UNM INTERNAL MEDICINE RESIDENCY PROGRAM - HOSPITALIST TRAINING TRACK

Meeting 2

28 September 2015

Charles Pizanis, Christopher Bartlett

Objectives• Describe hospitalist training track concept

• Share results of needs assessment of former UNM IM grads

• Review vision and structure of training track at UNM

• Decide on required rotations, format of small group curriculum, any additional elements of track

Hospitalist Training Tracks

• Programs across country have developed training tracks to provide training, exposures residents interested in hospital medicine

• Tracks share clinical rotations, small group meetings, quality/research experiences

• Graduates of these tracks go on to become community hospitalists, academic hospitalists, and leaders in hospital medicine

Needs Assessment

Why Did We Do It?

By understanding the strengths and weaknesses of the UNM Internal Medicine Residency Program,

from the perspective of current hospitalist physicians, a Hospitalist Training Pathway

curriculum can be developed to meet and exceed the needs of future graduates entering academic

and community hospitalist medicine.

All UNM Internal Medicine graduates within the past 3 years who are currently employed as an academic

and/or community hospitalist physician.

Who Did We Contact?

Question 1:

Internal Medicine residency at the University of New Mexico fully prepared me to become a hospitalist physician.

A majority of respondents agree or strongly agree that their residency experience fully prepared them for careers in hospital medicine.

# o

f R

esp

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Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree

6

2

1

1 2 3 4 50

1

2

3

4

5

6

7

What Did We Learn?

Question 2:

In which aspects of your job as a hospitalist today do you wish you had received more training during residency?

Respondents believe they would have benefited from more training in Neurology (44%), Quality Improvement/High Value Care (44%),

Consultative/Perioperative Medicine (33%), Medical Education (33%), and Medical Economics (33%).

44%

22%

33%

33%

33%

22%

44%

22%

Neurology

Infectious Disease

Consultative/Perioperative Medicine

Medical Education

Medical Economics

Hospital Administration

Quality Improvement/High Value Care

Procedure Team

What Did We Learn?

Question 3:

A Hospitalist Pathway could have filled these gaps?

A majority of respondents agree of strongly agree that a Hospitalist

Pathway could have filled perceived gaps in their education.

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f R

esp

on

ses

Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree

1

1 2 3 4 50

1

2

3

4

5

1

3

4

What Did We Learn?

Question 4:

I would have considered participating in a Hospitalist Pathway?

A majority of respondents agree of strongly agree that they would have considered participating in a Hospitalist Pathway.

# o

f R

esp

on

ses

Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree

2

1

2

4

1 2 3 4 50

1

2

3

4

5

What Did We Learn?

Question 5:

How many electives per year would you have been willing to exchange in order to take part in a Hospitalist Pathway?

A majority of respondents felt like they would be willing to exchange 1 elective in order to take part in a Hospitalist Pathway. The average and median were

2.

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0

1

2

3

4

5

1 2 2-3 3 4

1 1 1

2

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What Did We Learn?

1.A majority of respondents agree or strongly agree that their residency experience fully prepared them for careers in hospital medicine.

2.Respondents believe they would have benefited from more training in Neurology (44%), Quality Improvement/High Value Care (44%), Consultative/Perioperative Medicine (33%), Medical Education (33%), and Medical Economics (33%).

3.A majority of respondents agree of strongly agree that a Hospitalist Pathway could have filled perceived gaps in their education.

4.A majority of respondents agree of strongly agree that they would have considered participating in a Hospitalist Pathway.

5.A majority of respondents felt like they would be willing to exchange 1 elective in order to take part in a Hospitalist Pathway. The average and median were 2.

What Did We Learn?

UNM Internal Medicine Residency Hospitalist Training Track Overview

Clinical Rotations

• Consultative Medicine (UNMH)• SRMC Hospitalist (SRMC)• Medical Economics (UNMH)• Palliative Care Consults

QI/Research Project

• Project chosen by resident• Guidance by QI/research

mentor• Goal of presentation at

conference and/or publication of project

• Small group meetings• Online Society of Hospital

Medicine (SHM) modules• Online Institute for Healthcare

Improvement (IHI) Open School curriculum

Didactic Curriculum

• Paired hospitalist mentor• Career mentoring• Leadership mentoring

• HTT director mentor

Mentorship

Track Basics

• 2-4 track participants per year

• Application process to begin in PGY1 year

• Track to occur over PGY2 - PGY3

HTT Track TimelinePGY 1

• Apply to HTT (January)

• Acceptance to track (mid February)

• Select PGY2 schedule (Spring)

• Meet with HTT director (Spring)

• Meet with QI/research mentor and decide on project (late Spring)

PGY 2 PGY 3

• Begin required HTT rotations

• Begin work on project• Begin SHM/IHI

curriculum• Attend scheduled

small group curriculum lectures

• Meet with QI/research mentor (quarterly)

• Attend one regional, one national conference

• Select PGY3 schedule (Spring)

• Complete required HTT rotations

• Meet with research/QI mentor (quarterly)

• Complete work on project (Fall, Spring)

• Submit scholarly work (Fall, Spring)

• Complete SHM/IHI curriculum

• Attend one regional, one national conference

• Complete HTT

Clinical Rotations – How Many and Which Ones?• Consultative Medicine (UNMH)

• Grow in skills as medical consultant, increase exposure to perioperative care

• SRMC Hospitalist (SRMC)• Provide exposure to work as community hospitalist

• Medical Economics (UNMH)• Increase knowledge and understanding of business and

economics principles of medicine

• Palliative Care Consults• Provide additional exposure to palliative and end-of-life care

Small Group Curriculum

• Format• Topics brainstorm• Journal Club

• Schedule• Monthly vs every-other month

Any Additional Elements We Should Include?

Timeline of Rollout2015• September meeting

• Decide on rotations, format of small group curriculum, additional elements

• Start work on curriculum• October – retreat

• Report back on progress of additional elements

• Solicit speakers for topics• Solicit QI/research

mentors

• November meeting• Review track curriculum

• December meeting• Finalize track curriculum

• Dec 31• Completed curriculum,

structure, materials for rotation

2016• January - applications

Thanks!