MPPDA 2014 Presidential Address Russ Kolarik, MD MPPDA National Meeting April 10, 2014

MPPDA.org 2014 Match Results 2012 ABIM and ABP Results Accreditation for Pediatric Hospital Medicine The first year of the NAS Year in Review

MPPDA.org First year of new web resource for our organization. Will briefly review site at the end of the day today. Please review it today and subscribe. Designed as a comprehensive information hub for everything you should need to access quickly as a Med-Peds PD.

MPPDA.org All feedback about the site, however small is highly welcomed! goes directly to me. Please Please take a moment to send your name, institution and academic rank to me at

2014 Med-Peds Match Results Total # of Programs 7977 Total Positions Offered Total Positions Filled Fill Rate96.8%99.2%95.0% % of Positions filled by US Graduates (MD) 75.9%85.2%76.2%

2014 Med-Peds Match Results 2014Med-Peds Internal Medicine Pediatrics Family Medicine Total # of Programs Total Positions Offered 3746,5242,6403,109 Total Positions Filled 3626, ,977 Total # of Unfilled Positions Total Unfilled Programs

2014 Med-Peds Match Results 2014Med-Peds Internal Medicine Pediatrics Family Medicine Total # of Applicants 58211,2363,9935,999 Total # of US Graduates Applying 3343,7622,0651,664 Fill Rate96.8%99.1%99.5%95.8% Positions filled by US Graduates 75.9%48.5%68.9%45%

2014 ERAS Data Applicants that applied to at least 1 Med- Peds program: US Allopathic applicants was 439 down from 468 total in US Osteopathic applicants 65 (14.8%) up from 48 in 2013 (10% of total).

Conclusions and Next Steps The total number of candidates applying to Med-Peds decreased from 603 in 2013 to 582 in 2014, but is still higher than the 560 in Local recruiting efforts are needed to promote our specialty. Get involved with NMPRA and creating Med-Peds Student Interest Groups

2012 ABIM Results

2012 ABP Results

Conclusions and Next Steps We have some breathing room, but still need to pursue board preparation aggressively with our at-risk residents. Maintaining equivalence with categorical programs is VITAL for our specialty. To compare favorably at this rate, only 40 MP residents nationwide can fail the ABP, and 56 the ABIM.

Board Preparation for at risk residents At risk residents include those with USMLE I less than 220, or ITE in final year of training of less than 65% 14 respondents to survey for up to four at-risk residents per program. Roughly 50% of respondents reported mandating resident-specific study programs for at-risk residents that involve additional board study and questions.

Board Preparation for at risk residents About 50% of respondents also said that they would recommend that they would recommend deferring the ABIM for at risk residents so they could focus on passing the ABP. About 30% did not counsel either way because the decision is up to the resident. 20% counseled them to take both exams.

From the PD Survey 43% of programs use the USMLE scores to determine residents at risk for failing the board certification exams, 79% use the ITE’s, and 43% use other or personal reasons. 72% who were identified at risk passed the ABIM, and 71% passed the ABP.

Next Steps We should know who our high risk residents are. We should take a personal interest in our at-risk passing their boards, starting as early in training as possible. Reach out to other programs and the MPPDA for assistance.

Accreditation for Pediatric Hospital Medicine JCPHM: Joint Council for Pediatric Hospital Medicine has initiated the application process for acreditation. Applying for an accredited two-year pediatric hospitalist fellowship that if approved would start in about 6 years time.

Intended impact Standardize care for pediatric inpatient clinical diagnoses. Focus on specialized clinical services and procedures for hospitalized children. Emphasis on healthcare systems, quality leadership and advocacy

Intended Impact Develop leaders in pediatric hospital medicine at academic medical centers and community hospital medical directors. Not intended to restrict ability of general pediatricians or Med-Peds physicians to practice hospital medicine in academic or community settings.

Potential unintended effects Board certification may ultimately become standard for medical staff offices hiring new hospitalists or leaders. Concern about grandfathering criteria for current Med-Peds hospitalist who see proportionately fewer pediatric patients.

Potential unintended effects Could potentially limit scope of employment opportunities for general pediatrics or Med-Peds graduates wishing to pursue jobs as hospitalists. Effectively increases training time to 6 years for Med-Peds graduates wishing to work primarily as hospitalists. Medical students are already inquiring about this as a significant concern.

Current proposal I am working to make criteria for grandparenting to sit for boards as encompassing as possible for current Med-Peds hospitalists. I have also proposed a one-year pediatric fellowship option for Med-Peds trainees that may or may not be combined with adult hospital or transitional care activities.

Follow-up Will share data with JCPHM leadership. Need for Med-Peds representation on Committees and at society meetings. Jen O’Toole is conducting a hospitalist workforce survey inquiring about recent graduates. PLEASE complete this survey.

Next Accreditation System First year of using the Milestones, implementing Clinical Competency Committees, and CLER visits. First reporting of Internal Medicine and Pediatric Milestones to the ACGME in May/June. Need to share experiences – website and listserve.

Next Accreditation System Need for ongoing Med-Peds representation with national organizations and feedback regarding milestone evaluation process. Need to share assessment and evaluation tools to help track milestones and other outcomes of training.

Just one last thing…. –I invite each of you, think of just ONE thing you can do when you go back home after this meeting is over that will help the specialty of Med-Peds. –Take a moment, write down one thing that you are going to do and the date you plan to do it. When you are successful, let the rest of us know.