Info for Applicants - 2010 Match

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

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

I like it! What do you think?

Thanks, Diane!

UTMB FMR Class of 2012

Resident Salary Increase Proposed

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

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!

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

growing again

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

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?

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!

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

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

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

The list

some updates

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

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

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

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

Ghost Town

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

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