1. WHAT I WOULD DO DIFFERENT James G. Tyburski, MD Detroit Medical Center/Wayne State University APDS, San Antonio April 21, 2010

2. Background Med school (Syracuse) 1987 Residency (Wayne State/DMC) 1992 Fellowship (Wayne State/DMC) 1994 Assistant Program Director 1997 Program Director 1998 54 residents (8 core/year, prelim for x 2 uro program, oral surgery)

3. Many Changes Over Past 13 Years Personal Professional Program (sponsorship, financial, personal) ACGME requirements ABS requirements New/discontinued fellowships

4. Looking out at the road rushing under my wheels I don’t know how to tell you all just how crazy this life feels I look around for the friends that I used to turn to to pull me through Looking into their eyes I see them running too Jackson Browne

5. ACGME – Program Director requirements Devote his or her principal effort to the program Designate other well-qualified surgeons to assist in the supervision and education of the residents Be responsible for all clinical assignments and input into the teaching staff appointments at all sites

6. Along with the faculty, be responsible for the preparation and implementation of a comprehensive, effective, and well- organized educational curriculum Ensure that conferences should be scheduled to permit resident attendance on a regular basis, and resident time must be protected from interruption by routine clinical duties.

7. Oral exams ABSITE review Re-established reading program Competency lectures Remedial reading Mentorship Department residency committee Skills labs

8. 80 hour work week – not surgery “lite” Restructured conferences/clinic Change expectations re: resident availability Program requirements Institute teaching credits/reimbursement

9. I would educate the attending surgeons in the department about changes in requirements more frequently and more thoroughly Documentation of performance

10. I would get more total department involvement sooner than I did You can’t do it alone – especially now No director of surgical education No curriculum development help No assistant Program Director These things are expensive in terms of dollars/time

11. Program Information Form I would have paid attention in greater detail to all parts, every time Six citations on RRC visit 3 were rescinded with further information I would have saved myself a fair amount of gnashing of teeth

12. Give regular updates to the department Need support of administration/Chair/Dean Educate the Department on changes Get total involvement

13. I’m starting with the man in the mirror I’m asking him to change his ways And no message could have been any clearer If you wanna make the world a better place Take a look at yourself, and then make that change S. Garnet, Glen Ballard