMD = 16
DO = 14
IMG = 18

Invited but not yet scheduled: 20

Rich's article

2009-10-02T08:16:00.000-05:00

kudos

2009-09-29T15:40:00.002-05:00

Congratulations to Rich Donaldson (R2) for his article "Integrative and Osteopathic Medicine" in the September 2009 edition of the Houston Medical Journal! Good work, Rich!

email from Dr. Epperly, AAFP President

2009-09-29T08:04:00.002-05:00

Dear Colleague,
In less than three weeks, I will have the distinct privilege of installing Dr. Lori Heim as the 63rd president of the AAFP. As my time serving you as president winds down, I want to take this opportunity to talk with you one last time about the important efforts your Academy is taking to help ensure reform of our health care system.

What a year of change for our country! What a year for health care reform! I think we can all agree that we need to reform our ailing health care system. What kind of health care reform we want becomes the key question. As we have all witnessed, this debate over needs versus wants has left the arena of thoughtful discussion around policy and has entered the arena of major league "Politics" with a capital "P."

There are several pieces of legislation in play, and these bills are under rapid evolution. Before the August recess, they were literally changing by the hour. We don't have a finished product in either chamber of Congress. That's why we see this evolving process as being a critical time to be "at the table, so we don't end up on the menu." We want to help shape the debates around the critical principles and values that we hold dear as family physicians.

So what principles am I talking about? Where does the AAFP stand on health care reform? It's really quite simple. We believe that the key to designing a new health care system is to reemphasize the centrality of primary care by:
• Ensuring health care coverage for all and aligning financial incentives to support this system;
• Increasing payment for primary care services ;
• Redesigning the manner of primary care delivery modeled on a ‘patient-centered medical home' ; and
• Reinvigorating the primary care workforce

In addressing all of these principles, our approach has been one of "Yes, if." "Yes, we will support certain provisions, if the following principles are present." The health care system we have is unacceptable and not financially sustainable long term. The rapidly growing health insurance premiums and cost sharing measures (like higher co-payments and bigger deductibles) are making more of our patients limit their access to their family doctors. The status quo is not acceptable to us or to our patients.

I want you to know that we will stay at the table and continue to help shape a better health care system for our country. It's the right thing for us to fight for on behalf of our members and our patients. We will not get everything we want and there will undoubtedly be elements of the final reform proposal that we won't like. But I can guarantee the result will be much better for our having been so fiercely involved.

In this vein, your AAFP leaders have been busy recently, talking face-to-face and via conference call with members of the Obama administration and Congress to stress the need to enact health care reform legislation that improves health care quality, enhances patient access and lowers costs via a primary care-based system.

I met with Nancy-Ann DeParle, director of the White House Office of Health Reform, and others in August. During this meeting, I told them that the AAFP continues it's commitment to the major principles of health care reform, including providing health care for all and the importance of better payments for family physicians and other primary care physicians. I stressed that adequate payment is key to building a primary care infrastructure in this country and that we must invest in the education and training of the primary care workforce so we have enough family physicians in our country.

In addition to the White House face-to-face meeting, I have participated in several conference calls with the White House, along with representatives of several other physician organizations, including the American College of Physicians, the American Osteopathic Association, the American Academy of Pediatrics and the American Medical Association. We discussed what we could do collectively to move health care reform along. I am very optimistic and encouraged by the discussions with the White House and with our colleague organizations, and believe we need these exchanges to get good, solid, factual information to our members.

I also have been part of six town halls where I've had a chance to represent the AAFP to both members of Congress and to you. I have seen the fear, heard the concerns, and witnessed much about the character of America. It is important that America is having this dialogue. The AAFP must stay engaged in the health care reform process. Now is not the time to walk away from the table, if anything now is the time for us to be more engaged and to advocate for the way the health care system needs to be reformed.

The AAFP is going to continue to be engaged and advocating every second for the good of health care for this country. I would ask of you to do the following:
• Stay optimistic. Keep focused on changing our health care system for the greater good of our country.
• Use the AAFP's web page and the "Connect for Reform" icon in the upper right hand corner to join and have a front row seat as this debate and process unfolds.
• Download the AAFP-developed one page information sheet for your patients . Please distribute this as you see fit. Included are links to two historically bipartisan fact check sites where you and your patients can learn about which statements about health care reform are true and which are not.
• Please help settle down all the rhetoric, fear, and confusion that exist with your patients, colleagues, and communities.

I would like to just end with this. We have never been closer to meaningful health care reform in the history of our nation than we are right now. I remain optimistic that we will step forward as a nation for the good of health care for all. I wish you all the best as we move forward.
Regards,

Ted Epperly, M.D., FAAFP
President
American Academy of Family Physicians

American Academy of Family Physicians Division of Government Relations
2021 Massachusetts Avenue, NW Washington, DC 20036
(888) 794-7481 (202) 232-9033

Recruiting Update

2009-09-28T15:08:00.002-05:00

Total Applications = 527

Scheduled to Interview (34)
USMD = 13
DO = 9
IMG = 12

Invited but not yet scheduled: 20

October interview dates are FULL, so please contact us ASAP to schedule if you are in the "invited but not yet scheduled" category!

ACGME site visit

2009-09-21T13:48:00.003-05:00

Putting the last touches on our preparations for our ACGME site visit scheduled for Wednesday. Countless hours of hard work have gone into the documents preparation. Thanks to all - staff, faculty, residents and others - who have helped!

Applications for the 2010 Match are being reviewed through ERAS. Although the site visit preparations have taken some of the time I would have otherwise devoted to the Match, we have been able to screen many applications and have begun inviting applicants for interviews. I still have roughly 100 unscreened applications, so be patient! After the site visit this week, we will get caught up. If you have already received an invitation to interview, please contact Louis right away to schedule your preferred date, as the October dates in particular are filling up fast!

new video and info

2009-09-16T12:50:00.001-05:00

Check out the 2009-10 UTMB GME recruitment video here.

2009-09-14T10:07:00.003-05:00

An interesting exercise from Southwest Airlines Spirit Magazine, September edition…

Last week I was at TMA for meetings and heard an interesting discussion about student/resident debt, which was prefaced with something close to the following… “part of the problem with student/resident debt is that medical students want the lifestyle of a resident and residents want the lifestyle of an attending, when what we all need to do is match our lifestyle to our current situation and income!”

As you all may know, an impressive infusion of funds was budgeted for the Physician Education Loan Repayment Fund in the current state budget. Residency graduates considering practice in rural or other underserved areas in Texas should look into this program. Contact the Texas Higher Education Coordinating Board for more information. You can read the TAFP brief on the program here.

Board Certified!

2009-09-03T10:02:00.001-05:00

The Class of 2009 is 3 for 3 on passing the Family Medicine boards so far! Big congratulations to Rene, Adriana and Roberto who have already received their results!!

The rest of you, please let me know when you hear your results?!

UTMB FMR Rural Training Track - better than ever!

2009-08-21T15:54:00.004-05:00

Challenge to Society: 177 of 254 (70%) Texas counties are rural.

Rural Training:
Residents will spend their first 20 rotation blocks training with the larger group of FM residents in standard Galveston area rotations.

PGY1 continuity clinic will be held in the Family Medicine Center in the University Hospital Clinics building. During rotation blocks 14 – 20, continuity clinics would be relocated to Weimar, TX in partnership with our local RTT faculty at the Youens-Duchicella Clinic. Rotation activities would continue to be in conjunction with the larger group of campus-based FM residents during this time.

At the completion of rotation block 20, RTT residents would relocate to the RTT site for the remainder of their training. They will maintain connection with the campus-based resident cohort via web-based conferencing of weekly Thursday afternoon didactic activities and periodic returns to campus for in-person participation.

Rural Site:
The RTT site is located 138 miles from Galveston in Weimar, Texas (on I-10 west of Houston) and in the year 2000, the population was 1,981. The local hospital, Colorado-Fayette Medical Center is a 38-bed facility organized as part of a private 501(c)(3) corporation.

The Curriculum:
Rotation blocks 1 - 20: Essential Skills in FM (Orientation), Principles of Family Medicine, FM Hospital Service 1-3, MICU, OB1-2, Emergency Medicine, Pediatric Urgent Care, Newborn Nursery, Community Medicine 1-2, Pedi Inpatient, Behavioral Medicine, Geriatrics, Ambulatory Peds1, Surgical Subspecialties, Neurology and Nephrology.

Rotation blocks 21-39: Surgery 1-2, FM Hospital Service 4-7, Ortho1-2 & Sports Med, Cardiology, Gynecology, FM Outpatient Procedures, Ambulatory FM, Ambulatory Peds 2, Electives 1-6.

What residents say about the RTT Experience:
Residents have reported that their rural training experience gave them the skills and background to be more competitive for rural practice jobs after residency. Generally, all felt comparable to their peers in terms of knowledge-base but that they may have a competitive edge in terms of “hands-on skills” and confidence related to performing procedures.

Residents reported learning a lot about “practice management” and the business of medicine in the rural track. Another benefit most residents cited is the immediacy of consultation/collaboration from specialists and other services. Residents feel that provider-to-provider communication is better in the rural setting (especially when a procedure/hospitalization is needed), as is continuity of care for patients and the ability to preserve the educational continuum when patients require specialty care.

If you are interested in the RTT, be sure to mention this during your interview process.

Heal Health Care Now: Doctors Speak Out for Reform

2009-08-03T14:33:00.001-05:00

Heal Health Care Now: Doctors Speak Out for Reform

Posted using ShareThis

RRC approves 20+19 Rural Training Track Proposal!!!

2009-07-23T09:23:00.001-05:00

Everyone,

I am extremely pleased to share the news that the RRC has just notified us of approval of our proposal for the 20+19 model of the Rural Training Track!!!!

The three residents currently enrolled in the Rural Training Track will complete their training under the previous integrated longitudinal model. From this point forward, no new residents will be accepted into that track. Current PGY1 residents and those thereafter considering the Rural Training Track would participate under the new format, outlined below.

Residents enrolled in the Rural Training Track will spend the first 20 rotations blocks in Galveston. Residents will then relocate to Weimar, TX to complete the final 19 rotation blocks of their training. Residents’ PGY1 continuity clinic will occur in Galveston, followed by PGY2 and 3 continuity clinic in Weimar. During blocks 14 – 20, residents would commute to Weimar for continuity clinics while completing rotation assignments in Galveston under much the same format as our current hybrid track (reversed).

For detailed curriculum information, interested residents should contact Dr. Nash. Additional details will be shared with residents and faculty at upcoming meetings.

It is likely that we will match resident applicants to this track for June 2010 start dates, final decision pending further discussion at Leadership and Residency Program Meeting. (Residents matching to the track would relocate to Weimar in approximately January 2012. Current PGY1 residents interested in participating could relocate to Weimar approximately January 2011.)

Many, many thanks to those involved in this project FOR THE PAST TEN YEARS, as we take this long anticipated major step forward!!! To Angela Shepherd, who started the dream and then allowed me to lead it when I came on board, to Dr. Thompson who has been always supportive, to Nita Caskey who has done as much or more footwork, sweat and effort as I have, and to our Weimar docs – Robert Youens, Jorge Duchicela and Olga Duchicela – who have hung in there with us all this time, keeping the faith that eventually if we hung in there long enough, it would happen. Also thanks to the residents who participated in all the early stages and growing pains! There have been so many people involved in this project over the years, I couldn’t possibly name them all.

With much gratitude and excitement,

Lisa R. Nash, DO, FAAFP
Program Director
UTMB Family Medicine Residency

2009 Program Directors' Workshop

2009-06-09T09:45:00.003-05:00

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!

Thanks, Dr. Triana!

2009-05-23T22:16:00.001-05:00

...for a great party honoring the graduates of 2009.

Check our FaceBook page for photos!

Doctors of the Day, Austin TX

2009-05-12T10:22:00.003-05:00

Drs. Miguel Guerra (RTT resident) and Jorge Duchicela (RTT faculty)!!

STFM 09 - Denver

2009-05-12T10:06:00.002-05:00

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!

interesting quote...

2009-04-24T08:08:00.004-05:00

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."

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?"

Want to know when this blog is updated?

2009-04-23T20:50:00.002-05:00

Scroll to the bottom and choose a blog reader subscription... keep up to date as new posts are published.

What does our interview day look like?

2009-04-16T15:30:00.001-05:00

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

Special Info for DOs re: the Match Process

2009-04-16T15:24:00.002-05:00

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.

See our Residency website at TX OPTI here.

We’re looking forward to two great Matches in 2010!

Areas of Concentration

2009-04-16T15:18:00.001-05:00

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.

2009 Match data from AAFP

2009-04-16T09:16:00.001-05:00

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.

Political Action at Work - April 2009

2009-04-16T08:38:00.001-05:00

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.

2009-2010 Curriculum

2009-04-04T11:48:00.004-05:00

Info for Applicants - 2010 Match

2009-03-25T15:38:00.006-05:00

Dear Applicant,

Thank you for your interest in our residency training program.Our basic requirements for consideration for interview include:

graduation from medical school within the past five years (not flexible)
your medical school MUST be ON the approved Texas Medical Board list (scroll down for link to "substantial equivalence") and NOT on the Texas Higher Education Coordinating Board list of disapproved schools (no exceptions)
passage of USMLE I and II, including CSA (preferably on first attempt) OR COMLEX for Osteopathic students. Obviously, the better your scores, the stronger will be your application
some U.S. clinical experience
three letters of recommendation, at least two of which MUST be from family doctors

We accept applications only through ERAS. Please do not email me long attachments in an attempt to circumvent the process because I will not read them. If you meet our criteria outlined above, then apply through ERAS. This will ensure that your application is reviewed.

Osteopathic students may apply to our program through either or both Match processes, however you will only be guaranteed a dual-accredited slot by matching through the AOA Match.

We will begin our interview season for the class entering in 2010 in September 2009 for Osteopathic students and October 2009 for all. We hope to conclude interviews by end of January 2010. We will begin screening applications immediately as they become available through ERAS. We will schedule interviews until we have interviewed sufficient candidates to fill our class, so you are encouraged to apply early.

Our program does sponsor J1 visas. Our program does NOT sponsor H-1 visas.UTMB does NOT sponsor externships or observerships for persons who have already graduated from medical school.

Please see our Residency website for more detailed information regarding our program. For specific questions that may not be covered, please contact our recruiter, Mr. Louis Johnston. His contact information is listed on the webpage.

Lisa R. Nash, D.O.

Program Director

UTMB Family Medicine Residency

Integrative Medicine in Residency - FYI

2009-03-25T15:31:00.001-05:00

Integrative Medicine in Residency (IMR) is a 200-hour curriculum development project of the Arizona Center for Integrative Medicine, University of Arizona, that is creating and delivering competency-based online integrative medical training to residents. IMR is a required component of the eight residency programs listed below, and is incorporated over the three years of your residency. Learning is accomplished through a combination of: web-based curriculum, program-specific experiential exercises, and group process-oriented activities.

Eight family medicine residencies nationwide are participating in the pilot phase of this program:
· Beth Israel Family Medicine
· Carolinas Medical Center
· Hennepin County Medical Center
· Maine Medical Center – Portland
· Maine Dartmouth – Augusta
· University of Arizona
· University of Connecticut
· University of Texas Medical Branch

Year 1 Content
Introduction to Integrative Medicine
Prevention and Wellness: US Preventive Services, Nutrition and Diet, Supplements for Prevention, Physical Activity, Sleep, Stress and Mind-Body Medicine, Spirituality
Tools in Integrative Medicine : Motivational Interviewing for Behavioral Change

Year 2 Content
Pediatric Topics: ADD/ADHD, Chronic Pain Syndrome, Asthma and Allergies
Women's Health Topics: Menopause, Fibromyalgia, Osteoporosis, Depression, Eating Disorders, PMS, prenatal care and lactation
Acute Care Topics: Back Pain, Urinary Tract Infection, Gastroenteritis, Otitis media,Vaginitis, Chest Pain/GERD, Upper Respiratory Infection
Tools in Integrative Medicine: Integrative Medicine Intake Process, Botanicals, Mind-Body Medicine

Year 3 Content
Chronic Illness: Cardiovascular Disease (hypertension, hyperlipidemia, coronary artery disease), Diabetes Mellitus II, Osteoarthritis, Rheumatoid Arthritis, Obesity, Irritable Bowel Syndrome, Chronic Back Pain
Special Topics: HIV, Cancer Survivorship
Tools in Integrative Medicine: Integrative Medicine Care Plan Process, Manual Medicine, Energy Medicine, Whole Systems, Practice Management

All courses have an interactive core content and contain case studies allowing you to apply the new knowledge to patients encountered in family medicine. Content includes evidence-based Conventional and Complementary approaches to the management of the medical problems presented.

Throughout the curriculum we will emphasize well-being and balance for physicians – this interactive and experiential part of the curriculum will encourage residents to work on an individual plan to maintain their well-being and balance while in residency.

For more information on the IMR program at the University of Texas Medical Branch Family Medicine Residency, please contact: Victor Sierpina, MD, 409-772-1847, vssierpi@utmb.edu

Redecorating

2009-03-23T10:52:00.003-05:00

I like it! What do you think?

Thanks, Diane!

UTMB FMR Class of 2012

2009-03-19T13:30:00.000-05:00

Resident Salary Increase Proposed

2009-03-18T11:03:00.002-05:00

We are pleased to announce approval to increase House Staff salaries effective September 1, 2009. Please Note: These increases are subject to approval of UTMB's final budget for FY 2010 by the UT System Board of Regents.

PGY1 - $44,168
PGY2 - $45,500
PGY3 - $47,179

(Personal note... this is approximately DOUBLE what I earned as a resident. At that time, before duty hour restrictions, approximately $2.63 an hour. And it was uphill in the snow both ways.)

Amazing

2009-03-17T12:22:00.001-05:00

Wal-Mart plans to market an EHR, undercutting rivals by at least HALF the cost! Read the report here.

Happy 2009 Match Day to us!

2009-03-17T11:21:00.000-05:00

WE FILLED!!!!!!!!!!!!!

growing again

2009-03-16T08:46:00.003-05:00

It's exciting times here in Galveston. Lately the news is all good regarding the future of UTMB. The powers in Austin seem to be behind rebuilding and finally the UTS Board of Regents has also pledged their support. The current tentative plan includes restoration of 500+ hospital beds here on the island, which will put us in great shape with our hospital service.

We're also taking advantage of this opportunity to seriously consider some changes the Residency program has been interested in for a long time. This is very timely, considering the national interest in the patient centered medical home. We are looking to move from the very large and not particularly patient-centered mega clinic housing all residents and faculty (approximately 40 - 50 doctors) to smaller clinics that more closely resemble environments where our graduates are likely to practice after graduation.

We have submitted a proposal to the RC-FM for approval to move 4 residents (two PGY2 and two PGY3) to our Stewart Road Family Health clinic, where they will join 3 - 4 faculty in that practice.

We have also submitted a proposal for expansion of the Rural Training Track to conduct the final 19 months of training at our rural site. This proposal is also for 4 residents, two PGY2 and two PGY3. It's taken 10 years and hurricane Ike to get to this point and I can't tell you how excited I am that we're finally taking this step. When we hear from the RC-FM, I will post a detailed outline of the new curriculum.

A third proposal in the works is for a new clinical site on the mainland that will mirror the Stewart Road Family Health clinic. That site should be ready for residents at the beginning of the 2010-2011 academic year. One year farther down the road potentially is a revitalization of an old partnership with the county public health system. That partnership was rated very highly by residents in the program during its lifetime and will be an excellent addition to our clinical site options if we are successful in negotiating that renewal.

Most likely we will retain some campus or near-campus presence as well, so that could bring our outpatient facilities to five sites. It is also quite likely that we may continue our hospital service in two locations - one on the mainland and one here on campus.

It's been awhile getting to this point, and some gloomy and disheartening times to live through getting here, but the future truly is beginning to look bright for the UTMB FM program!

Let the dialogue begin

2009-02-12T08:42:00.002-06:00

Read the Galveston Daily News articles on the consultant report and the Texas House Select Committee on Hurricane Ike's recommendations.

As the GDN proclaims in a large banner headline: MIXED SIGNALS.

What does the future hold?

2009-02-11T22:01:00.002-06:00

The long-awaited consultant report was released today by UT System. Access the 14 page executive summary here.

Dr. Callender's response is here.

I have read the executive summary and will post my thoughts and reflections a bit later. Of course, there is as of yet no indication which choice will be selected by the Board of Regents nor what counsel will come from the governor's office. The next several days and weeks are likely to be pretty news-filled. I have some work travel obligations coming up but will try to keep updates posted as I learn more.

It's a wrap!

2009-02-06T16:06:00.003-06:00

Our Match 2009 recruiting season is finished!! We completed interviews this week and last night held our official Rank Meeting. The Rank List is completed and will be loaded for the match next week.

I was very happy with the quality of our applicants' credentials. USMLE scores, medical school academic performance and recommendation letters were overall excellent and I'm quite pleased that despite the hurricane, we were able to hold steady regarding our commitment to performance standards for our applicants. Proportionately, we interviewed our usual number of applicants per slot (remember that we will be matching for 4 this year). Overall, I have to consider our 2009 Match recruiting season a success and we are hoping to fill our slots in the Match.

Many thanks to the Recruiting Team, especially our resident members and also to our applicants. We appreciate your openness to consider whether our challenges related to the hurricane recovery fit with how you'd like to see yourself grow and the experiences you'd like to have during residency.

Best wishes to our applicants for a successful match!

update for 2009 Match applicants

2009-01-12T08:53:00.001-06:00

Thank you again for coming to interview with us here in Galveston. I wanted to send you a brief update on how things are progressing here.

The debris cleanup is completed in most of the busiest parts of town. Many restaurants and businesses have reopened and more are still in progress. You will see construction all over town and I take that as a positive sign. I’ve been happy to learn over the past six weeks or so that all of my personal favorite restaurants either have already reopened or will soon! Post office access is improving, my favorite private mail business is back to normal operations and the UPS store is open. Mail delivery to homes has been restored for quite some time now. Grocery stores are back to normal, with the exception of the HEB which I’m told will not reopen.

I’m not sure about the status of apartment availability, but there are some homes for sale on the island again so it looks like the housing situation is beginning to have more options. There are plenty of housing options available on the mainland for those who might wish to commute to the island.

And probably most importantly from our perspective, John Sealy hospital reopened last week! We began admitting patients on day 1 and have continued to build a modest hospital service. We started block 8 today with 4 residents on the service. I will try to keep our progress updated on the blog, so you can keep up with the latest here.

We have successfully updated our curriculum with two new rotations – Nephrology in PGY3 and Geriatrics in PGY2 and we’re excited about both of those. Residents begin those new rotations today for the first time. We also have our R3s finishing up their last hospital block for the rest of this academic year with a private hospitalist service at Mainland Medical Center and we’re excited about that new opportunity.

There are two rotations that we are still working on at present. Cardiology will be transitioned to a private practice outpatient experience and we are still working to identify an appropriate community faculty for that rotation. Pediatric Emergency Medicine remains undecided. For the remainder of this academic year, the rotation will be a combination of pediatric urgent care experiences in the new location for the Department of Pediatrics Urgent Care Center here on the island and the Pedi ER at Clearlake Regional. Closer to the end of the academic year we will evaluate those two experiences and make a decision for next academic year.

As you probably already know, we are in our new clinic space in the University Hospital Clinics building. We’re pleased to have two of our nurses from the PCP stay on with us and they are doing a great job trying to get us organized in our new space. The volume is picking up and I think over the next month will be our best indication of how that may be leveling off for the immediate future. We are exploring some new options for resident/faculty partnerships that we hope will build volume for the residents more quickly.

I am extremely pleased that our Residency Program infrastructure and staff are intact and stable so that our administrative activities remain productive. Unfortunately we did have some impact to the faculty in losing Dr. King and Dr. Irwin from Residency, as well as some of the other department faculty being impacted. My Assistant Program Director, Ron Williams, is also subject to having his time reduced to 50% the end of May and I am hoping that we are able to continue increasing our departmental productivity so that is not implemented. Two departmental faculty have announced their resignation effective March. These faculty were not members of the Residency Program faculty, but did have a small percentage of time in attending. In all fairness, I expect we will lose another one or two department faculty in the next six to twelve months so we will be in faculty recruiting mode again. The Residency Program faculty is stable to the best of my knowledge and I believe we have only one faculty member considering looking for another opportunity.

We still have some work to do, but we’ve come a long way since the hurricane. I’m pleased that we’ve been able to take advantage of the situation to go ahead with some curriculum changes we’d been considering prior to the storm and that we’re going to come out of this better than we went in. I will be doing my best to ensure that we take similar advantage of the need to recruit new faculty by recruiting selectively for skills to move us forward with some projects we’ve been considering as well as building in some areas we’d like to strengthen current activities.

As we discussed when you interviewed, we plan to recruit for four residents in the 2009 Matches (AOA and NRMP). If the recovery proceeds as expected, we will add one or two R2s to that class for the 2010-11 academic year and recruit a full class of eight in the 2010 Matches.

Thank you again for interviewing with us. We look forward to the Match and wish you the best as well. We hope that Galveston remains in your consideration and would be happy to answer any further questions you might have before submitting your match list.

Sincerely,

Lisa R. Nash, DO, FAAFP
Program Director
UTMB Family Medicine Residency

long time

2008-12-18T16:47:00.004-06:00

I had no idea so much time had passed since I last blogged. It seems like only a few days ago that the RIF occurred. It is still painful.

Some good things are happening though. I heard today that alumnus Pompeyo Chavez and his wife had a healthy baby boy today. Also current R2 Sashi Braga and his wife welcomed a healthy baby girl to their family this week. Congratulations to all of them!

Also, faculty member Jim King who was affected in the RIF has been hired by the Baytown FMRP, so he will stay in the area. They are adding a great faculty member to their program. Our loss is their gain. I'm happy that Jim found a good spot in a good program.

Former Dept of FM member Susan Berkley PA who was working for the Dept of Surgery most recently and affected by the RIF has accepted a position at the 4Cs Clinic.

A community hospitalist physician at one of our community hospital partners today agreed to take the R3s onto her hospital service to finish out their last required block so they are on track to finish their curriculum and graduate on schedule. We are still waiting to see if John Sealy reopens on January 5th as projected. If so, we will staff that service with R1s and R2s.

Things are coming along with our new clinic space at UHC. We have been plagued by computer bugs and glitches since opening but it seems that some significant progress was made yesterday in resolving most if not all of the current problems.

Scheduling has been a major problem since the RIF, because key administrative staff were lost who normally managed that function. This week saw major strides toward figuring out a new process for dealing with scheduling and we are all hopeful that it will be simpler and easier to manage from January forward.

Recruiting is going very well, much better in fact than I ever dreamed it would this year. We appreciate the support shown by our applicants and are grateful that we've been able to progress with this more or less as normal.

I think we are all very much looking forward to the holiday break. I'm hopeful that the new year will bring good things for Galveston Island and UTMB.

Faculty RIF

2008-12-02T08:31:00.000-06:00

The list

some updates

2008-11-26T13:17:00.002-06:00

I read in this morning's paper that 125 faculty were laid off on Monday. The newspaper staff has filed an open records act request for the list of names. If they are able to obtain that and publish it, I'll post the link here. I know of a few individuals because I've needed to contact them since Monday, but will defer listing them for now in hopes that we can have a complete list and not just the ones I've stumbled across.

Curriculum update: our Cardiology rotation has been worked out. We'll be working on the Cardiology service at TDCJ. Procedure rotation is coming along. I'm waiting on word back from a few individuals before we can finalize a new template for that. Surgical Subspecialties is resolved. Gyn is back. Adult Med is 50% worked out, still trying to establish a faculty contact for the other half. Geri rotation progressing well but I still need to meet with one faculty about a few pieces of that. Pedi ER is resolved.

ER should be available in January. The latest projection on the hospital reopening date is December 9. Today I started working on a backup plan for the R3s in the event we have further delays with that.

Have a safe and happy Thanksgiving holiday.

faculty RIF

2008-11-24T15:28:00.003-06:00

Today has been very painful as we've said goodbye to more of our colleagues and friends.

The impact to the Dept. of FM of the faculty RIF is as follows:

Two faculty who had been recruited or were in the process of being recruited for December and January start dates will not be hired.

Dr. Weaver, Dr. Irwin and Dr. King will be leaving us. Although not official, I heard that Dr. Weaver may be staying on in some volunteer capacity with her POM groups. Dr. King has volunteered to continue to do some attending with the residents. As I hear anything official related to those two items, I will post here.

Also, my friend and right hand man (Assistant Program Director) Ron Williams will have his time reduced to 50%. He and I are in the process of figuring out exactly how we can arrange that to work best for all concerned.

Barbara Ferrell's time will also be reduced to 50%.

Many of our faculty are in dual-career families, and some who were able to retain their jobs in FM were still faced with the loss of their spouse's job.

We all, residents and faculty alike, are clearly saddened by these changes brought to us by Ike. Family Medicine was hit hard and rumor is, other departments took even harder hits. I won't go into details here because it would only be rumor at this point. Most likely you will be able to read about it on the local newspaper website before long.

In other news, the hospital opened briefly this morning, only to close again after a few hours due to air quality concerns as I understand it. I believe the next potential opening date is a week from today.

I am typically a silver-lining kind of person, but I'm having a hard time finding it today. I know I will find it and that I'm just feeling sad about today's events. But I'm going to allow myself to feel sad today and leave it at that. Check back later and I'll let you know about that silver lining. Or lemonade from lemons, or however you want to put it...

RIF

2008-11-20T14:30:00.003-06:00

Yesterday we lost 7 of our administrative staff in the first wave of the RIF. Some who have been particularly instrumental in Residency Program activities - Dee Ann F., Susan R., Rosie V. and Cassie B. Fortunately, we lost none of our core Residency Admin staff and for that I am extremely grateful.

It is too soon to know the outcome of the clinical services RIF. All clinic employees were pink-slipped today and asked to reapply for a reduced number of jobs over the next two weeks. I still don't know exactly the number of positions that will be listed for FM. Some employees elected not to return to their jobs this morning after they were notified of the decision and process.

Faculty RIF is to occur on next Monday.

It is painful to be here right now and I'm looking forward to the recovery beginning in earnest because enough is enough. Some hopeful signs are that the next potential date for the hospital to reopen is 11/24, pending negative culture results due out tomorrow. We are still scheduled to move from the Fast Track/ER into clinic space in the UHC on 12/3.

And let me lay a rumor to rest... from somewhere there is coming a rumor that we will need to reduce our current residents by 4. NOT TRUE. We have no plans to let any of our current residents go.

We will only be matching for 4 residents for our INCOMING class in the Match this year. We hope to pick up 2 more residents for that class as PGY2 when the time comes. Perhaps this got miscommunicated to become the source of the rumor? I anticipate that we will match for either 6 or 8 in the 2010 Match. We plan to rebuild as quickly as our clinical volume allows.

well said

2008-11-19T09:52:00.000-06:00

Read this story about UTMB in today's Galveston Daily News.

Ghost Town

2008-11-19T08:59:00.003-06:00

Sorry about the disappearing right side bar. It's located way at the bottom of the page. Formatting problem with the links in the previous post that I don't have the time or energy to fix at the moment. And I want those links to stay there, so we'll deal with the format issue until that post rolls off the page.

The layoffs have begun in earnest today. Yesterday 450 employees across campus were notified they were affected. Today it has started in my building. Every employee is being called one by one into the Chairman's office and being told whether they are staying or going. Those who will return are being instructed to leave the building and return at 1:00. Those who are laid off are clearing out their offices and then leaving. The silence is deafening.

The nurses and other clinic staff will officially learn their fate tomorrow, although leaks are numerous and many have already heard through the grapevine. I honestly do not know how we are going to staff our clinics the rest of the week. My first task of the morning was to write letters of recommendation for nurses I can't believe we may not have with us next week.

Faculty will learn how the decision affects us on Friday. There is no question that this will be a different workplace on Monday.

Some decisions about how to handle the situation have been made at high levels that leave me apalled. Everyone knows that the layoff is necessary. But it should have been possible to work through this painful process with dignity and respect.

My Chairman has chosen to handle things much more professionally than what I've seen happening all around me in other areas. Although we don't always see eye-to-eye on things, my respect for my Chairman's professionalism, humanitarianism, and leadership have reached a new high. At least in Family Medicine, for the things we can control, we have continued to act like family, respect one another and act with integrity.

I hold out hope that this is the bottom and from here things improve as we start to rebuild.

ups and downs

2008-11-17T14:41:00.003-06:00

It is SO NICE to have most of the residents back to Galveston, as of today! It's been such a great day having the residents trickle by my office one by one and welcome them home.

Some ongoing challenges... I'm sure many have read by now that UTMB plans to downsize the campus workforce by 3800 FTE sometime this week. There will be impacts to the FM department both in faculty and staff, but to a much lesser extent than many other departments across campus. This is in large part thanks to Dr. Thompson's leadership and the dedicated efforts of our faculty, staff and residents to get back to business as usual, as quickly as possible.

Also, the opening of the hospital has been delayed, probably until the first week or so of December, although no proposed dates have been released as of yet. The last rumor I heard the end of last week was that a medical floor might reopen first, in advance of surgical capability, as the latest delay was caused by poor results on mold/fungal cultures in the ORs.

UTMB has been in the news quite a lot since the announcement of the proposed layoffs. Below are links to some of the recent stories.

Word on the Street
Galveston County Daily News, Nov. 17, 2008
Numerous Letters to the Editor concerning UTMB and its recovery were published calling for restoration of its Level 1 trauma center, establishment of a hospital district and urging state and local officials to support the university. http://galvestondailynews.com/letters.lasso

Docshop says so long, Mary Ann
Galveston County Daily News, Nov. 17, 2008
In her Scenes column, Frances Powell wrote: “Many ’grats to Divafave Mary Ann Ross, who’s retiring from UTMB. Her swansong party at Salsa’s was organized by Pat Reazin and Anna Perez.” http://galvestondailynews.com/story.lasso?ewcd=92729a3d5b72b60e

Hankins again named a national top doctor
Galveston County Daily News, Nov. 17, 2008
Dr. Gary Hankins, chairman of the department of obstetrics and gynecology at UTMB, was named one of the nation’s best doctors for women for the fourth straight year. The ranking was published in the November issue of Women’s Health. (Link unavailable.)

Galveston biodefense lab was fortress during Ike
Dallas Morning News, Nov. 16, 2008
This article surveys the safety and security measures of the Galveston National Laboratory at UTMB. Reporter Emily Ramshaw wrote, “The nation’s newest mammoth biodefense lab towers like a fortress over this hurricane-battered ghost town, a rare unscathed sight among uprooted palm trees, shattered shop windows and beach homes teetering perilously on warped stilts.”
http://www.dallasnews.com/sharedcontent/dws/news/texassouthwest/stories/DN-ikeside_16tex.ART.State.Edition1.4a63bc5.html

For health’s sake, take action now
Galveston County Daily News, Nov. 16, 2008
In this editorial, publisher Dolph Tillotson urges Galveston officials to create a countywide health care taxing district to help the county’s health care providers, including UTMB. http://galvestondailynews.com/story.lasso?ewcd=3184d927c43952e8

Smaller UTMB causes worries
Galveston County Daily News, Nov. 16, 2008
State health care leaders said a plan to downsize UTMB poses vexing questions about the future of Galveston County’s poorest and most traumatically injured patients. David Lopez, CEO of the Harris County Hospital District, said the plan will cause a ripple effect across the Texas health care system, a patchwork of overburdened providers that treat the 30 percent of Texans without insurance.
http://galvestondailynews.com/story.lasso?ewcd=e5d65e052f4890e6c8545f57966c90b3

UTMB hires Atlanta firm to assist in downsizing
Galveston County Daily News, Nov. 16, 2008
UTMB has hired Kurt Salmon Associates of Atlanta to advise about reshaping UTMB as it cuts as many as 3,800 jobs and downsizes its 550-bed hospital to a 200-bed operation. The company will conduct market, facility and financial analyses of the medical branch.
http://galvestondailynews.com/story.lasso?ewcd=e6a15dd01f373482

Hospitals jammed since UTMB’s down
Galveston County Daily News, Nov. 15, 2008
Admissions are up 40 percent, emergency room visits have increased by a third and operating rooms are running around the clock at Mainland Medical Center. Since Hurricane Ike ravaged UTMB’s John Sealy Hospital on Sept. 13, admissions at Mainland Medical have jumped, as has demand for other medical services it provides. Likewise, Clear Lake Regional Medical Center in Webster reported a 30 percent increase in hospital admissions while emergency room visits doubled. http://galvestondailynews.com/story.lasso?ewcd=cfdd17e4506f95c5c8545f57966c90b3

Waco representative fights for isle
Galveston County Daily News, Nov. 15, 2008
During a tour of Galveston Island, U.S. Rep. Chet Edwards said he would encourage FEMA to expedite funding for projects throughout the city to help officials prepare for next year’s tourist season. He also is pushing the agency to fast-track damage reimbursements for UTMB.
http://galvestondailynews.com/story.lasso?ewcd=cc9665b3336d78ee

UTMB woes back on county agenda
Port Arthur News, Nov. 15, 2008
BEAUMONT – Damage to UTMB continues to reverberate throughout Southeast Texas as counties reconsider medical treatment for uninsured residents. “This is something that is affecting not only Jefferson County, but much of the state in a critical way,” Bo Alfred, Precinct 4 County Commissioner, said. http://www.panews.com/local/local_story_320165336.html

Hospital flooded in storm to cut its staff by a third
New York Times, Nov. 14, 2008
This article summarizes the effect of Hurricane Ike on UTMB and includes comments from a number of UTMB employees, including Karen Sexton, executive vice president and CEO of the UTMB Health System. “We can’t make any promises,” she said, “because we don’t know what’s going to happen. We are committed to getting back into the health care business. We know we have to be a lot smaller right now.”
http://www.nytimes.com/2008/11/15/us/15hospital.html?scp=1&sq=%22medical+branch%22&st=nyt

UTMB layoffs may have major ripple effect in Houston hospitals
KTRK-TV (Ch. 13) Houston, Nov. 14, 2008
This report focuses on the effect that UTMB’s layoffs are having on hospitals in the Houston area.
http://abclocal.go.com/ktrk/video?id=6506299

checking out new space

2008-11-07T19:46:00.000-06:00

Today I got to go look at our proposed new clinic space. I was less than enthusiastic. We are so spoiled, having been in such a nice clinic up until hurricane Ike. The new space will work. I think. It's just not great.

We are to have 15 exam rooms and the two team rooms (precepting rooms) are each about half as big as in our previous space, which already felt pretty cramped. There is no room for medical students and very little room for faculty.

As we're walking the space, the clinic director says to the group that we need to look on the bright side. It took about half an hour for anybody to figure out what that was. And this is what we came up with:

It's better than the Fast Track in the ER, which is where we are currently seeing patients.
It's closer to the hospital than our previous clinic space, so more convenient in that way.
The waiting area is much nicer than in our old clinic.
And there is a beautiful view of Old Red from the registration area.

At least there's something good about it.

faculty presentations

2008-11-05T10:50:00.003-06:00

For STFM Annual Spring Conference 2009 in Denver CO:

Outcomes of a Texas Family Medicine Residency Rural Training Track: 2000 – 2008
Nash LR, Olson MM, Caskey JW, Thompson BL (scholastic poster)

Osteopathic Medicine: Contributions for The Future of Family Medicine
Nash LR, et. al. (1 day pre-conference session) (also includes Sierpina VS, Curka PA)

Portfolio Smorgasbord: Exploring Portfolio Experiences From Across The Country
Kulie T, et. al. (includes Williams RE) (3 hour theme session)

Integrative Medicine In Residency Curriculum: First Year Implementation And Evaluation
Lebensohn P, et. al. (includes Sierpina VS) (90 minute seminar)

Contributions of Community-based Preceptors to The Family Medicine Clerkship Curriculum
Bulik RJ, Wright DP (scholastic poster)

Supplementing Student Experiential Learning At Community-Based Training Sites
Bulik RJ (special topic breakfast)

national conference presentations accepted!

2008-11-05T10:38:00.002-06:00

Congratulations to the Drs. Melendez on the acceptance of their scholastic poster for presentation at the STFM Annual Conference next spring! The title of their poster is "Community Medicine Program In Co-occurring Substance Abuse, Psychiatry Disorders And Primary Care, a Tri-service Model".

Good work!

opportunities to help

2008-11-03T16:33:00.002-06:00

The Texas Medical Association is hosting a fund drive for UTMB medical students. Click here to review the call and donation instructions.

letter to our applicants

2008-10-30T13:43:00.001-05:00

So… what about Hurricane Ike?!

This is a very good question you might ask yourself and us in relation to residency training at UTMB – Galveston!

What I can tell you at this point is that the Family Medicine Residency Program in Galveston is continuing. We have for many years been fortunate to have available to us community hospitals in the area for several of our core rotations, as well as electives. Thanks to our off-campus sites and community preceptors, the FMRP experienced the least disruption in training probably of all the UTMB GME programs. Our residents were back on clinical rotations within one week of landfall, although many chose to rotate out of the immediate Houston-Galveston area for one or two rotation blocks, due to housing and personal family needs. No delays in graduation related to the storm are anticipated.

We don’t yet know exactly what the future of the clinical enterprise on campus will look like. Possibilities range from the establishment of essentially a 200 – 250 bed community hospital to as much as full recovery (650+ beds) although I think what eventually will come to pass probably lies somewhere in the middle. Campus-based rotations continue to come back online as time passes and various departments make progress in the recovery effort.

The future location of our Family Medicine Center (outpatient clinic) remains under negotiation. The two most likely contenders seem to be 1) in the University Health Clinics building near the ER or 2) that our Primary Care Pavilion clinic will be refurbished. If the long-term decision is option #2, we may temporarily be housed in the UHC until the PCP is ready for our return. At present, we are temporarily located in the Fast Track area adjacent to the ER. The only thing I can tell you for sure is that we won’t be staying there!

Now, why should you come here? If you enjoy building things, consider yourself a pioneer or adventurer, have a strong sense of personal responsibility and professionalism and are flexible and innovative in making the most of a wide variety of learning experiences, this may be the program for you! While many of our core rotation experiences remain stable, we intend to take this opportunity to reevaluate our curriculum as a whole and reinvent ourselves to our best potential in the coming few years. Sometimes change occurs slowly and incrementally and sometimes it occurs quickly in big ways. It would be a shame not to capitalize on this opportunity for amazing progress and we don’t intend to miss it. Come join us and be a part of reinventing our future!

Lisa R. Nash, DO, FAAFP
Program Director

interviews

2008-10-20T16:04:00.003-05:00

5 brave souls who are not afraid of a challenge have signed up for interviews since we started inviting applicants last week! We are so excited to begin looking FORWARD and planning for the future, beyond our immediate recovery timeframe.

In further news, OB and Adult ER rotations at UTMB return to our schedule in block 6 (November 17) and we're excited about that too. This is "hot off the press" news, just learned today.

News about the FM Clinic and HOS service

2008-10-20T13:46:00.001-05:00

This morning’s update from Dr. Thompson included the news that the UHC building is currently targeted to be restored to service first, before the PCP. Most likely this means that our clinic will move to the UHC at least temporarily but possibly “permanently” (whatever “permanently” means…). Currently, the belief is that faculty offices, conference room space, etc. will remain in the 2nd floor of the PCP. Timeframe undetermined. I have sent an email to the powers that be requesting to be included in the decisions regarding our clinical space and also informing them of our RRC requirements. I will be looking forward to the opportunity to be involved in those ongoing negotiations.

The better news is that the first med/surg unit at JOHN SEALY is scheduled to open November 10, in time for us to resume our hospital service in block 6!! We have been promised beds, although I don’t have an exact number yet. As you know, L&D and NBN are already functional. I’m told no decisions have been made yet regarding pedi beds.

Last week we saw about 370 outpatient visits in our various locations, but mostly at Stewart Road. This is excellent, with steady increases in demand occurring every day. It is possible that I may put some R3s back into continuity clinics in this block even, so stay tuned! FYI, 370 would be about 50% of our normal volume for this time of year and is excellent under the circumstances. The key question is where will the demand level out? I’ve been saying all along that one of my indicators would be school enrollment. Last week while I was at Ball High for prenatal clinic, I learned that about 60% of GISD students have returned.

Today when I drove in, I noticed that almost all of the trash and debris has been removed from Holiday Drive between Seawall and Harborside. I got phone service at my house late yesterday afternoon. No DSL, but I do have telephone. And somebody (FEMA, the city?) picked up my stinky freezer full of rotten food from the alley. You may have seen that the curfew was lifted for all but part of the Strand and downtown areas a little over a week ago. The last Red Cross shelter on the island is closing today.

Slow but steady improvement all over the island is evident. We continue to await news from Dr. Callendar about the future of UTMB as a whole but at least I can say all things considered, FM is in about the best position we can be. Our programs are all functioning and we are serving our patients. Our students and residents are completing their educational experiences and we are going about our business.

Updated recruiting information

2008-10-16T13:42:00.002-05:00

Please see the link to the right regarding Info for Applicants 2009, as the information has been updated to reflect our current status related to recovery from hurricane Ike.

Also, our new website has launched and the link to the right has been updated, so check out our new look and available information!

Relocating

2008-10-02T14:10:00.002-05:00

We will close down our temporary office in Fort Worth tomorrow afternoon. Effective Monday, you can reach us at our usual telephone numbers in Galveston.

progress!

2008-10-01T10:08:00.002-05:00

Wow, finally some exciting news to report!

There is a preliminary prediction (unconfirmed as of yet) that the PCP 2nd floor (NOT the clinics) will reopen next week, which would allow the Residency Program faculty and staff to be all located in one place. Our usual place. It's so hard to believe.

I read on the UTMB updates today that MS1 and MS2 return to classes has been delayed to 10/20.

There are still tremendous difficulties with lack of housing. Dr. Triana is on the island now and will be actively seeking out opportunities for our residents, so watch for email from her. I've asked Becky to contact various island daycares and check on their status and openings, so if you have childcare needs, watch for emails from her too.

Our SRFH location is still expected to reopen this week (mobile units there now, faculty seeing patients) and we hope to have two residents there in block 5 for FM outpatient rotations.

Various favorite restaurants and businesses are starting to reopen... I've heard Casey's, Fishtails, Chili's and NY Pizza have all reopened for lunch service.

Program faculty have begun preliminary discussions about recruiting for the 2009 Match and we will have definitive plans in the next couple of weeks. At this point, we're thinking about recruiting for a smaller class, somewhere in the 4 to 6 range with the option to pick up some PGY2 residents in the following cycle. We may be able to locate hotel rooms for the applicants in Houston, which will make the process simpler. Most likely we will not begin interview until at the earliest the first week in November.

That's all for now, but watch the UTMB website, this blog and email for further updates! Things are beginning to happen faster now.

incremental recovery

2008-09-24T13:23:00.002-05:00

There is not a tremendous amount of "new" news since my last post. Incremental recovery efforts continue.

The FM residents are dispersed across the state and Linda and I are working on plans for block 5 now. We hope to have a little more than half to maybe 2/3 of the residents back to the Houston/Galveston area by the beginning of block 5. We are fortunate in that we've worked with a number of mainland community hospitals for certain core rotations for several years and they are up and running already and taking on additional residents beyond the usual numbers.

It looks like FM will be able to open one of our clinic sites in the next week or so and I hope to put some residents there for the outpatient FM core rotation in block 5.

This morning I read a news article stating that 75% of the island's housing is uninhabitable so I'm concerned that even once we're able to return, many of our patients simply will not be there. The ABFM is being flexible with us regarding continuity clinic requirements, but we will need to aggressively work towards recovery of our FMC even so. Dr. Thompson and others have this high on their priority list.

We're beginning to work on housing options for our residents whose housing is uninhabitable. This will be a significant challenge, given the widespread destruction of housing and very limited availability for the foreseeable future. We are exploring several different avenues as solutions.

No definite decisions regarding recruiting and the 2009 Match have yet been made. We WILL interview and recruit a class, although I'm not sure what size that class will be. I definitely plan to interview and recruit for our 2 PGY1 AOA positions and some ACGME positions as well, number to be determined. In all likelihood, we will not begin interviews until late October or early November. Stay tuned for further updates!

RTT article

2008-09-19T14:37:00.005-05:00

An article about our Rural Training Track was published in this month's edition of Texas Medicine.

Block 4 assignments

2008-09-19T14:37:00.003-05:00

All FM residents have now been reassigned for block 4 rotations. Early next week, Linda and I will begin working on block 5 assignments. We hope to begin bringing a few people back to the Galveston/Houston area. Primarily, this will be residents whose housing is habitable and on the mainland.

Generally speaking, recovery efforts on the island appear to running ahead of schedule, which is good news. I encourage you to keep up to date on the progress at the UTMB website, the Galveston Daily News, Channel 2 and KHOU. These are the most extensive coverage sites I have located and the ones I am personally following daily.

At present, it looks like we have about 6 to 8 residents whose housing on the island is definitely or likely not habitable upon return to the island. These will be the folks who are on displaced rotations longest. The Chiefs are busy compiling a list of residents and faculty who have space in their homes for temporary housing and we will coordinate that as it becomes feasible to bring people back to the local area.

All things considered, I'm feeling optimistic about recovery for the Family Medicine Program.

the scope of the problem

2008-09-18T13:25:00.001-05:00

If you're wondering how big a job UTMB faces in terms of its medical students and residents, see the excerpt below. Full article here.

Campus officials say it could be a month or more before the hospital resumes regular operations and is able to bring all of its students and residents back. In the meantime, administrators are working on temporary placements for 557 medical residents and about 2,400 medical, nursing, allied-health, and graduate students. The hospital has about 12,000 employees, 8,000 of whom work in Galveston.

new office location, general update

2008-09-17T15:48:00.003-05:00

After 22 hours traveling yesterday, I am now sitting in the fully equipped temporary FMR Administrative office at Texas College of Osteopathic Medicine in Fort Worth. They have graciously agreed to house us for the immediate future, until we are able to return to the UTMB-Galveston campus.

Our new telephone number is 817-735-2737.

Almost all of the FM residents have new rotation assignments to begin on Monday in accordance with our usual rotation timeline. We should have that task completed by the end of the week so that everyone can be back to clinical work/education on Monday 9/22. It is anticipated that no one in the FMR will have a break in training.

Many, many thanks go out to FMR Program Directors across the great state of Texas, all who have volunteered rotations and many also housing for our residents. We are deeply grateful.

Applicants for the 2009 Match can expect an update regarding our status within the next two weeks, after we've been able to attend to the immediate needs of our current residents.

All FM residents and faculty are holding up well and making the best of a difficult situation. From my perspective, I feel a little bit guilty because although I'm displaced, the inside of my home is virtually untouched and will be easy to move back into. I am sitting in an air-conditioned office and am well-supported. I have electricity and internet access and I can buy gas without waiting in line for 90 minutes. When I turn on the tap, water comes out and I took a wonderful shower this morning. My kids, pets and I are safe and healthy and housed with family. All things considered, I have much to be thankful for.

communications

2008-09-15T13:29:00.001-05:00

UTMB email system is operational again, so we will resume using that as our primary communication venue.Updates will be posted here from time to time, but please communicate with me by email from now.

housing/rotations

2008-09-14T18:51:00.002-05:00

I heard from Donna just a little bit ago. UTMB medical personnel are being relieved by a military medical unit. Donna has also been in contact with Adriana.

I understand from the two of them that there are a number of residents who are in hotels and need to be relocated. I'm not having much luck reaching people by cell phone, so please post a comment here and let me know if you are in housing where you can remain for potentially 2 to 4 weeks or if you need to be relocated. Linda and I will be working to make arrangements starting tomorrow.

Everyone try to be patient. Hang in there and call either Linda or me if you don't hear from us in the next 48 hours. Meantime, leave a comment here and let me know your housing status/needs.

Press conference

2008-09-14T13:07:00.003-05:00

The mayor says there is no water, no gas, no electricity and no communications. No time estimate about restoration.

Governer Perry says DO NOT make any effort to return to the island until further notice.

City Manager LeBlanc says UTMB is first on the list for restoration of services and the timeline is 1 week.

Search and rescue is the immediate concern and all efforts directed towards that until this has been completed. As of last night, they had completed to 11 mile road. Current info is that 3 bodies have been found.

For the residents - my plan is to have everyone sit tight for the remainder of this week. If we do not have information regarding imminent re-entry to the island towards the end of the week, I will locate alternate assignments for you all, hopefully in the areas where you are currently evacuated to. It will be important to begin bringing people back to the island as it is re-opened because we will need to be available as recovery begins. Some of the recovery work will be dependent upon availability of medical services when needed so we need to be there to do our part.

Stay tuned.

anyone checking here?

2008-09-14T11:41:00.001-05:00

Residents & Faculty: please post a comment if you are checking this blog! It only just occurred to me to try to communicate with everyone this way. The UTMB alert website is up but minimal information is being posted there. I have not been able to log in to the email system to try to reach everyone that way.

As I'm sure you know, very little information is coming from the island. Our faculty and staff who stayed on the island are all safe as far as I know. I've heard directly from or about Dr. Thompson, Dr. Simmons, Dr. Yadiki and Becky.

The best source of information that I've located is KHOU. They are broadcasting on DirectTV channel 361 non-stop. Their website is also being updated regularly. They just posted an important update. The mayor is supposed to hold a press conference at 1pm. Residency staff and I will be making another round of telephone calls to update everyone, but the latest I've heard to this point is that it will be AT LEAST Tuesday or Wednesday before the island is re-opened. IMO, that may be an optimistic timeline. Everyone please just stay put where you are for the immediate future and await further instructions.

2008 ALSO Course

2008-08-27T08:16:00.008-05:00

As usual, I had a blast at our annual multi-residency ALSO Course, held in Baytown last week. I enjoyed working with both our residents and the others and working with my FMOB faculty colleagues from across the region.

I think the residents had fun too, or at least if anyone didn't, they didn't tell me! Several of you commented to me that you learned a lot and had a good time. And now you all have the basic tools you need for managing urgent and emergent situations in L&D. You just need some experience putting them into practice.

Click on the photo to access the photo set.

new FM baby!

2008-08-19T10:31:00.001-05:00

Drs. Hanan Hussein and Saleh Elsaid (both faculty) welcomed a new addition to their family today!!

baby Saad, 6lb and 6oz

Everyone is doing well.

More end of Block 1 photos

2008-08-15T11:08:00.001-05:00

End of Block 1 Party - Galveston Country Club

2008-08-15T11:04:00.000-05:00

updates on Edouard

2008-08-04T13:49:00.002-05:00

Keep abreast of the UTMB emergency management plans re: Edouard here.

All residents should have received your individual assigments from Residency staff already. If you have questions or did not receive the message, contact me on my cell phone or staff at the office until 3pm.

Why Your Doctor Needs A Raise...

2008-08-04T13:46:00.001-05:00

The good news: A year into our grand healthcare experiment, nearly everyone in Massachusetts has insurance. The bad: It's never been harder to actually get in to see a doctor. The fix? Pay primary care physicians more. Lots, lots more.

Sound interesting? Read the entire Boston Magazine article here.

kudos to Dr. Gomez!!

2008-07-28T11:29:00.001-05:00

Dr. Gomez' presentation has been accepted by the NAPCRG Program Committee for presentation at the 2008 NAPCRG Annual Meeting being held Nov 15 - 19 at Wyndham Rio Mar, Rio Grande, PR.

Poster on Research in Progress Submission
Submission Title: Relationship between Depression and glycemic control and its correlation with medication adherence in patients with Diabetes Mellitus type 2: a cohort study in a primary care setting

Interesting discussions

2008-07-25T13:23:00.003-05:00

Today I attended a school of medicine committee meeting where one of the agenda items involved a discussion about teaching behavior change counseling techniques to medical students. As part of the discussion, a concern was raised about identifying and teaching skills for students to deal with their own personal biases that might affect their patient care... primarily biases that center around choices patients make that are not in the best interest of their health. And whether or not students personally make some of those same choices and how that impacts their patient care. Interesting discussion.

Which led me to remember something that happened to me during medical school and residency, and some lingering thoughts about how the things that happen TO us during training also create some biases that have the potential for affecting our patient care.

Have you ever read the book House of God? I hadn't read it until medical school. There was a great deal of discussion about that book among a group of my peers at some point and I was pretty out of the loop, having not read it. So, as a first year medical student, I read it. I was horrified and apalled that anyone could possibly conceive of health professionals thinking about and acting toward their patients in some of the ways described. Horrified. And personally insulted, actually. Certainly I would never do such things. Would I?

Five years later, as a second year resident, I read the book again. (Because, let's face it, who has time as an intern to read anything not absolutely necessary and related to what might confront you immediately or in the next 24 hours?!) My experience this time was vastly different. Vastly. So much that I'm at least a little bit ashamed. I remember laughing until tears ran out my eyes at some points. I remember completely identifying with some of the circumstances and situations described. At the time, I remember thinking how naive and idealistic I was as a first year medical student.

Now, a good number of years removed (we won't go into detail about how many) from the supreme endurance test of q3 call blocks and 100+ hour work weeks (yes, I pre-date duty hour restrictions), I once again have a different perspective. I think about discussions among my current faculty peers, about how we seem to do our best to "train out" some of the very best qualities in medical students and residents. We all seem to lose some of our humanity in the process. I like to think that these days that I'm a lot closer to the humanity and idealism I started out with than to the ridiculously over-fatigued and callous R2 I became for a time.

I invite your thoughts and reflections on this topic...

Play-Doh Workshop

2008-07-16T16:46:00.003-05:00

We recently had our Circumcision workshop for the interns during Orientation. They were all quite excited about getting to play with Play-Doh during this experience. Unfortunately, we had a few untoward outcomes with detachment of certain important anatomic structures, but in the end it was a successful activity. And a good time was had by all, including me! What a great group of interns!

Information for applicants 2009

2008-07-08T15:58:00.004-05:00

Update to reflect the impact of Hurricane Ike:

10/16/08 The UTMB campus continues its recovery efforts. As of today, FM is seeing patients in three clinical sites... a new shared/borrowed space on the mainland at League City, our faculty clinic Stewart Rd location and temporary space in the Fast Track area of the ER. We are in negotiations at present for the relocation of our hospital service, which I expect to take place in the next week or two. This will be a temporary measure until the John Sealy Hospital on campus reopens.

We will be recruiting for a class of 4 in the 2009 Match and have just as of yesterday begun to issue interview invitations. I anticipate that we will interview about 40 - 45 applicants. You can help us greatly by keeping your application status up to date and advising whether you plan to accept or decline the invitation to interview once received.

Thank you for your interest in our program. If you enjoy being part of building something new and dynamic, you will find great experiences, training and professional community as we emerge from the effects of hurricane Ike!

Dear Applicant,

Thank you for your interest in our residency training program.

Our basic requirements for consideration for interview include:

graduation from medical school within the past five years (not flexible)
passage of USMLE I and II, including CSA (preferably on first attempt) OR COMLEX for Osteopathic students. Obviously, the better your scores, the stronger will be your application.
some U.S. clinical experience
three letters of recommendation, at least two of which MUST be from family doctors.

We accept applications only through ERAS. Please do not email me long attachments in an attempt to circumvent the process because I will not read them. If you meet our criteria outlined above, then apply through ERAS. This will ensure that your application is reviewed.

Osteopathic students may apply to our program through either or both Match processes, however you will only be guaranteed a dual-accredited slot by matching through the AOA Match.

We will begin our interview season for the class entering in 2009 in September 2008 for Osteopathic students and October 2008 for all. We hope to conclude interviews by end of January 2009. We will begin screening applications immediately as they become available through ERAS. We will schedule interviews until we have interviewed sufficient candidates to fill our class, so you are encouraged to apply early.

Our program does sponsor J1 visas. Our program does NOT sponsor H-1 visas.
UTMB does NOT sponsor externships or observerships for persons who have already graduated from medical school.

Please see our Residency website for more detailed information regarding our program. For specific questions that may not be covered, please contact our recruiter, Mr. Louis Johnston. His contact information is listed on the webpage.

Lisa R. Nash, D.O.
Program Director
UTMB Family Medicine Residency

UTMB FMR Graduation 2008

2008-06-27T16:02:00.003-05:00

Click to view the 2008 graduation photos!

Many thanks to Cassie Boatwright (our photographer) and Becky Hamilton (our video producer). The photos and video are outstanding and I know our graduates will cherish them for years to come.

salary increases!

2008-06-16T08:19:00.000-05:00

We are pleased to announce the pending salary increases for House Staff have been approved effective September 1, 2008, reflecting the October 1st paycheck.

PGY-1: $42,757
PGY-2: $44,015
PGY-3: $45,620

PHNP

2008-06-05T13:44:00.002-05:00

Our Grand Rounds presentation June 5th was given by Dr. Ana Malinow. It was an excellent presentation covering U.S Health Care Policy. I encourage you to look at the following resources:

Physicians for a National Health Program

Healthcare for All Texans

One of the most sobering points in her presentation was when she asked how many of us in the room had ever been uninsured. This was an audience of medical students, residents and faculty physicians and other faculty members. About 50% of the people in the room raised their hand. I was one of them. Can you imagine?! Fifty percent of the healthcare professionals in that room have been uninsured at some time in their life. Unbelievable. And unacceptable.

exciting faculty developments

2008-06-05T11:15:00.003-05:00

Yesterday I met with our new part-time faculty member (Peter Curka, DO) who starts next week and we enjoyed planning our Osteopathic Manual Medicine (OMM) conferences for next year and some of the other projects he will be involved with. DO and Alternative & Integrative Medicine track residents will be required to attend, our other MD residents are welcome and we have two MD faculty members who already have requested to attend the course.

Our OMM Consult Clinic will be open for scheduling in the next six weeks or so. Of course, all the DOs in our practice also are able to schedule OMM in their continuity clinic, but the consult clinic will allow our MD colleagues to easily refer patients for OMM.

We are in the process of setting up an interview with another DO candidate for a full-time faculty position with the residency as well.

Today I interviewed a faculty candidate for Residency who has a CAQ in Sports Medicine (MD) and will take the lead on development of our Sports Medicine fellowship if we are successful in recruiting him. You may remember that one of our 2007 graduates is starting his Sports Medicine fellowship next month and we hope to also recruit him back to join the faculty.

It’s exciting times around here at UTMB!

Departmental Review

2008-06-04T08:22:00.003-05:00

Recently, our Department underwent the most recent formal review. These occur roughly every 5 years and are rather a big deal in the land of academic medical centers. Among other things, the Departmental Review identifies strengths and suggests areas for improvement. For this post, I'd like to share with you the strengths identified by our reviewers.

8/8/8 FMRP scheduled for next review in about 18 months
Adequate patient volume to support most aspects of outpatient and inpatient training, with the exception of maternity care. (Maternity care being an area we've been working on with various strategies for the past several years. More to follow on that front...)
Resident graduates who remain to practice in the region
Unusually high percentage of residents graduating this year entering various fellowship programs
Strong commitment to rural education via a rural track residency program
Residen tcohort who reports satisfaction with attending support in both the hospital and ambulatory settings
Adequate administrative resources in support of residency training
Strong faculty commitment to residency teaching in all clinical venues
Appropriate educational relationships with other disciplines providing training for Family Medicine residents

Sports Physicals day

2008-05-28T08:30:00.000-05:00

AODME Conference

2008-04-11T13:16:00.002-05:00

I've been away this week, attending the Association of Osteopathic Directors and Medical Educators annual meeting.

Many of you know that we have received our Osteopathic certification this past year for the residency program. Our Osteopathic residents will be eligible upon completion of the program to sit for both the ABFM and AOBFM certification exams.

The meeting I'm currently attending includes educators from both undergraduate and GME settings, as well as across multiple specialties. One of the things I've been struck with during the course of the meeting is how closely aligned allopathic FAMILY MEDICINE is with Osteopathic Philosophy and Practice (OP&P). What I mean by that is primarily related to the bio-psycho-social approach, the doctor-patient relationship and communication skills. All of my allopathic/ACGME residents are being instructed in OP&P... you just didn't know it!

As a result of our recent certification and the inclusion of more DOs in our program from here forward, I will be making more of an effort to explicitly point out OP&P where it occurs in our training program. We will also begin an Osteopathic Manual Medicine workshop series as a component of our Thursday afternoon didactics. Our DO residents will be required to attend and the MD residents will be invited.

I've learned a lot of good things at this conference and I plan to share a number of them here through the blog over the next few days.

A FM kid turns 1!

2008-03-23T09:09:00.002-05:00

Josie (& Family!) blow out the candle

My girls looking at a HUGE redfish in the aquarium

Abbye & Dani

(children of Dr. Nash (L) and Dr. Alonso (R))

Dr. Montiel in the background

The big event was held at Moody Gardens and I think everyone had a blast. Many thanks to Dr. Montiel for inviting us to the party. :-)

Welcome, Class of 2011!!!

2008-03-21T08:43:00.002-05:00

Michael Crawford – University of Texas Medical Branch – Galveston
Richard Donaldson – W. Virginia School of Osteopathic Medicine
Cesar Gerez - Universidad Autonoma de Tamaulipas, Tampico Mexico
Eduardo Guerra Valencia - Universidad Peruana Cayetano Heredia, Peru
Toni Hernandez – University of Texas Medical Branch – Galveston
Jose Rodriguez – Universidad de Oriente, Venezuela
Lisset Parets - Saint George's University, Grenada
Bhanu Yadiki - Jss Medical College, India

Match Results Show Resurgence

2008-03-21T05:24:00.002-05:00

According to AAFP, the 2008 Match results show a resurgence in interest in Family Medicine.

Although helpful, the increase still falls short of estimated manpower needs for 2020.

The fill rate for FM was 91% this year, which explains what the Scramble pool liked like to me... more US grads unmatched than I expected.

Read the full story on the AAFP website here.

filled!

2008-03-20T17:00:00.003-05:00

We have filled our incoming class for 2008!!

I'd like to thank the applicants who made the trek to Galveston to interview. We have selected our final candidate and as soon as I have a chance to notify each of those who interviewed, I will post our new class here. We had 830-some-odd applications through ERAS for our two positions, so it was an extremely competitive field. That is not counting the emailed applications, phone calls and attempted faxes that we received. True to our word, we screened only those applications submitted through ERAS. Unfortunately, many people did no research to know that we would not accept email applications and I found myself deleting massive amounts of email several times a day just to keep my email working.

The Scramble (or re-Match as some now like to call it) is always a challenge. It's a much higher stakes, higher stress level process for all involved than the regular interview season, and that's saying something.

My staff did a wonderful job answering the phones, often redirecting frustrated applicants to ERAS submission and offering helpful advice. They screened calls directed at me so that I was able to focus on the business at hand, which was screening applications, selecting and interviewing appropriate applicants and making tough decisions. I'd like to thank them as well. If you tried and weren't able to get through to me directly, please know that my staff did pass on all messages from faculty members and medical schools and all applications referrenced in those messages were personally screened by me.

I also need to thank the faculty and residents who participated in the selection, pre-screening and interview process. In particular my residents found Scramble stressful and I was proud of the way they handled it. We would not have been as successful as we were in selecting our final two members of the class without the residents' help.

We have a great group of residents here at UTMB-FMR, and I'm confident our incoming class will continue the tradition.

Criteria

2008-03-19T08:25:00.002-05:00

Please review our criteria for applicants here.

I WILL NOT REVIEW APPLICATIONS SENT BY EMAIL OR FAX. You MUST apply through ERAS.

Additionally, you must have graduated from medical school 2003 or more recently. Your medical school must be on the approved list for the Texas Medical Board, which you can review here. Click on the link "Substantial Equivalence".

We have one remaining position and will be interviewing selected applicants today and tomorrow.

1 spot left

2008-03-18T16:13:00.003-05:00

We have screened all applications submitted through ERAS for the Scramble. We have interviews scheduled with selected applicants today, tomorrow and Thursday. We have filled one position and have one remaining.

Because we require an in-person interview, there were several excellent applicants who are geographically challenged to get here in our timeframe. I am holding those applications for now and if we do not fill our remaining position with any of the applicants currently scheduled for interview, we will be contacting additional applicants to set up interviews.

Thank you all for your interest in our program, and I wish you the best of luck with the Scramble.

Scrambling for 2

2008-03-18T12:09:00.002-05:00

We will be scrambling for two additional residents for the coming year.

We are accepting applications only through ERAS, so please do not call, fax or email. Just send your application through ERAS.

You can find our criteria here.

We do require an in-person interview, so you must be able/willing to travel to Galveston this week.

We will contact successful applicants as we screen your application.

Chief Residents 2008-09

2008-03-18T10:02:00.003-05:00

I am pleased to announce our new Chief Residents for 2008-09!!!

Dr. Donna Simmons (L) and Dr. Adriana Gomez (R)

Welcome, and I look forward to working closely with you over the next year.

schedule oddities

2008-03-05T09:37:00.002-06:00

Bear with me, this is complicated...

The FMR tries to maintain our schedule in accordance with the Dean's calendar for the medical students, as do most of the other GME programs at UTMB. We do this for many reasons, one of which is coordination. The more of us who are on the same schedule, the simpler it is to manage rotation orientations and that sort of thing. Periodically, the medical school alters the schedule by a week at the beginning of the academic year. This is one of those years.

Block 13 of AY2007-08 ends on June 22. Block 1 of AY2008-09 will not begin until June 30.

Graduating resident contracts end June 30. As has been our custom, R3s will be scheduled for their mandatory university checkout routine during that extra week. You may also use up any comp time you've accrued and/or take vacation days, once your checkout obligations are met.

Linda is in the process of investigating our options for the current R1s and R2s. If you are on the FM Hospital service, block 13 will be 5 weeks long for you, and you will remain on the hospital service. This may also be the case for certain other rotations - likely MICU, Newborn Nursery, ER, etc. We will let you know as soon as we know. For some, we will schedule you for R2/R3 Orientation activities during that week. Likely that will be no more than 3 days (hopefully just 2), so that may turn out to be a good time to take some comp or vacation days as well. Stay tuned for updates as more information becomes available. See Linda if you have individual questions.

Attention R1s!

2008-03-05T09:29:00.002-06:00

R1s who are interested in the Rural Training Track and/or Ball High Prenatal Clinic for next academic year need to submit:

Rural Training Track - updated/current CV, copy of your ITE scores, and letter or email outlining the reason(s) for your interest in the program. We will be scheduling interviews with the RTT faculty in the very near future. As a reminder, the RTT faculty choose the residents who will participate in the RTT. Current R2s will automatically be enrolled for PGY3 unless I hear differently from you... Jaime and Rene. Submit documents to the Program Director.

Ball High Prenatal Clinic - email or letter (to me) outlining the reason(s) for your interest in participating. Generally speaking, this opportunity is appropriate for residents who have a higher than average interest in including maternity care as part of their future practice.

Deadline is Friday, March 14 at 5pm.

A new addition to the family!

2008-03-03T11:37:00.002-06:00

Congratulations to Dr. Liliana Andrade and family on their new addition:

Andres Eduardo was born on 02/26/08 at 12:46 pm. He weighted 6 lb and 2 Oz. and his length was 18 1/2 inches.

Evaluations

2008-02-28T13:25:00.001-06:00

R3 Evaluation Meeting was held today. R3s, please check the portfolio for a summary within the next few days.

Will There Be Enough Family Doctors?

2008-02-15T09:56:00.000-06:00

Please watch this short video produced by TAFP. It features (among others) Dr. Falcon, who is one of our preceptors in Rio Grande City, Dr. Clare Hawkins who is the FMR PD in Baytown and Dr. Sam Adkins who is the FMR PD in Austin. Residency funding is addressed.

BTW, UTMB residents - on 2/12 the GMEC voted near unanimously (1 nay) to recommend a pay raise for next fiscal year. This recommendation goes to Finance. When further action is taken, I'll post an update.