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WELCOME
All Program Directors & FM Site Directors Meeting
Friday, May 29, 2015
• Welcome
• Awards and Thanks
• Charles Mickle Fellowship Address
• Documentation Issues and Implications – A Legal Perspective
• HealthForceOntario
• PGME Strategic Plan – Update
Agenda
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Exiting Residency Program Directors - from July 2014
• Dr. Eudice Goldberg – Adolescent Medicine • Dr. Mark Levine – Anesthesia • Dr. Gideon Cohen – Cardiac Surgery • Dr. John Langley – Child and Adolescent Psychiatry • Dr. Damon Scales – Critical Care (Adult) • Dr. Simon Ling – Gastroenterology • Dr. Barbara Cruickshank - GREI • Dr. Roberto Mendoza – Medical Genetics • Dr. Tony Mazzulli – Medical Microbiology • Dr. Marc Freeman – Nuclear Medicine • Dr. Peter Ferguson – Orthopedic Surgery • Dr. Giovanna Sirianni – Palliative Care • Dr. Fran Scott – Public Health and Preventive Medicine
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New Residency Program Directors - from July 2014
• Dr. Katherine Hick – Adolescent Medicine • Dr. Lisa Bahrey – Anesthesia • Dr. Robert Cusimano – Cardiac Surgery • Dr. Daniel Gorman – Child and Adolescent Psychiatry (on leave) • Dr. Raj Rasasingham – Child and Adolescent Psychiatry (Interim) • Dr. Andrew Steel – Critical Care (Adult) • Dr. Yaron Avitzur – Gastroenterology • Dr. Kim Liu - GREI • Dr. Melissa Carter – Medical Genetics • Dr. Larissa Matukas – Medical Microbiology • Dr. Amer Shammas – Nuclear Medicine • Dr. Markku Nousiainen – Orthopedic Surgery • Dr. Barry Pakes – Public Health and Preventive Medicine
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Awards Acknowledgements – Previously Presented
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2015 PGME Excellence Awards Development/Innovation • Dr. Michael Pollanen – Forensic Pathology • Dr. Jordan Chenkin – Emergency Medicine
Teaching Performance/Mentorship/Advocacy • Dr. Leslie Wiesenfeld – Psychiatry • Dr. Eric Yu – Cardiology
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2015 Sarita Verma Award for Advocacy and Mentorship in
Postgraduate Medicine
Dr. Mark Fefergrad
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Inaugural Year: 2015
Social Responsibility Award in Postgraduate Medical Education – Faculty • Dr. Lisa Andermann - Psychiatry • Dr. Kenneth Fung - Psychiatry
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2015 PARO Award Recipients Excellence in Clinical Teaching • Dr. Edsel Ing – Ophthalmology & Vision Sciences • Dr. Ophyr Mourad – General Internal Medicine
Resident Teaching • Dr. Alireza Mansouri - Neurosurgery • Dr. Heather Millar – Obstetrics and Gynecology
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2015 Charles Mickle Fellowship
Awarded annually to a member of the medical profession anywhere in the world
who has “..done the most within the preceding 10 years to advance and
promote sound knowledge of a practical kind in medical art or science by careful
and thorough work.”
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2015 Charles Mickle Fellow • Dr. Murray Urowitz, MD, FACP, FRCPC
• Professor, Department of Medicine
• Director, Health Professional Affairs, CEPHEA (Now Touchstone), 2005 to 2015
• Associate Dean, Postgraduate Medical Education, 1995 to 2005
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Awards Presentation
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PGME Trainee Leadership Awards: 2015 Recipients
• Dr. Tarek Abdelhalim – PGY4 - Internal Medicine
• Dr. Matthew Boyle – PGY5 – Psychiatry • Dr. Michael Fralick – PGY3 – Internal
Medicine • Dr. Danielle Rodin – PGY3 – Radiation
Oncology
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2015 Social Responsibility Award in Postgraduate Medical Education – Trainee
• Dr. Nicole Kozloff - Psychiatry
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2014 Charles Mickle Fellowship Address Reflections on Postgraduate Medical Education • Dr. Rayfel Schneider, Professor and
Associate Chair (Education), Department of Paediatrics
Reflections on Postgraduate Education
Rayfel Schneider, MBBCh, FRCPC Department of Paediatrics
Can you relate to this?
Program Director
Pressure from Government
• To what extent is the current graduate medical education system producing an appropriately balanced physician workforce providing health care that is – High quality
– Patient-centred
– Affordable?
Adapted from the Institute of Medicine Report, 2014
Lofty educational vision from our colleges
PGME Strategic Plan: 2012-2017
Agenda item (Glen Bandiera)
Pressure from Hospitals
• MORE – Patients – Documentation – Patient safety – Patient-centred care
• LESS/FEWER
– Costs – Resources/support – Duration of hospital stay –early discharge by 11am – Admissions
Pressure from Academic Chiefs
• MORE – Billings – Grants – Publications – Teaching
• LESS/FEWER
– Departmental (AFP) or University $$$$$$$
– Faculty – Clinical assistants, clinical fellows
Faculty vs Resident Perceptions
FACULTY • Too few residents for service • Too many evaluations • Residents are never around
– post-call, protected time, mock codes, conference leave, exam prep, handover, etc
• Entitled!
RESIDENTS • Too much scut • Too much call • Not enough feedback • Not enough responsibility • Not enough procedures • We have PARO
Clinical work Research Administrative
Education
WORK-LIFE BALANCE
No wonder cracks appear!
Program Dir
On the other hand, residents are….
• Fully engaged when they are given responsibility – Best rotations – Oncology, ward senior
• Keen to pursue clinical excellence – They worry about their competence
• Highly motivated by social accountability and issues of social justice – Multiple impressive advocacy projects; global health projects
• Curious and some of the brightest people on the planet • Committed to teaching junior trainees • BUT…. they ‘sniff out’ insincerity, and don’t tolerate token
teaching experiences
Are we are on a collision course?
• Educational enhancements based on sound pedagogy
AND • Patient care enhancements
based on sound principles – Safety and quality – Cost-effectiveness – Efficiency – Patient-centred approaches
What is a PD to do?
• Advocate for educational priorities • Ensure support from Chair/Division Chief
– Adequate time (%FTE) for education is critical – Seek appropriate and strong administrative support
• Share the burden – Involve your divisional faculty; you cannot do this alone
• Collaborate with colleagues • Draw on the strengths of PGME • Seek mentorship
PGME Leadership (to June 2015)
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Promotions in the Dept of Paediatrics
2007-14 inclusive = 118 promotions • Clinician Scientist 31 (75%) • Ciinician Investigator 26 (55%) • Clinician Educator 11 (55%) • Academic Clinician 49 (60%) • Clinician Administrator 1
Interpretation: From 2007-14, 118 members of our faculty have been promoted, representing 75,55, 55 and 60% of CSc, CI, CEd and AC categories Comment re CEd: few in number (~20), but advance as with everyone else.
Trainees from around the world
What will the future bring?
• Changing economics and focus on higher quality and lower costs require a new operating model for academic medicine
• Every aspect of academic medical centres will undergo
transformation in the decades ahead – How care is delivered – How residents are educated and integrated into clinical care – How research enterprise is organized and funded – How the missions come together in a new and meaningful way
Enders and Conroy, AAMC, 2014
New York Times: April 14, 2015
Op-ed: The Moral Bucket List by David Brooks • Resume virtues: skills you bring to the marketplace
• Eulogy virtues: qualities – kindness, honesty, humility,
compassion, etc…
• “The call within the call” – some people have experiences that turn a career into a calling
Dr. Haslam and Residents
Department of Paediatrics: Education Program Directors
Kathy Hick Adolescent Medicine
Irena Nulman Clinical Pharmacology (clinical fellows)
Jennifer Russell Cardiology
Roberto Mendoza Melissa Carter Clinical Genetics
Suzanne Beno Emergency Medicine/ Tania Principi/ Anna Kempinsa
Diane Wherrett Endocrinology
Yaron Avitzur Gastroenterology,Hepatology and Nutrition
Michaela Cada Haematology/Oncology
Sarah Schwartz Paediatric Medicine
Eyal Grunebaum Immunology/Allergy
Anupma Wadhwa Infectious Diseases
Emer Finan Neonatology
Rulan Parekh Nephrology
Ann Yeh Neurology
Melinda Solomon Respiratory Medicine
Shirley Tse Rheumatology
Adelle Atkinson Core Paediatrics
Anne Kawamura Developmental Paediatrics
THANK YOU!
Paediatric Education Leaders Adelle Atkinson Angela Punnett Mark Feldman Shelly Weiss Tina Martimianakis
Medical Education Advisory Committee Paediatric Subspecialty PDs
PGME
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Documentation Issues and Implications for Residency Program Directors and Family Medicine Site Directors – A Legal Perspective
• Sari Springer, Cassels Brock Lawyers
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HealthForceOntario Marketing and Recruitment Agency • Matt Kirkham Regional Advisor – Toronto Central LHIN
Practice Ontario Services available to the University of Toronto Presentation to Postgraduate Program Directors 29.05.15
Matt Kirkham
Practice Ontario Services at the University of Toronto
Free & flexible job search service for permanent and locum practice opportunities for both family and specialty Residents
Provide personal career guidance to find jobs that match personal & professional interests and priorities
Prepare Residents for a smooth transition to practice – Practice U
Online Transition to Practice Resources: Practice U
http://www.healthforceontario.ca/en/M4/Practice_U
What services are provided through Practice Ontario?
•Transition-to-practice information, including rural incentives •Personal job search support, exposing residents to permanent and locum opportunities in rural Ontario •Assistance with résumé preparation •Support arranging site visits to communities of interest •Integration/retention support of physicians in their new communities •Guidance for international medical graduates with return of service commitments In 2014 HFO MRA assisted in the placement of over 700 physicians in Ontario!
Practice Ontario
Presentations to Resident
Groups
Assistance with Spousal Employment
Personalized Job Search
Transition to Practice Supports
Practice Ontario Activities at UofT: 2014-15
(30) Transition to Practice (TTP) talks facilitated by Regional Advisors - University of Toronto Team Topics ranged from: • Overview of Practice Ontario Services & Supports • Countdown to Practice • Labour Market & Career Planning • CV Assistance & CV Panels (eg. OB/GYN, CIP) • Locuming • Return of Service
Practice Ontario - Program Specific Sessions:
Anaesthesiology (2) Clinical Immunology & Allergy
Clinical Investigation Program
Emergency Medicine
Endocrinology
Family Medicine (4)
Gastroenterology Geriatrics Internal Medicine (3)
Medical Genetics Medical Oncology Nephrology
Obstetrics & Gynaecology
Paediatrics (2) Paeds - Endocrinology
Pathology Physical & Rehabilitative Medicine
Plastic Surgery
Psychiatry
Opportunities for Enhanced PO Services Benefit of having Regional Advisor contact info on
academic days agendas Booth/table set up at academic days Presentations to Residents on academic half days Panel discussions with Program Directors – discuss life after residency, work-life balance, etc. Practice Ontario presence during UofT CaRMS interviews Program specific custom tailored Transition to Practice presentations
Practice Ontario Enhanced Menu of Services 2015-16
Next steps?
Please feel free to follow up with me to schedule a presentation for your learners or regarding ideas for additional TTP content
Matt Kirkham Regional Advisor & Practice Ontario Lead
Toronto Central [email protected]
416-689-8261
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PGME Strategic Plan – Update • Dr. Glen Bandiera
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Foster leadership in social accountability among PGME learners and faculty
Strengthen each learner’s experience across the medical education continuum
Learner Experience
Leadership in Curricular Innovation
Clinical Teachers
Social Accountability
Recognize and support clinical teachers in the delivery of learner and health-system focused education
Support and develop local, national and international leadership in evidence-based curricular innovation
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