Residency Updates from the Program Director

September 2018

Big News

4+4 Schedule Update: After a summer of discussion across the residency and what has been largely very positive feedback, we have decided to take the next step in moving forward with the 4+4 schedule. Thank you all for the feedback you gave to us and the changes you allowed us to incorporate to make this plan even better. If you’d like to offer any additional thoughts, please email them directly to Katie Suddarth or myself. If anyone has not heard about the 4+4, please also speak up now. Your impression that this is valuable is critical to us moving forward. The next steps include building an entire mock schedule to look for where any issues could crop up in real life, meeting with the Division Heads and Clinic Directors to get their high-level thoughts and impressions and establishing working groups within the residency to build each of the components of the new model. Since we are making a big change, it’s a great time to consider what else about your educational experience could be improved upon. If you are interested in joining one of these redesign working groups – WES design, QI curriculum, scholarly activity/research curriculum, ambulatory subspecialty training or intern boot camp – please let me  know. 

Our plan is to have this 95% worked out and designed by October 31st so that we can be ready to describe it accurately during intern recruitment. 

For more information on the planned 4+4 Schedule and to see the questions that were asked, considered and answered this summer by your colleagues, please see the attached document “FAQs for the 4+4” attached to the email containing this Update. Or call or email me, I’d love your thoughts. 

Fall M&M – A Focus on the Resident Experience: As you all know, workplace harassment of physicians, commonly women, minorities and often those in training positions, is a very real experience for many people. This summer, a group of residents came to me, interested in improving this experience. In addition, we held one of our monthly CAM night dinners at Dr. Schwartz’ house on the topic of Challenges in Medicine: Special Challenges for Women and Minority Physicians, which brought the issue attention at the highest levels. As part of our effort to help improve the culture in our hospitals, we are holding a special M&M conference this December to start this conversation out loud at UCH.  In this M&M, the “adverse event” will be the behavior of a colleague or patient toward our trainees. If you are interested in sharing your story for this special event or wish to participate in any way, please email myself of Dr. Darlene Tad-y (darlene.tad-y@cuanschutz.edu). This is only the first step among many that are needed to make our workplaces as supportive and safe as possible, but it is a good place to start. 

Upcoming Events 

Tis the season for submissions and big on campus events – there are a lot of them.  Read below for grant opportunities, paper submissions, travel awards and on-campus calls to participate.

Pulmonary Grand Rounds Mentoring Project:  The Pulmonary Fellows want you! Many pulmonary fellows want to hone their education and mentoring skills. They also have a wealth of great cases that need writing up and publishing. Many residents want to be pulmonary fellows, or at least want to be pulmonologists and have yet to find another way of accomplishing that without doing a fellowship. See the attached flyer for an opportunity to write up and publish a case with a real, live fellow. 

Shark tank 2018: The DOM Quality and Patient Safety program is proud to invite you to our 3rd Annual Shark Tank Competition. The Event will be held on Wednesday October 24th from 4-6pm, in AO1, Rm 7000 (AKA the Chester Ridgeway Board Room). This year the focus will be on High Value Care projects and initiatives. Abstracts are DUE  on Monday, Oct 1st, 10pm. 

Shark Tank 

 ABIM Board Opportunity: This one is coming late but only because it hit my inbox late as well, I apologize. Every year, the American Board of Internal Medicine invites Program Directors to recommend a resident for   the open resident member position on the Internal Medicine Residency Review Committee (RC-IM). The resident member participates as a full voting member of the committee. The term for the resident member position is two years, from July 1, 2019 through June 30, 2021.  In Internal Medicine, this is  open to all interns (you cannot be in your final year of training as of July 1, 2019). I am happy to support  a nomination from the program if anyone is interested. Recommendations are due on or before October 1, 2018 with the following attachments: 

  • Letter of recommendation (I would write this)
  • Letter of support from the program director ensuring that the resident will have sufficient time to participate in RC-IM and ACGME activities (I will write this as well)
  • Letter from the resident outlining educational goals, professional interests, and intent to serve, if selected
  • Current resident CV 

If you are interested in this unique opportunity, please send me an email expressing your interest as well as a current CV and the letter outlining your educational goals, professional interests and intent to serve by September 25th, 2018. I can submit one name from our program so depending on the number of applications, this may be a competitive process. 

ACP National Abstracts Program: ACP's Abstract Portal will begin accepting abstracts from Resident and Fellow Members on October 1, 2018 (https://www.acponline.org/membership/residents/competitions). The ACP Abstract competition offers an ideal opportunity for your residents to submit their work for national recognition. The College has updated the abstract information pages, simplifying the process  for residents to submit their work while helping your program realize its scholarly activity requirement. Please note and share the submission deadlines for the national competitions:

  • Clinical Vignette Deadline: Wednesday, November 21, 2018
  • Research Deadline: Wednesday, November 28, 2018

ACP Forest for the Trees Competition: The American College of Physicians (ACP) Colorado Chapter is pleased to announce the second year of its “humanism in internal medicine” story contest. For internists, it can sometimes be easy to lose the “forest for the trees,” so to speak, in our busy clinical practices and not pause to reflect on the meaningful experiences that we share with patients. To

promote mindfulness in our profession, we invite you to submit a story about a patient that has had a particular impact on your growth as an internist over the past year. Submissions are due October 15th and more information can be found here: https://forms.acponline.org/webform/colorado-forest-trees- project 

On Campus Liver Conference: Together with the Liver Health Connection, the GI Department is sponsoring a one-day conference that is particularly relevant to both inpatient and outpatient providers and might be of interest to those of you going into Primary Care. See the attached flyer for more details. 

Western Medical Research Conference Call for Abstracts: The Western American Federation of Medical Research’s annual meeting is Jan 24-26, 2019 in Carmel, California. This can be a great forum for residents to present their research and our own Kevin Deane is this year’s Chair of the conference. It can be a place to present research that doesn’t have an obvious subspecialty home. 

To see more details about the conference go here: PDF

Dean's Distinguished Speaker

 

The Dean’s Distinguished Speaker conference is an annual forum where 10 truly outstanding figures in medicine are brought to CU to share their experience with our faculty, house staff and students. The more of these you can find a way to attend over your three years, the better you will be for it. All lectures are held in RC1 in the Hensel Phelps Auditorium from 4-5PM. 

This month’s speaker is Dr. Leslie Vosshall, PhD who is the Robin Chemers Professor of Neurogenetics and Behavior at the Howard Hughes Medical Institute and Rockefeller University. I encourage everyone who can get free of their clinical duties to attend.

RPEC Output 

I had been delaying this issue of the Residency Update mostly because I wanted to get you the results – with some tangible results – of this summer’s final RPEC of the UCH MICU. Suffice to say, I need to publish and so I’ll tell you what we have so far with more to come. 

The primary thing we heard from the UCH MICU RPEC is that people felt the intensity was high but that they loved the challenge and experience. We also heard that work hours were a little bit closer to going over than I would like. People felt OK working that hard, and I appreciate that, but this is not something we want to have happen. 

The primary issues with the UCH MICU we heard were the following: 

  • The APP role needs clarification; which team are they on, when do they admit, who does procedures and what are their hours
  • The night intern coming in right at 7:00PM can be tough if you are supposed to leave at 7:00PM (makes sense)
  • That getting late admissions (after 5PM) was the primary reason someone would break hours
  • The overnight intern presenting in the morning is nice, but is the second biggest reason for breaking hours
  • A computer is needed in the noon conference room if MICU residents are to even have a chance of attending – it’s too hard otherwise 

Outcomes of the RPEC: Like I said, this is not done due to a number of moving parts on the Pulmonary Division side of things right now. Some of these parts will move in directions that help us with our issues, some may lead to more challenges so we’ll be revisiting the UCH MICU later in the year.  Here’s what we accomplished so far based on your suggestions: 

  • A computer and phone in the noon conference area (thank you Julia!)
  • A set schedule for the APPs. This is one of the likely-to-move parts but the APPs now know they are to come in at 7AM and stay until 7PM, every day.
  • A set admitting structure for the APPs. Again, likely to change soon but APPs are only to admit on days when their team is admitting. Same for procedures – you do the procedures on your admissions and patients, they will only do them on their admissions and patients. You can of course help on another during busy times, but this is where we’ll start.
  • We will be moving up the night intern time to 6:00PM and eliminating them staying in the AM to present patients. We have done this in the past few months at the other sites, as you know, to great success with hours and happiness. The chiefs will be in touch about when  this new changes takes place, sometime in the next few weeks.
  • One other proposed change was to swap the day resident for the night intern. On the good side of things, this would make the structure look more like DH MICU nights, which are very popular. You’d have a buddy senior there with you at night.  It also means fewer nights for the interns. On the bad side, it means more nights for the residents. I did not enact this suggestion as it is a big move and there were not a ton of attendees at the RPEC. So speak up now!  Send me a quick note with your feelings on this – yes or no, I’d like the see a day helper intern and a night helper resident in the UCH MICU. We’ll decide on this after you all have a chance to speak up and I see what the UCH MICU leadership is doing on a bigger scale in the next few days. 

The next RPEC is this coming Monday September 24th at 6:30PM. Dr. Walker Keach and the RPEC committee will be reviewing the Denver Health ward rotation. He has been kind enough to open his house for the occasion so go check it out and give us feedback on your experiences at DH.  As always, food will be provided if you RSVP to Jefferson.

What I’m Reading 

ERAS applications!

What I’m Reading When I’m not Reading Medicine

 

Even more ERAS applications. Did you know that many internal medicine applicants like to solve puzzles? True story.

Residency Update Archive