1. What it Means to be a Program Director Rita M Patel MD Professor of Anesthesiology & Vice-Chair, Education Department of Anesthesiology Associate Dean for Graduate Medical Education University of Pittsburgh School of Medicine ACGME/NRMP Designated Institutional Official UPMC Medical Education

2. Disclosure Former Program Director Anes Residency UPMC Former Program Director Anes Residency UPMC Vice-Chair, Education Vice-Chair, Education Oversight of all edu programs, inc med student, residency, fellowships and CME Oversight of all edu programs, inc med student, residency, fellowships and CME UPMC ACGME/NRMP DIO UPMC ACGME/NRMP DIO Oversight of 110+ residency/fellowship programs Oversight of 110+ residency/fellowship programs Member of Anes RRC Member of Anes RRC OPINIONS EXPRESSED ARE MY OWN and NOT ON BEHALF OF THE RRC, ACGME OR UPMC OPINIONS EXPRESSED ARE MY OWN and NOT ON BEHALF OF THE RRC, ACGME OR UPMC

3. Timeline RRC meets Oct 27 & 28 2011 RRC meets Oct 27 & 28 2011 Following the ASA Following the ASA PIF is produced by a separate area of the ACGME & must be reviewed by the RRC PIF is produced by a separate area of the ACGME & must be reviewed by the RRC Program Requirements, PIF, FAQs typically posted at same time Program Requirements, PIF, FAQs typically posted at same time Plan is PIF availability for potential January submission of program applications for consideration at April meeting Plan is PIF availability for potential January submission of program applications for consideration at April meeting

4. Anesthesiology & Subs 2010-2011 Program# Programs# Residents Anesthesiology1315678 Adult CT Anes52151 Critical Care Anes4894 Pain Medicine93318 Peds Anes46191 All Programs8893114,058

5. Multiple Impacts on GME Organizations – AAMC, AHME, FSMB, AHME, AHA, ABMS Organizations – AAMC, AHME, FSMB, AHME, AHA, ABMS ABMS American Board of Medical Specialties ABMS American Board of Medical Specialties American Board of Anesthesiology American Board of Anesthesiology FSMB Federation of State Medical Boards FSMB Federation of State Medical Boards Licensing Board of Medicine for State Licensing Board of Medicine for State Local Sponsoring Institution Local Sponsoring Institution May be medical school or hospital system May be medical school or hospital system

6. More Info – www.ACGME.org www.ACGME.org  Residency Review Committee – Anesthesiology  RRC Members & Staff (Pat Surdyk & Billy Hart)  Common Program Requirements – 7/2011  Program Director Guide to the CPRs  Anes & Subs PRs*  FAQs – Frequently Asked Questions  PIFs – Program Information Form*  Responsibilities of Residency & Fellowship Program Directors Rita M Patel MD - Dec 2010

7. Responsibilities of Residency & Fellowship Program Directors RRC 2007 Accreditation Issues Accreditation Issues Educational Program Educational Program Administration Administration Institutional Role Institutional Role

9. Rita M. Patel, MD TIME – Practical Suggestions DEVELOP existing teachers HELP from institutional sponsor USE SEA, ASA, SOAP, AMA, SI EXPAND existing structures SHARE information PRODUCE new material MONITOR implementation DISCARD things that don’t work

10. Rita M. Patel, MD Accreditation Issues Demonstrate “Substantial Compliance” with Program Requirements Comply with Institutional Process – Int Review Prepare accurate & complete PIF+ Ensure DIO reviews & Co-signs PIF+ Maintain program & trainee files Develop Policies & Procedures Work with Residency PD & other Fellowship PDs + Dept Chair

11. Rita M. Patel, MD Documentation – Practical Suggestions Make it EASY Web-Based/Electronic Evaluation System Duty-Hours Monitoring Post Important items on Website Give AWARDS & RECOGNITION

12. Educational Program Elements Recruitment and Selection Recruitment and Selection Clinical and Didactic Curriculum Clinical and Didactic Curriculum Evaluation and Competence Evaluation and Competence Administration and Review Administration and Review

13. Recruitment & Selection Faculty of 3 is a committee Faculty of 3 is a committee Ensure that only eligible individuals are enrolled Ensure that only eligible individuals are enrolled All applicants at time of interview must be provided with terms & conditions of employment, benefits, & contract All applicants at time of interview must be provided with terms & conditions of employment, benefits, & contract Program-Specific Selection Policy Program-Specific Selection Policy Must review NRMP history of applicant for match violations PRIOR to contact Must review NRMP history of applicant for match violations PRIOR to contact

14. Think of the physician you want to take care of your mother, father or child What characteristics does that doctor possess? HONEST RELIABLE GOOD HANDS EXPLAIN WHAT’S GOING ON ETHICAL SMART KIND KNOW WHAT TO DO UP-TO-DATE EASY TO TALK TO UNDERSTANDINGRESPECTFUL KEEP THINGS PRIVATE

15. ACGME General Competencies Medical Knowledge Medical Knowledge Patient Care Patient Care Interpersonal and Communication Skills Interpersonal and Communication Skills Professionalism Professionalism Practice-Based Learning and Improvement Practice-Based Learning and Improvement Systems-Based Practice Systems-Based Practice

16. Clinical & Didactic Curriculum Write Competency-Based Goals & Objectives for each rotation & overall program Write Competency-Based Goals & Objectives for each rotation & overall program Describe how they will be taught Describe how they will be taught Clinical Experience – specific rotations, types and volume of cases & appropriate faculty Clinical Experience – specific rotations, types and volume of cases & appropriate faculty Didactic – lectures, workshops, simulation & appropriate faculty Didactic – lectures, workshops, simulation & appropriate faculty Share curriculum with faculty & fellows at least annually Share curriculum with faculty & fellows at least annually

17. Evaluation & Competence Fellow - Evaluation of achievement in all competencies Fellow - Evaluation of achievement in all competencies Multi-Source is not the same as 360 Multi-Source is not the same as 360 Obtain confidential written evaluations Obtain confidential written evaluations of the faculty by the fellows of the faculty by the fellows of the program by the fellows of the program by the fellows of the program by the faculty of the program by the faculty Conduct Annual Program Evaluation Conduct Annual Program Evaluation Formal, documented, minutes kept Formal, documented, minutes kept

18. Administration & Review Program-Specific Policies Program-Specific Policies Selection, Evaluation, Promotion, Dismissal, Duty Hours, Moonlighting Selection, Evaluation, Promotion, Dismissal, Duty Hours, Moonlighting Manage clinical scheduling – on call, rotation & ensure supervision & backup systems available Manage clinical scheduling – on call, rotation & ensure supervision & backup systems available Implement & follow institutional policies ie. for grievance & due process Implement & follow institutional policies ie. for grievance & due process Know what requires DIO, GMEC & RC approval Know what requires DIO, GMEC & RC approval

19. What to do Now Go to the ACGME website Go to the ACGME website Begin learning terminology -the language of the ACGME: G& Behavioral O, Multi-Source Eval Begin learning terminology -the language of the ACGME: G& Behavioral O, Multi-Source Eval Meet with your Faculty, Chair, Div Chief & the Core PD - FUNDING Meet with your Faculty, Chair, Div Chief & the Core PD - FUNDING Establish timeline for GMEC & DIO review Establish timeline for GMEC & DIO review Read Common Program Requirements Read Common Program Requirements Keep them on your desktop Keep them on your desktop Refer to them frequently Refer to them frequently Look at the PD Guide to the CPR Look at the PD Guide to the CPR

21. After PR & PIF becomes available… Accurate & Complete PIF Accurate & Complete PIF Answer the Question being asked. Answer the Question being asked. PD & Faculty Qualifications ABA-certified, CV briefs demonstrate qualifications in PRs PD & Faculty Qualifications ABA-certified, CV briefs demonstrate qualifications in PRs Rotation Schedule/Didactic Schedule/Goals & Objectives/Evaluation Forms Rotation Schedule/Didactic Schedule/Goals & Objectives/Evaluation Forms Description of Rotations &/or Experiences Description of Rotations &/or Experiences Provide correct data Provide correct data

22. Pay Attention! Avoid risky behaviors DUTY HOURS DUTY HOURS SUPERVISION & RESPONSIBILITY SUPERVISION & RESPONSIBILITY ACGME COMPETENCIES ACGME COMPETENCIES Teaching Teaching Evaluating Evaluating OUTCOMES OUTCOMES POLICIES/PROCEDURES POLICIES/PROCEDURES Contracts Contracts Grievance & Appeals Grievance & Appeals

23. Formation of GMEC subcommittees GME Leadership Conferences Team Approach to Institutional Review Coordinator Development Programs Continuous Site Visit Preparation GME Business and Politics Conferences Orientation Programs for new Program Directors, Coordinators, Residents/Fellows UPMC Programs to Develop the GME Community

25. Thank You rpatel@pitt.edu patelrm@upmc.edu