Question/Comment: Please clarify #18 on the Navigant recommendations, with reference to limiting total residents to those with outside funded resources.
Response: Recommendation 18 reads: “Limit the total number of residents to those with outside funding sources.”
The only significant external source of funding for graduate medical education (GME) costs is Medicare. However, Medicare has established “caps,” or limits on the number of residents it is willing to fund. For UTMB, the Medicare cap is 497 residents. In 2005, UTMB had 563 residents. We fall short of being fully reimbursed for what it costs us to train our residents. Adding to the direct cost of “extra” resident positions, the university must also support additional faculty to help train and supervise those residents, must treat a proscribed number of patient conditions to provide sufficient clinical experience (many of those patients are unfunded), and incurs additional administrative costs. Navigant estimated that our total unfunded costs associated with GME amounted to $26.4 million, a large amount for UTMB to absorb.
UTMB, through a committee specifically charged to explore this issue, is currently considering the consultant’s recommendation to reduce the number of residents to the Medicare cap, which is what one typically sees at other academic health institutions. The recommendation has not been accepted yet.
Downsizing the number of residents is a complicated and somewhat long-term process that would need to be undertaken carefully and strategically. It would need to be achieved over several years by reducing the number of new residents coming to UTMB rather than reducing the number of residents already here.
http://www.utmb.edu/president/FIP/FAQs.htm
LRN comment: looks like the difference is about 66 slots, which is quite a bit different than the 118 slots currently circulating the rumor mill. Let's hope the downsizing applied to GME is closer to the 66 cap/gap in the MCR funding.
Saturday, July 29, 2006
Friday, July 28, 2006
FAQ - continuity OB
Every year, I'm always asked what exactly counts as a continuity OB delivery. This topic was addressed at the Program Directors' Conference in June. You are required to do 10 continuity deliveries AND 40 deliveries total. Your 10 continuity deliveries may be counted toward your 40, as may any deliveries you do for your OB buddy (I'd try to make sure I saw all my OB buddy's continuity patients at least twice for prenatal visits too) and all deliveries that happen on your rotations.
In order to be eligible to count the delivery as a continuity delivery, you MUST have:
1. seen the patient for two or more prenatal visits AND
2. either perform the SVD or assisted in the C/section (scrub in) AND
3. see the patient post-partum
Duty hour exceptions are allowed for continuity deliveries.
You may count up to 10 C/sections (that you at least scrubbed in for) toward your total requirement of 40 deliveries.
If an R1 or R2 is supervised by an R3 for the delivery, both may count the delivery toward their 40. If the continuity requirements are met for both residents, then both can also count them toward the continuity requirement of 10.
In order to be eligible to count the delivery as a continuity delivery, you MUST have:
1. seen the patient for two or more prenatal visits AND
2. either perform the SVD or assisted in the C/section (scrub in) AND
3. see the patient post-partum
Duty hour exceptions are allowed for continuity deliveries.
You may count up to 10 C/sections (that you at least scrubbed in for) toward your total requirement of 40 deliveries.
If an R1 or R2 is supervised by an R3 for the delivery, both may count the delivery toward their 40. If the continuity requirements are met for both residents, then both can also count them toward the continuity requirement of 10.
Tuesday, July 25, 2006
R2 Advisor meetings due
R2 meetings with your Faculty Advisor are due to be completed by the end of the month, in preparation for the Quarterly Faculty Review next week!! R2's, if you haven't met with your Advisor this month, please do it this week.
This will be our first month to use our new online portfolio for documenting the meetings!! You don't have to chase down that paper form any longer. But please make sure you have set the appropriate permissions for your Advisor in the portfolio prior to the meeting. Also please set them for me, as I will need to be able to display the pertinent sections for the Quarterly Review.
Heads-up to the R3's: your Advisor meetings are due in August, so please get those scheduled.
Thanks, everyone!
This will be our first month to use our new online portfolio for documenting the meetings!! You don't have to chase down that paper form any longer. But please make sure you have set the appropriate permissions for your Advisor in the portfolio prior to the meeting. Also please set them for me, as I will need to be able to display the pertinent sections for the Quarterly Review.
Heads-up to the R3's: your Advisor meetings are due in August, so please get those scheduled.
Thanks, everyone!
Saturday, July 22, 2006
We had a great time at the party! I'm glad so many people were able to make it. If you missed it, you missed some of the best BBQ brisket in TX! My Dad really knows how to do it. Everyone ate well, we had lots of kids and a wonderful time. In addition to our new R1 class, I was really happy Lorena S., who will join our next class, and her husband were able to make it as well. Andy took advantage of his last FMR party opportunity too, as he will be 
graduating at the end of next block. David came as soon as he handed off the call pager to the night float resident. All in all, it seemed each class was well represented.
We missed Hanan and Saleh, who had a tragedy in their family this past week. Please keep them in your thoughts and prayers and let's all do what we can to help them in the coming days.
Most of us had our first opportunity to meet Dr. Weaver's newly-adopted son, from Perm, Russia. It's good to see our family growing, and he is a perfect addition. There were a few new children in the new R1 class too.
Linda is talking about having end-of-rotation 2 at her house, so I'll let her keep us posted about the plans for that. Dr. Thompson also wants to have a party soon at her house and end-of-rotation 3 might be a really nice time of year for that, with her house on the water and opportunities to fish off the deck.
Thanks for coming everyone. I enjoyed having you at my home and the opportunity to spend some casual and fun time with you all.
Friday, July 14, 2006
Strolling Through the Match
Last night was the FMIG's annual Strolling Through the Match. I think the turnout was smaller than last year, but there were lots of good questions. It's always an exciting time to help students get ready for the Match process. It's also a good opportunity to visit with some of my fellow Program Directors. The TX PDs are a pretty close group and we enjoy getting together.
I still can't believe it's almost that time already.
Let me review some of the "top tips"...
Load your documents to ERAS early.
Be sure your letters of recommendation are appropriate to the programs where you're applying. For example, if you're applying to both Pedi and FM, make sure you send the correct letters to the program. It's very bad form to send a FM PD a letter that says, "I'm so pleased to recommend X to you for your Pedi program..."!! It's also not very cool for the letters to be generic. They should indicate that the person writing it knows which specialty you're applying for. The letters should come from practicing physicians, not residents or fellows. Letters from community physicians are encouraged. Some programs prefer to see that you've waived your right to review the letters before they're uploaded.
Personal statement - draft it NOW, and then put it away for a few days. Get it back out and reread it. Have two or three other people read it and give suggestions. Run spell checker. Check your document after you upload it. Sometimes ERAS does weird formatting things and you'll want to correct those. If you had some stumble in medical school or took a leave of absence, the personal statement is the place to address that. Hopefully you will be able to say what you learned from that experience and put a positive spin on it. Don't lecture to us about what is Family Medicine... we already know. We do, however, like to hear any personal experiences you may have had that influenced you to choose FM.
Choosing programs - don't forget, if you will be moving with family that your family has to be happy there too. If they're not happy, you're not going to be either. The consensus among the PDs is that the most important thing is that you like the people you will be working with... that you get a good feeling from the faculty and residents you meet and feel comfortable in the environment. What you get out of residency is a whole lot about what YOU put into it and less so about details of the program. Remember, the accreditation process makes sure all the programs have the minimums. That said, if you have special interests... THAT is worth considering. Make sure the programs you're looking at can meet those needs.
Interview - be on time and be professional. Dress nice. Be on your best behavior. Turn off your cell phone or leave it in the car. Ask questions every time you get an opportunity, even if you've already asked the same question of someone else that day. At the very least, you'll get a different perspective. Most programs have residents involved in the interview process. Often, it is a more casual atmosphere such as a lunch or dinner. Remember that this too is part of the interview process. Being able to work in a team and get along with a group is a huge part of residency, and we'll be looking for clues about you during the group activities. Although more casual, they ARE a part of the interview process. Review your notes about the program the night before the interview. If you are knowledgeable about the basics, it shows real interest in the program and that's important to us.
Don't interview with your top pick first. Do a "practice interview" or two with programs you think are probably lower on your list.
Special needs - if you're couples matching or have a spouse who will need a certain kind of job, there will times it is appropriate to ask for that sort of information. Please do, because it's likely we can help you. We can set you up with a realtor, make sure you get to see the public school system, or whatever you need.
Most importantly, be yourself. Don't put on a show to be what you think the program wants. Obviously, you do want to put forward your best image, but don't try to be something you're not. Chances are, you're going to just know when the fit is right.
Talk to as many 1st and 2nd year residents currently in the program as you can. These are the people you will spend the most time with over the next 3 years of your life.
Good luck! We look forward to seeing you over the coming months.
I still can't believe it's almost that time already.
Let me review some of the "top tips"...
Load your documents to ERAS early.
Be sure your letters of recommendation are appropriate to the programs where you're applying. For example, if you're applying to both Pedi and FM, make sure you send the correct letters to the program. It's very bad form to send a FM PD a letter that says, "I'm so pleased to recommend X to you for your Pedi program..."!! It's also not very cool for the letters to be generic. They should indicate that the person writing it knows which specialty you're applying for. The letters should come from practicing physicians, not residents or fellows. Letters from community physicians are encouraged. Some programs prefer to see that you've waived your right to review the letters before they're uploaded.
Personal statement - draft it NOW, and then put it away for a few days. Get it back out and reread it. Have two or three other people read it and give suggestions. Run spell checker. Check your document after you upload it. Sometimes ERAS does weird formatting things and you'll want to correct those. If you had some stumble in medical school or took a leave of absence, the personal statement is the place to address that. Hopefully you will be able to say what you learned from that experience and put a positive spin on it. Don't lecture to us about what is Family Medicine... we already know. We do, however, like to hear any personal experiences you may have had that influenced you to choose FM.
Choosing programs - don't forget, if you will be moving with family that your family has to be happy there too. If they're not happy, you're not going to be either. The consensus among the PDs is that the most important thing is that you like the people you will be working with... that you get a good feeling from the faculty and residents you meet and feel comfortable in the environment. What you get out of residency is a whole lot about what YOU put into it and less so about details of the program. Remember, the accreditation process makes sure all the programs have the minimums. That said, if you have special interests... THAT is worth considering. Make sure the programs you're looking at can meet those needs.
Interview - be on time and be professional. Dress nice. Be on your best behavior. Turn off your cell phone or leave it in the car. Ask questions every time you get an opportunity, even if you've already asked the same question of someone else that day. At the very least, you'll get a different perspective. Most programs have residents involved in the interview process. Often, it is a more casual atmosphere such as a lunch or dinner. Remember that this too is part of the interview process. Being able to work in a team and get along with a group is a huge part of residency, and we'll be looking for clues about you during the group activities. Although more casual, they ARE a part of the interview process. Review your notes about the program the night before the interview. If you are knowledgeable about the basics, it shows real interest in the program and that's important to us.
Don't interview with your top pick first. Do a "practice interview" or two with programs you think are probably lower on your list.
Special needs - if you're couples matching or have a spouse who will need a certain kind of job, there will times it is appropriate to ask for that sort of information. Please do, because it's likely we can help you. We can set you up with a realtor, make sure you get to see the public school system, or whatever you need.
Most importantly, be yourself. Don't put on a show to be what you think the program wants. Obviously, you do want to put forward your best image, but don't try to be something you're not. Chances are, you're going to just know when the fit is right.
Talk to as many 1st and 2nd year residents currently in the program as you can. These are the people you will spend the most time with over the next 3 years of your life.
Good luck! We look forward to seeing you over the coming months.
Thursday, July 13, 2006
Keeping up with Navigant
The FM Department budget has been completed, submitted and provisionally accepted. The campus-wide update is that about 70% of the budget cuts recommended by Navigant have been included in the FY07 budgets. Dr. Stobo plans to hold us to 100%. We are awaiting an update on where the remainder will come from... hopefully from the areas that have not yet achieved their Navigant budget target.
The plan regarding FMC support staff (nursing and administrative, OSA, etc.) has not yet been made public. I know that Lynda and Cheryl are currently working on it.
No further word on the recommended GME cuts... Hopefully, we will hear soon because we are beginning plans already for recruiting season. At this point, I remain hopeful that the impact to the FMR will be none or at least very small.
For those of you following from out of town, I'm including some links to articles in the Galveston Daily News.
July 13 July 10 July 8 July 6
The plan regarding FMC support staff (nursing and administrative, OSA, etc.) has not yet been made public. I know that Lynda and Cheryl are currently working on it.
No further word on the recommended GME cuts... Hopefully, we will hear soon because we are beginning plans already for recruiting season. At this point, I remain hopeful that the impact to the FMR will be none or at least very small.
For those of you following from out of town, I'm including some links to articles in the Galveston Daily News.
July 13 July 10 July 8 July 6
Tuesday, July 11, 2006
kudos to Ron
Ron has been invited by the AAMC to come show them our portfolio. They are currently working on their own portfolio project, so kudos to Ron for being invited to this collaboration!
Wednesday, July 05, 2006
End of Rotation 1 Party
Don't forget the annual End-of-Rotation 1 Party. It will be at my home this year. My dad is doing his famous brisket and we'll have the usual accompanying food and beverages. Bring your families and a few lawn chairs. It will be held on the last Friday of rotation 1, from 5:30pm until 9:00pm. At that point, my parents and I turn into pumpkins, so if you want to continue partying you'll have to follow Louis to the next location! R1s can check with the upper level residents for the inside scoop on that.
Mark the party on your calendars! Watch your email for directions and more details.
*****
In other news, I'm happy to welcome Oscar to the group and say the new class is now all present! This was a record year for getting in-training permits, visas, and all other necessary paperwork done! A big thank you goes out to all the incoming residents and to the FMR staff for being prompt and efficient with all of that. No easy task. Good work!
*****
Check out the progress Darren Burns has made on our snazzy new electronic resident portfolio! Major portions are now activated and available through the FMR homepage. HUGE thank you to Darren and Ron Williams for your work on that! Residents - please look at your access permissions page and grant permission to your Advisor for the appropriate sections.
Mark the party on your calendars! Watch your email for directions and more details.
*****
In other news, I'm happy to welcome Oscar to the group and say the new class is now all present! This was a record year for getting in-training permits, visas, and all other necessary paperwork done! A big thank you goes out to all the incoming residents and to the FMR staff for being prompt and efficient with all of that. No easy task. Good work!
*****
Check out the progress Darren Burns has made on our snazzy new electronic resident portfolio! Major portions are now activated and available through the FMR homepage. HUGE thank you to Darren and Ron Williams for your work on that! Residents - please look at your access permissions page and grant permission to your Advisor for the appropriate sections.
Subscribe to:
Comments (Atom)
Posts
