1. New Program director & Program Coordinator Introduction
Office of Graduate Medical Education
August 9, 2019

2. Agenda The Nuts and Bolts of Running a GME Program ACGME WebADS
New Innovations
The GME Yearly Cycle
SLU-Specific GME Matters

3. GME Training Oversight
ACGME
SLU SOM
Specialty Society

4. Institutional Sponsorship Reporting Structure
Board of Trustees
Dean of SOM
DIO
GMEC
Program Directors
Program Coordinators
Departmental Chairs
Teaching Faculty

5. SLU SOM Institutional Sponsor Employer Policies/Processes
64 programs
630 trainees
2 states
SLUH, St. Mary’s, CGCH, VA, Mercy, St. Elizabeth’s
Employer
Policies/Processes
Accreditation/Certifications

6. Coordinator Responsibilities monitor, schedule, manage
Clinical Experience and Education Hours
CCC meetings
PEC meetings
Evaluations
VA Reports (Quarterly)
Program Coordinator Meetings
Scholarly Activity Tracking
Recruitment activities
Crisis management
Procedure log confirmations
Monitor Recertification
Expirations
Resident Roster
Away Rotation Paperwork
Rotating Residents from Other Institutions
EPIC access
PD/PA Weekly Meetings
Program Coordinator Development
Elective schedule requests
MDFEA reporting
Verify and pay lab-coat and pager invoices

7. Program Director Role teach, supervise, direct
GMEC (then Dean) approves PD
term adequate for continuity & program stability (length of program + 1 yr)
certification in the specialty
evidence of scholarship
oversee didactic, clinical and sites
approval local site directors
approve and evaluate teaching faculty
monitor resident supervision
prepare and submit ACGME materials and annual program updates
ensure compliance with grievance and due process
provide verification of residency education
implement and distribute policies and procedures
monitor resident duty hours and adjust schedules as needed
monitor and deploy backup support for residents
comply with the institution’s written policies and procedures
obtain review and approval of GMEC/DIO for ACGME matters

8. July August September October November December
Specialty Match
ADS Updates
Orientation
APE report
CCC
Recruiting
January February March April May June
Main Match
PEC Meeting
Graduation
Milestones
CCC
ACGME Survey
Milestones

9. APE Process May PEC Meeting Continuous Data Collection for APE
PEC Meeting for APE
Develop APE Report & Action Plan
Disseminate to Faculty, Residents & GMEC
Implement Action Plan
PEC Meeting
PEC Meeting
Aug.
APE & ACTION PLAN MUST:
be distributed to and discussed with teaching faculty and residents
be reviewed by the GMEC

10. July and August Program Director Orientation ERAS Opens ACGME WebADS
Complete GMEC APE
Special Board Data Review
Residency Website Updates
ITE
Semi-Annual evals
Recruitment pre-activities
Program Coordinator
Orientation Activities
GME Program Survey Deadline
ITE Roster/Exam
ACGME WebADS
Resident recruitment pre-interview activities
(schedule/dinner/hotel/
shuttle/arrangements)
AOA Membership
APE data gathering

11. September and October Program Director Program Coordinator ERAS
NRMP Registration
Register for The Match
Recruitment pre-activities
Interviews begin in October
Conduct Interviews
Crisis management
Program Coordinator
Resident Recruitment (Interview, Dinners, Tours)
Renew Resident Educational Subscriptions/Board Materials
ACGME Milestones Open October 30
Prepare Milestone Packets for CCC
National GME Census Deadline
Schedule and proctor ITE exams
Holiday Party Preparations
Crisis Management

12. November and December Program Director Continue Resident Interviews
Mentor Meetings
CCC
PEC
Military and Fellowship Match where applicable
Semi-Annual Evals
December submit Match List
Program Coordinator
Resident Recruitment (Interview, Dinners, Tours)
GME Program Survey Deadline
Renew Resident Support Materials
Semi-Annual Evaluations
AAMC Deadline for National GME Coordinate Residency meetings
Prepare recommendation
letters for fellowships

13. January and February Program Director Match Rank List Due January
Continue CCC follow-up with Residents
Recruiting Wraps UP
Milestones Due
Interviews for Chief Resident
ACGME Survey
Program Coordinator
Recruitment
USMLE 3
ACGME Surveys
Resident Deadline for National Boards
Milestones Due
Graduation Diploma/Ceremony Planning

14. March and April Program Director Canadian Match – March 1
NRMP Match – March 16
Specialty Program National Conferences
Rotation schedules for Upcoming Academic Year
PLAs for New Rotations
Finish ACGME surveys
Recruitment pre-activities
Complete ACGME surveys
Program Coordinator
Collect Contract Signatures
Special Program National Conferences
Solicit Schedule Requests
ERAS Registration
Review Expiring PLAs
Resident recruitment pre-interview activities
Complete ACGME surveys
Onboarding activities
Training credentials and info verification for training sites

15. May and June Program Director Graduation Dinner Graduation Ceremony
Welcome Party Preparations
Orientation Materials
CCC
PEC
Mentor-Milestone Evaluation Meetings
End of Year Reports for Each Resident
Summative Residency Reports
Recruitment pre-activities
Program Coordinator
Prepare and Send Invitations
Graduation Dinner planning
and ceremony
Create Graduation Brochure
Orientation Materials
Graduate Offboarding
Faculty Teaching Awards
ITE Exams
ACGME milestone reporting
Bi-annual evaluations
Schedule final evals for graduates
Alumni certificates
CCC
PEC
Order new lab-coats and pagers
Distribute lab coats, assign pagers
Assign lockers
Assign mailboxes
Schedule orientation breakfast and other activities
Website updates

16. GME at Saint Louis University

17. GME Website

18. SLU GMEC: ALL ARE WELCOME! 2nd Wednesday 12:30-1:30pm Beaumont + lunch
oversight committee for residency, subspecialty and fellowship programs
At least 14 voting resident and faculty from clinical departments
one patient safety or quality improvement officer
3-yr term: IM, peds, psych, neurology, FM, OB, surgery
2-yr term: 1) Urology, plastic surgery or neurosurgery; 2) otolaryngology or orthopaedic surgery; 3) ophthalmology or dermatology; 4) pathology, radiology or anesthesiology
At least 2 at-large faulty members
At least four peer-selected residents for one-year term (peer selected/voted) 

19. GMEC Subcommittees Patient Safety & Quality Improvement
Tracking/trending resident-placed and resident-involved events
Collaboration with SSM sites
Annual Program Evaluation (APE)/Special Review
Annual Program Review
Semi-annual action plan review
Letters on program progress
Annual Institutional Review
Institutional Executive Summary
Institutional Oversight
Professionalism Oversight
Duty Hours/Citation Monitoring
Tracking/trending resident events

20. Special Reviews Overseen by GMEC Required by ACGME
Identify underperforming program (data driven)
Citations, surveys, resident/faculty performance
SLU GMEC Special Reviews
PD/PC interview
Faculty interview
Resident interview
Data/training file/WebADS review
Report generated with recommendations
For Cause, pre-site visit, self-study, concern-focused

21. Centralized Processing
MO license
No Illinois clinical practice (except IL family medicine)
BNDD
Medicare/Medicaid enrollment
Malpractice
Covered at CGCH, VA, Mercy
Some covered at St. Mary’s
Invoiced to SLUH
HR/Payroll/Insurance/Benefits/Parking
Affiliate Monthly Invoicing (via MDFEA)
Onboarding, drug screening/employee health, background checks
Visas
Certificates, employment files

22. SLURA Saint Louis University Resident Association
President, Vice President (president elect), Secretary, Treasurer
Peer selected
Peer-voted
GME provided budget
Plan and organized activities
Social, educational, volunteer
Voice for residents to GMEC and GME Office

23. GME Financing GME paid Departmental paid Positions paid by
Stipends
benefits (29%): insurance
Parking
Malpractice
Accreditation, match, licensure costs
Departmental paid
Books, travel, research
ITE, exam costs
Lab coats, meals, pagers
Coordinators, PD, faculty
Positions paid by
Hospitals
Military
Departmental funds
Grants/contracts
Negotiated yearly
Rotations at site of FTE allocation
Germane Solutions
SSM-SLU joint venture
GME Strategic Analysis
Report being reviewed

24. Leadership SLURA Women in Medicine & Science (WIMS)
Student Interest Group Advisors
GMEC & Subcommittees
Wellness Champions
Code of Conduct Council
ACGME Chief Resident Training
ACGME committee membership
Coordinators Leadership Council
Hospital Committees/Subcommittees

25. ACGME expectations

27. Common Program Requirements Updates 2017, 2019
Professionalism
Well-Being
Patient Safety
Quality improvement
Supervision
Fatigue Mitigation
Clinical Responsibilities, Teamwork, and Transitions of Care
Clinical Experience and Education (formerly “duty hours”)
80-hour “never event”

28. Board Pass Rates
3-year aggregate 1st time pass rate above national 5th % OR
3-year aggregate pass rate >80%
AND
Rolling 3-year ultimate board certification rate at 7 years post-graduation

29. Surveys

30. Program Evaluation Committee Conducts the Annual Program Evaluation APE Annual Report (minutes) Written Action Plan
curriculum
outcomes from prior APE
ACGME letters, citations
quality and safety of patient care
aggregate resident and faculty:
well-being
recruitment and retention
workforce diversity
engagement in QI and patient safety
scholarly activity
resident and faculty surveys
written evaluations of the program
aggregate resident:
achievement of Milestones
in-training examinations
board pass & certification rates
graduate clinical performance
aggregate faculty:
faculty performance
faculty development

31. Web ADS Annual ACGME Updates (*new)
Response to Citations
Major Changes
ALL Changes!!, action items, activities, new faculty etc
Updated block schedule (use suggested online template)
Faculty certifications
Scholarship: do not leave blank
*Program mission and aims
*Resident board certification (7-yr ago)
*PLAs: date, site director (must be listed faculty), DIO signature
*CCC/PEC members and process for committees for APE/action plan

32. Web ADS: How will the program….
achieve/ensure diversity in trainees and individuals participating in the training program (e.g. faculty, administrative personnel)
Vice Dean of Diversity Equity and Inclusion & Chief Diversity Officer, Daniel Blash, PhD
Multiple GME Orientation recordings
deal with and/or report problems and concerns in a confidential and protected manner as well as steps taken to minimize fear of intimidation
GME Website information
advance knowledge of ethical principles of medical professionalism
Ethics workshop: all new interns (recorded)
IHI module: end of life care
Compliance training modules
educates residents/fellows on event reporting of near misses, adverse events, and serious adverse events are communicated to patients and families
Event reporting and disclosure simulation training: new intern/fellows orientation (recorded)
educated about pain management, including the recognition of the signs of addiction
“responsible prescribing” presentation: new intern orientation (recorded)

33. Hospital Event Reporting
Attached is an event report regarding your resident.
This is Dr. XXX’s third event.
Dr. Gammack and GMEC have developed a form for standardized reporting of resident events which you can use to respond. Below is the link:

34. Faculty Development: Annually
in quality improvement and patient safety
in fostering faculty and residents’ well-being
in patient care based on their practice-based learning and improvement efforts
in contributing to an inclusive work environment

35. Faculty Development
GME Faculty Scholarship for 6-day ACGME Competency-Based Assessment Course (March yearly)
2 faculty per year (applications December)
ACGME 3-day/6-day Faculty Development Courses
Department of Pediatrics Faculty Development Program
Faculty Affairs Brown Bag Sessions
Semi-Annual Faculty/Staff Development Program
May/November: 2 hour evening
Sponsored periodic guest speakers
Reinert Center for Transformative Teaching & Learning (SLU)

36. Scholarship Housestaff Research Symposium (April)
Oral and poster presentations/awards
Support for Manuscript Submission and Publication Fees
Program for Research Project Funding: max $6000
application April 1/October 1
Program for Away Rotation (PAR)
Scholarship for international experiences (application May/Nov)
1 month and 1 week

37. Educational Resources
Sonosim: web-based ultrasound simulation education
AMA GME Competency Education Program: 30+ modules
IHI Open School Online Courses: 30+ safety/quality modules
GME Website: Recorded Trainings and Sessions (GME Orientation Sessions)
SLU Simulation Center (Assistant Dean, Tina Chen, MD)
ACLS/BLS certifications

38. Wellness & Recognition
Wellness Champion Program
1 resident/faculty per department
3x yearly workshops
Wellness resources and networking
GME Wellness website
Self-assessments, resources, educational tools
Humanistic Healer Award (quarterly nominations)
SLUH Caring Physician Awards (nominations August)
Excellence in Professionalism Award
Office of Professional Oversight

39. Professional Support Services
Office of Professional Oversight
Learning Specialist
Lisa Israel, M.Ed. (Director)
Desloge Towers, Room T-6147
GME Ombudsman
Confidential, neutral, negotiation, navigator
Recipient of reporting, concerns, complaints
Residents, students, staff, faculty, hospital employees
Sara H. Barnett, PhD
Multi-Cultural Affairs-L 103A
Test taking assistance
Study strategies
Time management
Career challenges

40. Resident Concerns
Office of Professional Oversight. T-6417 Desloge Tower; ;
SLU SOM Grievance Reporting:
Chief residents, program director, departmental chair, Associate Dean for Graduate Medical Education
Saint Louis University Resident Association (SLURA)
Semi-annual resident forum
GMEC resident members
GME Resident ombudsman, Lisa Israel, Director of the Office of Professional Oversight
SLUSOM compliance hotline KNOW (5669)
Riskonnect event reporting system
SLU SOM event reporting system
University Health Plan, 24-hour confidential behavioral health assistance..

41. Support Services English Language Center (North Campus)
Effective Communication Course (Behavioral Medicine)
4 X 1 hour, 1:1 communication session
Missouri Physicians Health Program (MPHM)
Employee Health Saint Louis University Hospital
PPD, respirator fit, immunizations, drug testing, work-related illness/injuries
New Innovations Assistance
Nicole Herzog, SLUH Medical Staff Office
Kaitlin Schneider, GME Office

42. Behavioral Health Program
University Health Plan: Behavioral Medicine Institute
6 free and confidential visits
does not need to be for a medical diagnosis
Referral form: single mandatory visit
Includes stress management, relationship problems, etc.
24/7 access to an on-call clinician for urgent behavioral health matters at
Behavioral Health Advisory Board (15 to 20 residents) meets twice yearly to discuss Behavioral Health Plan benefits
Onsite service: Tues and Wed Rm M-205 in Schwitalla

43. Moonlighting: Faculty Work
Officially: not allowed
Cannot on J-1 visa
Difficult with H1B
Template for institutional approval (signed by the Dean)
At SLU-affiliated sites
External (must have own MO license, DEA)
Internal (no billing, still supervised): provided additive pay

44. Leave: per 12 month period
3 weeks of vacation
1 week = 5 business days or 7 consecutive days
Additional days: program-specific
Conferences, interviews etc.
30 days sick
FMLA 12 weeks of job protected leave (not all is paid)
Apply if 3+ days of leave
2 weeks paid caregiver sick (paternity, ill family)
Qualifying condition
12 months employment prerequisite
Total leave (all reasons) cannot exceed specialty-society requirements (or training will need to be extended)

45. Observerships If MD graduates – processed by GME Office
2 weeks – 3 months
Processed by employee health, background checks
Cannot provide care (history, exam, procedures)
If students (U.S., international, high school) – processed by student affairs
If < 2 weeks (and in hospital) – processed by hospital
Must have a sponsoring faculty at SLU (we do not identify the sponsor)

46. External Rotators/Rotations
Accept outside clinical trainees
Need license, malpractice, EPIC training, employee health….
Institutional or program agreement/contract
Can take 3-6 months to establish (if outside of Missouri)
Away Rotations
Cost is limiting factor ($ malpractice)
Institutional or program agreement, license required
Visa can be limiting
Cannot extend training time
Program for Away Rotation (PAR): international experiences
Covered for some programs based on hospital/funding agreements

47. Trainee Appointment/Onboarding
FAQ’s
How long does it take to obtain a MO temporary license?
Generally 6 to 8 weeks
Requires ECFMG, Step 1, Step 2 (H1B Step 3)
Does GME support MO Permanent licensure?
No. Housestaff that desire to obtain a full physician's license are responsible for all fees associated with the process and must secure personal DEA and BNDD licenses
Some programs pay for this.

48. Trainee Appointment/Onboarding
FAQ’s
What types of visas does GME support?
J-1 Visa (no cost to programs) Valid for only up to 7 years, regardless of training duration
H1-B Visa (program sponsored; $960 – $2,185)
All other Visas are subject to housestaff discretion
When seeking a J-1 visa, it is important for programs to ensure the prospective resident or fellow has enough time left on the visa to complete the training program.

49. New Innovations: Residency Management Platform
Scheduling rotations
Managing – tracking evaluations
Reporting time to CMS
Logging duty hours
Archiving – housing resident/faculty data
Storing resident documents
Completing APE

50. Please call as soon as…
License, visa, insurance, accreditation concern
Legal paperwork, subpoena, summons
Trainee leave, illness, FMLA
Serious issue with hospital, faculty, peers
Faculty leaving
Trainee transfer, resignation, non-standard program
Considering probation, non-renewal (6 month notice), dismissal, disciplinary action

51. Thoughts……. Questions…… Suggestions……