1. UNM INTERNAL MEDICINE RESIDENCY PROGRAM - HOSPITALIST TRAINING TRACK Meeting 2 28 September 2015 Charles Pizanis, Christopher Bartlett

2. Objectives Describe hospitalist training track concept Share results of needs assessment of former UNM IM grads Review vision and structure of training track at UNM Decide on required rotations, format of small group curriculum, any additional elements of track

3. Hospitalist Training Tracks Programs across country have developed training tracks to provide training, exposures residents interested in hospital medicine Tracks share clinical rotations, small group meetings, quality/research experiences Graduates of these tracks go on to become community hospitalists, academic hospitalists, and leaders in hospital medicine

4. Needs Assessment

5. Why Did We Do It? By understanding the strengths and weaknesses of the UNM Internal Medicine Residency Program, from the perspective of current hospitalist physicians, a Hospitalist Training Pathway curriculum can be developed to meet and exceed the needs of future graduates entering academic and community hospitalist medicine.

6. All UNM Internal Medicine graduates within the past 3 years who are currently employed as an academic and/or community hospitalist physician. Who Did We Contact?

8. Question 1: Internal Medicine residency at the University of New Mexico fully prepared me to become a hospitalist physician. A majority of respondents agree or strongly agree that their residency experience fully prepared them for careers in hospital medicine. # of Responses Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree 6 2 1 What Did We Learn?

9. Question 2: In which aspects of your job as a hospitalist today do you wish you had received more training during residency? Respondents believe they would have benefited from more training in Neurology (44%), Quality Improvement/High Value Care (44%), Consultative/Perioperative Medicine (33%), Medical Education (33%), and Medical Economics (33%). What Did We Learn?

10. Question 3: A Hospitalist Pathway could have filled these gaps? A majority of respondents agree of strongly agree that a Hospitalist Pathway could have filled perceived gaps in their education. # of Responses Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree 1 1 3 4 What Did We Learn?

11. Question 4: I would have considered participating in a Hospitalist Pathway? A majority of respondents agree of strongly agree that they would have considered participating in a Hospitalist Pathway. # of Responses Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree 2 1 2 4 What Did We Learn?

12. Question 5: How many electives per year would you have been willing to exchange in order to take part in a Hospitalist Pathway? A majority of respondents felt like they would be willing to exchange 1 elective in order to take part in a Hospitalist Pathway. The average and median were 2. # of Responses 122-3 34 1 11 2 4 What Did We Learn?

13. 1. A majority of respondents agree or strongly agree that their residency experience fully prepared them for careers in hospital medicine. 2. Respondents believe they would have benefited from more training in Neurology (44%), Quality Improvement/High Value Care (44%), Consultative/Perioperative Medicine (33%), Medical Education (33%), and Medical Economics (33%). 3. A majority of respondents agree of strongly agree that a Hospitalist Pathway could have filled perceived gaps in their education. 4. A majority of respondents agree of strongly agree that they would have considered participating in a Hospitalist Pathway. 5. A majority of respondents felt like they would be willing to exchange 1 elective in order to take part in a Hospitalist Pathway. The average and median were 2. What Did We Learn?

14. UNM Internal Medicine Residency Hospitalist Training Track Overview Clinical Rotations Consultative Medicine (UNMH) SRMC Hospitalist (SRMC) Medical Economics (UNMH) Palliative Care Consults QI/Research Project Project chosen by resident Guidance by QI/research mentor Goal of presentation at conference and/or publication of project Small group meetings Online Society of Hospital Medicine (SHM) modules Online Institute for Healthcare Improvement (IHI) Open School curriculum Didactic Curriculum Paired hospitalist mentor Career mentoring Leadership mentoring HTT director mentor Mentorship

15. Track Basics 2-4 track participants per year Application process to begin in PGY1 year Track to occur over PGY2 - PGY3

16. HTT Track Timeline PGY 1 Apply to HTT (January) Acceptance to track (mid February) Select PGY2 schedule (Spring) Meet with HTT director (Spring) Meet with QI/research mentor and decide on project (late Spring) PGY 2PGY 3 Begin required HTT rotations Begin work on project Begin SHM/IHI curriculum Attend scheduled small group curriculum lectures Meet with QI/research mentor (quarterly) Attend one regional, one national conference Select PGY3 schedule (Spring) Complete required HTT rotations Meet with research/QI mentor (quarterly) Complete work on project (Fall, Spring) Submit scholarly work (Fall, Spring) Complete SHM/IHI curriculum Attend one regional, one national conference Complete HTT

17. Clinical Rotations – How Many and Which Ones? Consultative Medicine (UNMH) Grow in skills as medical consultant, increase exposure to perioperative care SRMC Hospitalist (SRMC) Provide exposure to work as community hospitalist Medical Economics (UNMH) Increase knowledge and understanding of business and economics principles of medicine Palliative Care Consults Provide additional exposure to palliative and end-of-life care

18. Small Group Curriculum Format Topics brainstorm Journal Club Schedule Monthly vs every-other month

19. Any Additional Elements We Should Include?

20. Timeline of Rollout 2015 September meeting Decide on rotations, format of small group curriculum, additional elements Start work on curriculum October – retreat Report back on progress of additional elements Solicit speakers for topics Solicit QI/research mentors November meeting Review track curriculum December meeting Finalize track curriculum Dec 31 Completed curriculum, structure, materials for rotation 2016 January - applications

21. Thanks!