How to Survive a Site Visit

Doreen J. Addrizzo-Harris MD

Program Director

Pulmonary Section Chief

New York University School of Medicine

Site Visits

• Who has never been through a site visit?

• Who will undergo a site visit this year?

• Who has been through a site visit in the last year?

Key points for a successful site visit

• Be organized • Be truthful• Be well aware of the requirements:

Institutional Requirements Common Program Requirements Subspecialty Program Requirements Subspecialty FAQ Program Letter Requirements www.ACGME.org

Key points for successful site visit

• Share resources amongst other subspecialty program directors within and outside your institution.

• Be sure your fellows are happy and deal with issues they may have about the program or faculty as best you can before the site visit.

• Educate your faculty and fellows Multiple faculty and fellow meetings Fellow selection (self selection)/chief fellow

• Rehearse Mock Site visit

Program Files

• see enclosed list

Program Files

• Program letters of Agreement Required for rotations of one month or longer Required for institutions with different governing

bodies Identify the faculty Specify teaching, supervision and formal evaluation

of fellows Duration and content (curriculum) Policies and procedures Not older than 5 years Signed by program director and site director (plus

DIO)

Pulmonary / Critical Care Medicine Fellowship

Lines of Reporting

Pulmonary/ Critical Care Fellows

IM Residents and Team

Director of Service/Unit

Program Director Pulmonary and Critical

Care Medicine(Dr. Addrizzo-Harris)

Division ChiefPulmonary/ Critical

Care Medicine(Dr. William Rom)

Chair of Medicine(Dr. Martin Blaser)

Chief Resident

Program DirectorInternal Medicine

(Dr. Ellen Pearlman)

Direction of arrow indicates reporting

relationship

Pulmonary/Critical Care Attending

Program Files

• Program Policy manual (handout) • Conference attendance record

Copies/ web-based/ print available for those who missed lecture

• Duty hour policy Mechanism for relief if over Dates of revision and distribution Evidence of duty hour monitoring

• Including monitoring of home call and moonlighting

Program Files

Documentation of internal review (cover sheet only) Annual program evaluation of faculty and curriculum Minutes of faculty meeting addressing curriculum with

fellow representation Written curriculum with increased responsibilities for

each level of fellowship Goals and objectives On-line resident survey and program’s response to

any deficiencies

Program Files

Autopsy reports and distribution to fellows Sample evaluations/schedules/conferences Supervision guidelines Program Improvement projects Faculty development

Fellows’ Files

• Usually most recent graduates and senior fellows

• Credentials• If non-ACGME trained, letter of PD, prior to

appointment of ABIM policies, etc• If transferring in, written verification from

prior program director• Procedure log (indications/complications)

Fellows’ Files

• Documentation of receipt of moonlighting policy, duty hour policy and curriculum/policies.

• Documentation of completion of sleep module or attendance at sleep lecture.

• All evaluations Rotation, research, clinic Final evaluation with summation statement-- practice

competently and without direct supervision 360 evaluations Semi-annual Conference, journal club or chart audit evaluations Mini-CEX (handout); simulation exercises, OSCE

Fellows’ Files

• Portfolio (printed out for one or two fellows) Lectures Grant applications Abstract/publications

Faculty Files(KCF and PD)

• All evaluations by fellows (or summation of)

• CV including participation in faculty development

• Checklist of receipt of policies, sleep module, curriculum

• Documentation of meeting with division chief/program director with regards to faculty portfolio prior to site visit