ACGME ACCREDITATION YOU CAN DO THIS

Transcription

1 ACGME ACCREDITATION YOU CAN DO THIS Jennie Faulkner, C-TAGME ACOFP Program Director Workshop Date Change is great YOU go first This is not apples to oranges 1

2 It is really apples to apples You are VERY Important! I.A.4.b) The sponsoring institution and participating sites must provide support for a fulltime residency coordinator and other support personnel required for the operation of the program. II.C.1. The program must have a program coordinator. Overview Primary Organizations Comparisons Reporting Requirements Specialty Board Certification Recruiting 2

3 Primary Organizations Primary Organizations Accreditation Council of Graduate Medical Education (ACGME) American Board of Family Medicine (ABFM) American Academy of Family Physicians (AAFP) Other ACGME Sponsoring Institution (usually Medical School or Hospital) Follow ACGME Institutional Requirements Financial and academic responsibility for Gradate Medical Education (GME) Designated Institutional Official (DIO) authority and responsibility over GME Graduate Medical Education Committee (GMEC) with DIO oversees programs for compliance and quality 3

4 ACGME Program Level Common Program Requirements Specialty Program Requirements Review Committees Eileen Anthony, Executive Director, American Board of Family Medicine (ABFM) Time Away from Training Approve Residency Transfer Credit In-Training Examination Board Certification Examination Kathy Banks, American Academy of Family Physicians (AAFP) National organization and state chapters Opportunities for faculty and residents to serve in leadership roles Spring Conferences Program Directors Workshop Residency Program Solutions Cristin Estes, 4

5 Other National Resident Matching Program (NRMP) Educational Council for Foreign Medical Graduates (ECFMG) Association of American Medical Colleges (AAMC) American Medical Association (AMA) Comparisons Comparisons Accreditation Curriculum Evaluation Resident Program 5

6 Some of ACGME s Secret Codes Must absolute requirement Should really a must unless you can justify its absence; can be cited for absence Suggested/Strongly Suggested clearly urged; no citation IR = Institutional Requirements PR = Program Requirements 1 month = 100 hours = 4 wk block Institutional Accreditation Institution Clinical Learning Environment Review (CLER) Visits Patient Safety Health Care Quality Care Transitions Supervision Duty Hours and Fatigue Management Professionalism Program Accreditation Resident Eligibility (IR IV.A.2) Meeting attendance PD and Residents (PR IV.A.6.s).(4)) Program Size 4 residents/year level (12) vs. 6 Didactics Regularly Scheduled vs. 5 hours/week Board Certification 95% take exam averaged over 5 years vs. 90% averaged over 5 years 6

7 Program Accreditation Program Monitoring Annual Updates entered electronically on ACGME site Annual Confidential Resident Surveys Annual Confidential Faculty Surveys Annual Review Site Visit Every 10 years Curriculum Inpatient Medicine 6 months AND 750 patient visits 1 month critical care or 15 ICU patient encounters Experience must span all 3 years of training Not more that 50% of the inpatient care experience may be Night Float Geriatrics 1 month (100 hours) or 125 encounters Long term care must be continuous over a minimum of 24 months Curriculum Emergency Medicine 2 months or 200 hours or 250 adult visits No requirement about which year training occurs Pediatrics 2 months (200 hours) AND 250 ill hospital and/or ED visits 75 inpatient visits AND 75 ED visits 2 months (200 hours) or 250 ambulatory visits 40 newborn visits 7

8 Curriculum Women s Health 1 month (100 hours) or 125 visits GYN, WWE, Family Planning 2 months (200 hours) Obstetrics, including some continuity deliveries No requirement when experience occurs Surgery 1 month general surgery with operating room experience No requirement for subspecialty rotations Musculoskeletal 200 hours with structured sports medicine experience Curriculum Structured Experiences Common Mental Illnesses Population Health Procedures Program Director and Faculty Develop List Scholarly Activity 2 projects, 1 must be a Quality Improvement project Electives At least 3 months (300 hours) vs. 4-7 months Evaluation of Residents Competency-based Each Rotation Semi-annual Milestone Evaluation by Clinical Competency Committee Summative Evaluation upon Completion of Program 8

9 Milestone Evaluation Similar to Annual Competency-Based Evaluation 6 Competencies, 22 sub-competencies Patient Care (Competency) PC1: Cares for acutely ill or injured patients in urgent and emergent situations and in all settings (Sub-competency) Milestones Milestone Evaluation 9

10 Milestone Evaluation Levels 1-5 of progress within each sub-competency Level 2 by end of second year Level 4 by graduation Level 5 master level Milestones Evaluation Clinical Competency Committee (CCC) Appointed by Program Director Semi-annual review of all resident evaluations Completes and reports Milestone evaluations Advises Program Director regarding resident progress, remediation, promotion, dismissal Entered in ACGME s site twice each year Program Evaluation Committee (PEC) Appointed by Program Director Minimum: 2 Faculty, 1 Resident Annual program evaluation (APE) Annual curriculum review Monitor and Track Resident Performance Faculty Development Graduate performance Program Quality Progress on Previous Year s Plan Recommendations made to faculty for approval 10

11 Reporting Requirements Annual Reporting Requirements ACGME Accreditation Data System (ADS) Primary and Participating Sites Faculty Roster Original Certification and Recertification Dates Years in Specialty Years in Each Activity Scholarly Activity Program Director CV is updated annually Annual Reporting Requirements ACGME Block Diagram of Curriculum Residents Education history Scholarly activity Attrition rate Completion rate Evaluation by Competency Assessment method Evaluators 11

12 Annual Reporting Requirements ACGME Family Medicine Practice 10 most frequent procedures in the center Top procedures all residents must learn Top 20 diagnoses of patients seen by residents Resident visits by patient age and gender Patient visits by each resident Annual Reporting Requirements ACGME Hospital Number of patients personally managed by residents at each year level on a daily basis for: Adult Medicine Pediatric Inpatient, Newborn Pediatric Inpatient, Excluding Newborn Top 10 adult medicine diagnoses for the hospital Top 10 pediatric (excl. newborn) diagnosis for the hospital Number of vaginal deliveries for each completing resident Number of continuity deliveries for each completing resident Annual Reporting Requirements American Board of Family Medicine (ABFM) Resident Training Management System (RTMS) Enter resident education information Annual updates Order In-Training Examination Verify completion of training for certification 12

13 American Academy of Family Physicians (AAFP) Program type Hospital size, number Clinic schedule and FQHC status Positions offered Demographics Salary, benefits Call and specific rotation information Faculty information GME Track and FREIDA GME Track Association of American Medical Colleges and American Medical Association GME Track and National GME Census Details very similar to AAFP annual survey Graduate practice information FREIDA (Fellowship and Residency Electronic Interactive Database Access) American Medical Association Listing of about 10K ACGME-accredited programs students use when considering programs Specialty Board Certification 13

14 American Board of Family Medicine (ABFM) RTMS updates essential 4 part process I Professionalism II Self-assessment Modules (SAMs) (15 points) III Cognitive (exam) IV Performance in Practice (20 points) Exams offered twice each year Program Director Newsletters on site Recruiting ACGME Policies and Procedures for Eligibility and Selection (IR V.A.) Provide terms and conditions of benefits to candidates invited to interview (IR IV.A.3.) 14

15 National Resident Matching Program (NRMP) Pay attention to deadlines Must be All In Cannot discuss ranking preferences Supplemental Offer and Acceptance Program (SOAP) National Conference of Family Medicine Residents and Students AAFP Sponsors End of July/beginning of August Kansas City International Medical Graduates (IMG) Uniform interview criteria for USG and IMG Things to consider Year of graduation US experience ECFMG Certification Visa Sponsorship 15

16 Educational Commission for Foreign Medical Graduates (ECFMG) Assess readiness of IMG s to enter ACGME residency and fellowship programs through certification Certification required: ACGME USMLE Step 3 Licensure Sponsorship of J-1 visas for physicians in clinical training programs Cannot moonlight Unexpected Openings Review NRMP Guidelines AAMC s Find-A-Resident Review ACGME requirements for transfers Before accepting must receive written verification of educational experience and summative competency based evaluation Review ABFM requirements for transfer Must obtain ABFM approval for transfer credit BEFORE resident joins program Review 16

17 Review Primary Organizations and Roles ACGME, ABFM, NRMP Comparisons Accreditation, Curricular, Evaluation Reporting Requirements ACGME, ABFM, AAFP, GME Track and National GME Census Specialty Board Certification Process Recruiting ACGME, NRMP, ECFMG Resources ACGME Family Medicine Requirements Family Medicine Milestones Policies Glossary Institutional Requirements CCC Handbook 17

18 Other ABFM NRMP ECFMG One more thing about change Just when the caterpillar thought the world was over, it became a butterfly -Proverb Questions? 18

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