1. Nuclear Medicine Review Committee Update SNMMI Winter 2016
Jon Baldwin, DO
Chair
Review Committee for Nuclear Medicine

2. Disclosures
None

3. Session Overview RC structure NM program stats Eligibility NAS Updates
Milestones/CCC
Questions

4. Current Committee Membership
Jon Baldwin, DO (AMA) – Chair
David Lewis, MD (AMA) – Vice Chair
Helena Balon, MD (SNM)
Frederick Grant, MD (SNM)
Barry Shulkin, MD (ABNM)
Kirk Frey, MD (ABNM)
Mary Beth Farrell, MS (Public)
Adonteng Kwakye, MD(Resident) 4

5. RC Meetings 2 meetings per year
Check RC website for agenda closing dates & meeting dates
Upcoming: April 8, 2016
(agenda closing date: March 7, 2016)
Meeting Length: 1 – 1 ½ days
Program reviews & other Review Committee business

6. Nuclear Medicine 2015-2016 43 accredited programs
84/157 (54%) filled vs approved resident positions

7. Nuclear Medicine 10-year Stats
Academic Year
Programs
Residents On duty 61
161
160 57 56
149
166 54
155
136 50
120 47
111 43 93 84

8. Nuclear Medicine Programs 2005-2015

9. Eligibility

10. 2016 NM Eligibility FAQ
As AOA-approved programs transition to ACGME accreditation, are there any considerations for nuclear medicine programs considering applicants who have previously completed AOA-approved training?
[Program Requirement: III.A.1.c)]

11. 2016 NM Eligibility FAQ
Answer: The Review Committee understands that during the transition to a single accreditation system, nuclear medicine programs may wish to consider NM1 applicants who have completed one year of graduate medical education in an AOA-approved program. Nuclear medicine programs will not jeopardize their accreditation status if they accept these individuals. All programs should check with the American Board of Nuclear Medicine (ABNM) and/or the American Osteopathic Board of Nuclear Medicine (AOBNM) regarding certification eligibility.

12. NAS Review Discussions

13. NAS Summary 40% programs Compliant, no feedback 37% programs
Minor issues in 1-2 areas, feedback in the form of AFIs
20% programs
Concerns, feedback either as citations and/or AFIs
3% programs
Site visits requested for more information
Area for Improvement (AFI)
Citations
Areas noted by the Committee for program improvement before it gets worse, “Heads Up”
Does not require program response
Areas of non-compliance with the requirements
Requires full program response for Committee review

14. NAS Most Common Flagged Items
Clinical Experience (Case Logs)
Many data entry discrepancies still occurring
Board Pass Rate
Reminder that the new pass rate is 75% for first time takers for 5yr period
Pgms below 75% can anticipate feedback from the Review Committee
Resident Survey
Flagged programs with less than 4 residents can anticipate feedback on the multi-year aggregate survey results.

15. Block Diagram in ADS Many programs providing inadequate block diagrams
Not representative of a 3-year curriculum
NM is a three-year specialty. This should be reflected on the block diagram.
Even programs with recruiting practices that only consider NM2 or NM3 residents

16. Block Diagram in ADS
Block diagram should be free of individual resident names or identifiers
If abbreviations are used for rotations or site names, a Key must be provided
Block diagram guide posted on Committee’s webpage

18. Block Diagram Example

19. Clinical Experience - Case Logs
All programs are required to use the ACGME Case Log System
Residents must enter all specified procedures performed during their residency education into the ACGME case log system regardless of stated minimums.
Inaccurate data will impede the Committee’s ability to set accurate and realistic future benchmarks for the specialty.

20. Clinical Experience - Case Logs
Among the graduates of 2015, the minimum number of procedures reported for all procedural categories was “0”
The highest procedural category reported was for parenteral therapies at 283

22. Omission of Data 5% of programs flagged for not providing data
Faculty Scholarly Activity
No Core Faculty designation
Program Director:
Must provide complete and accurate information (II.A.4.h).(1)
Review all information before “hitting” the submit button

23. Milestones

24. NM Milestones Reporting
Data appears skewed for resident competency progression
Most likely linked to inaccurate resident reporting in ADS
Several residents reported in ADS with inaccurate “Year in Program” compared to their NM year

25. NM Year Consideration < 12 months of training remaining
= NM3 (or year in program 3)
Between 24 and 12 months of training remaining             
= NM2 (or year in program 2)
Between 36 and 24 months of training remaining             
= NM1 (or year in program 1)

26. EXAMPLE Resident length of training was 1yr,
Year In Program should be 3

27. Milestones
Milestones designed to help residencies/fellowships produce highly competent physicians to meet the health and healthcare needs of the public
Guide curriculum development
Provide developmental framework for Clinical Competency Committee (CCC)
Residents do not have to achieve level 4 to graduate from the program
The determination of an individual’s readiness for graduation is at the discretion of the program director

28. Milestones/ Clinical Competency Committee
CCC should help analyze and synthesize resident assessments
Using milestones, CCC should reach consensus judgement regarding resident performance
CCC provides conclusions to program director
Program director has ultimate authority to determine residents’ milestone developmental level at least twice yearly
Journal of Graduate Medical Education, September 2015

29. Clinical Competency Committee
For CCC composition, programs should consider including a physicist or other faculty member who assesses NRC/AU requirements
A Clinical Competency Committee (CCC) Guidebook is posted on the Milestones webpage

31. ACGME Staff Contact List
Executive Director
Felicia Davis, MHA
Associate Executive Director
Kate Hatlak, MSEd
Senior Accreditation Administrator
Sara Thomas
Case Log questions

32. Questions?
Thank you
Our Answers