UNM INTERNAL MEDICINE RESIDENCY PROGRAM - HOSPITALIST TRAINING TRACK UNM Hospital Medicine Spring Retreat 2 June 2015 Charles Pizanis Patrick Rendon

Food for Thought In which aspects of your job as a hospitalist today do you wish you would have received more training during residency? What is unique to your hospital which you feel residents interested in hospital medicine should experience?

Background of the UNM Hospitalist Training Track Idea Hospital medicine is awesome Hospital medicine is becoming more specialized and competitive We have an amazing setup at UNM Division of Hospital Medicine We can offer our residents a quality hospitalist training UNM Hospitalist Training Track was born

Hospitalist Training Tracks Programs across country have been developing training tracks University of Colorado Tulane Northwestern Banner Health Applicants interested in hospital medicine Graduates of these tracks go on to become community hospitalists, academic hospitalists, and leaders in hospital medicine

Some Elements of Hospitalist Training Tracks Training in clinical areas of hospital medicine Medical consultation and perioperative medicine Procedural medicine Transitions/post-acute care Palliative Care, Neurology Exposure to quality improvement (QI) and patient safety principles and participation in QI/research efforts Promotion of growth in healthcare leadership traits and characteristics Education on economic concepts affecting medical practice End result: a highly trained resident skilled in clinical, quality, and economic aspects of hospital medicine

UNM Internal Medicine Residency Hospitalist Training Track Overview Clinical Rotations QI/Research Project Consultative Medicine (UNMH) SRMC Hospitalist (SRMC) Medical Economics (UNMH) Neurology Consults (UNMH or VA) Project chosen by resident Guidance by HTT mentor Goal of presentation at conference and/or publication of project Online Society of Hospital Medicine (SHM) Modules Online Institute for Healthcare Improvement (IHI) Open School Curriculum Small Group Lecture Curriculum Paired hospitalist mentor Track mentorship Project mentorship Career mentorship Didactic Curriculum Mentorship

Clinical Rotations Consultative Medicine (UNMH) SRMC Hospitalist (SRMC) Medical Economics (UNMH) Neurology Consults (UNMH or VA) Rotations would be completed during PGY2 and PGY3 year during elective time

Quality Improvement/Research Project Project of either hospital medicine research or quality improvement to be completed by the end of the track Work together with mentor in identifying project, facilitating project, and monitoring project Goal: present at research at a regional or national meeting and/or publishing article

Mentorship Paired mentorship with hospitalist Mentors meet with HTT participants regularly (quarterly) Guidance on meeting requirements HTT, supervising the quality/research project, and assisting in career goals and advice

Didactic Curriculum SHM Modules IHI Open School Small Group Curriculum Hospitalist Journal Club Lecture Circuit “Applying for Hospitalist Positions” “Creating a solid CV” “Turning QI into Research” “Writing an Abstract” “Documentation for the Hospitalist” “Approach to the IRB”

Additional Elements Societal membership SHM IHI American College of Physicians (ACP) Society of General Internal Medicine (SGIM) Attendance at regional, national conferences SHM Quality Safety Educators Academy (QSEA) ACP

Suggested HTT Timeline PGY 1 Apply to HTT (early Spring) Acceptance to track (Spring) Meet with mentor (Spring) Identify schedule Identify/choose project Select PGY2 schedule (Spring) PGY 2PGY 3 Begin required HTT rotations Begin work on project Begin SHM/IHI curriculum Attend scheduled small group curriculum lectures Meet with mentor (quarterly) Attend one regional, one national conference Select PGY3 schedule (Spring) Complete required HTT rotations Complete work on project (Fall, Spring) Submit scholarly work (Fall, Spring) Complete SHM/IHI curriculum Attend one regional, one national conference Meet with mentor (quarterly) Complete HTT

Upon Completion of HTT Certification in QI (IHI) Publication and/or presentation at regional or national conference Certification of completion of University of New Mexico Internal Medicine Residency Program Hospitalist Training Track

Additional Future Areas Potential rotations Palliative Medicine Procedural Medicine VA QI rotation Presbyterian Hospitalist Potential areas HM Journal Club Divisional/Departmental/Hospital Committee membership

Benefits to Residents Acquisition of skills to become future hospitalist Mentorship from current hospitalist Structure for QI/research project Attendance at conferences Peer, program identification as leaders in hospital medicine Certification in IHI, QI Certification of completion of UNM Hospitalist Training Track

Benefits to Faculty Resident involvement in QI/research efforts Pipeline to publication CV building Identification of future hospitalists Satisfaction of mentorship, teaching

What Will Be Needed Site directors creation of rotation curriculum at site overseeing orientation/scheduling of residents at site periodic meetings with HTT director and other site director Mentors quarterly meetings with mentee assisting mentee in identification, implementation of project assisting mentee in publishing of project Small group leaders creation of various talks on hospitalist topics

Open Forum Proposal? Additions/changes to curriculum? Are there unique elements at your hospital which we should include in track?