Graduate Medical EducationNew Program Coordinator Orientation

Part 2May 28, 2020

Confidential – For Discussion Purposes Only

AGENDA GME Operations

− Recruitment

− Benefits

− Visas

Misc.

− GMEC

− Quality Improvement

− GME Communities

− Program Expansion & Funding

MedHub

− Resident Evaluations

− Program Evaluations

− Work Hours

Confidential – For Discussion Purposes Only

GME Operations

Confidential – For Discussion Purposes Only

GME Operations

Recruitment

Interviewing/Hiring

Recommendations of Appointment

− Continuing Trainees

− New Hires

Registration/Orientation Requirements

− Incoming Residents /fellows

Confidential – For Discussion Purposes Only

Recruitment

− If you are using the NRMP Check the important match dates (www.nrmp.org)

Activate your program with the NRMP annually

Inform Ann Dohn of any changes in quota (numbers to match)

Enter Rank Order list in NRMP

Send Rank Order List PDF to Ann Dohn with URMs highlighted

Avoid Match Violations

GME Operations

Confidential – For Discussion Purposes Only

Recruitment Do’s and Don’ts

Confidential – For Discussion Purposes Only

Recruitment

Confidential – For Discussion Purposes Only

Interviewing/Hiring

− You must have a Program Policy on Recruitment

− Resources for interviewing can be found on: http://gme.stanford.edu

Under Program Directors Monthly Meetings: see Power Point Slide decks from the sessions on Employment Law and the Great Visa Debate

GME Operations

Confidential – For Discussion Purposes Only

Recommendations of appointment for all continuing residents/fellows are due to GME no later than December of each year. − GME provides an excel spreadsheet to all coordinators in November

New Hires need a recommendation of appointment form also due by December 2.

GME Operations

Confidential – For Discussion Purposes Only

2019-2020 SHC Benefit Information

Confidential – For Discussion Purposes Only

GME Operations PGY Level

− A resident/fellow’s appointment is determined in accordance with the level recognized by the specialty board in the residency training program.

− NOT ALL YEARS MAY COUNT FOR PGY DESIGNATION!!!

Visas

− H1B Visa only for graduates of US Medical Schools (program must pay costs)

− J1 Visa – GME Processes

CA Medical License –

− Regulations changed 1/1/2020

− CA now requires 3 years of ACGME residency/fellowship to qualify for a license

− NEW MBC forms are available at: https://www.mbc.ca.gov/Forms/

Confidential – For Discussion Purposes Only

New California Physician License Requirements

Senate Bill 798 effective 1/1/2020

MD applicants must complete 3 years of ACGME before obtaining a full unrestricted license

US or international medical school graduates

Training must include 4 months of general medicine (pediatrics, Ob/Gyn, family medicine, etc.)

Must complete 24 consecutive months of training in the same program

Confidential – For Discussion Purposes Only

2020 Changes to CA MD Licensing

All residents must obtain a Postgraduate Training License (PTL) to participate in ACGME training in CA

Must be obtained within 180 days after enrollment in the program

Does not need renewal

For unlicensed residents currently in Ca programs-must have the PTL by August 31, 2020.

Confidential – For Discussion Purposes Only

What medical schools are acceptable? To be eligible for licensure in California, you must have received all of your

medical school education from and graduated from a:

− U.S. or Canadian medical school accredited by the Liaison Committee for Medical Education (LCME), the Committee on Accreditation of Canadian Medical Schools; or

− The foreign medical school which has been evaluated by the Educational Commission for Foreign Medical Graduates (ECFMG), the foreign medical school is listed on the World Federation for Medical Education (WFME), the Foundation for Advancement of International Medical Education and Research (FAIMER) World Directory of Medical Schools joint directory, or the World Directory of Medical Schools; or

− A foreign medical school that has been approved by the Medical Board of California (Board).

Confidential – For Discussion Purposes Only

Cost of the Training License There are two fees involved in the licensing process. The first fee is the

application fee, which is $491 and includes the $49 non-refundable fingerprint processing fee.

Confidential – For Discussion Purposes Only

Postgraduate Training License (PTL) Checklist Can apply on line

− PTL1-5 application-all 5 pages (can be completed on line: https://www.mbc.ca.gov/Forms/)

− Have application notarized (GME has free notary service)

− Application fee which includes the fingerprinting fee (can be paid on line but be sure to obtain a receipt)

− Live Scan fingerprinting form or cards (from the MBC website). Must be mailed to MBC

− USMLE (or Canadian LMCC) scores. (Parts 1 and 2)

− ECFMG Certification status (IMGs only)

− Certificate of Medical Education (Form Med-sent directly from the Medical School)

− Official Medical School Transcript (sent directly from the Medical School)

− Certified Medical School Diploma (sent directly from the Medical School)

− Certification of any previous ACGME training (Form PTA-PTB) (example internship from out of CA)

− Postgraduate Training License Enrollment Form (Form EF) (sent directly from the program to MBC)

Confidential – For Discussion Purposes Only

Postgraduate Training License (PTL) Checklist cont’d Timeline of activities (Form TOA) –if applicant graduated from medical school

more than 6 months prior

Explanation of Application Question (Form EXP) –used to provide detailed explanations of any questions on the application

License verification-official verification of any MD licenses. Sent directly from the licensing agencies to MBC. Verification of other training licenses is NOT required.

Confidential – For Discussion Purposes Only

Program Requirements MBC must be notified within 30 days of the following (FormPSU1-PSU2):

− Transfers to other CA residencies

− Terminations

− Resignations

− Leaves of absence

Confidential – For Discussion Purposes Only

J-1 Visas Allow 6 months

Can be used for ACGME programs (or “non-standard” programs found on the ECFMG list (www.ecfmg.org)

May NOT be used for research or “extra years of training”

May not be clinical instructors, bill, or moonlight

Confidential – For Discussion Purposes Only

J-1 Visas-getting started

Please send adohn1@Stanford.edu all of the following in PDF format after you have completed your new hire spreadsheet.

Name and ECFMG number of the resident/fellow

LETTER OF OFFER

STATEMENT OF NEED (SoN) The original, official SoN issued directly from the Ministry of Health in the country of most recent legal permanent residence must be submitted directly to ECFMG.

CURRENT CURRICULUM VITAE (C.V.).

COPY OF PASSPORT NAME PAGE(S) Submit a copy of the passport name page for the applicant and each dependent.

PROGRAM DESCRIPTION (www.ecfmg.org)

Confidential – For Discussion Purposes Only

Familiarize yourselves with the registration/orientation requirements for incoming house staff located on the GME website.

Start Dates:

− 6/25

− 7/1

− 7/7

− 8/1

− 1/1

GME Operations

Confidential – For Discussion Purposes Only

Remediation, Probation, Non-Renewal of Contract, Dismissal…. GME has many resources…please reach out for guidance….

Document…document…document…

Confidential – For Discussion Purposes Only

GMEC

Confidential – For Discussion Purposes Only

GMEC Graduate Medical Education Committee (GMEC) is in charge of overseeing

Stanford as an ACGME institution. GMEC is led by DIO Ann Dohn and GME Chair Dr. Larry Katznelson. Monthly meeting on the second Thursday of every month at 5pm-6pm.

Webpage - https://med.stanford.edu/gme/program_portal/gmec.html

Membership

− GMEC consists of leadership of core residency programs, resident representatives, chief residents, and program coordinator representatives.

Confidential – For Discussion Purposes Only

GMEC GMEC reviews the following:

− ACGME letters

− New PD & APD changes

− Institutional policies

− Duty hours

− Safe reports

− Expansion & funding

− Program considerations

− Other topics that affects the institution and programs

Confidential – For Discussion Purposes Only

Quality Improvement

Confidential – For Discussion Purposes Only

Chief Residents Council Chief Residents Council is comprised of Chief residents across all residency

programs at Stanford Health Care. Meets to discuss large issues reported by house staff and create an QI project every AY.

Monthly meeting on the second Thursday of the month at 6pm-7pm

Contact Chief Residents at GME_Chief_Residents@lists.Stanford.edu

Webpage - https://med.stanford.edu/gme/housestaff/chief_housestaff.html

Confidential – For Discussion Purposes Only

Resident Safety Council The Stanford Resident Safety Council (RSC) is an institution-wide,

interdepartmental council of resident physicians engaged in high-impact quality improvement (QI) projects throughout Stanford Health Care and Stanford Medicine.

Webpage - https://med.stanford.edu/rsc.html

Hosts annual Quality Improvement & Patient Safety Symposium

− https://med.stanford.edu/qipss.html

Confidential – For Discussion Purposes Only

Reporting SAFE reports

− SAFE reports (Stanford Alert For Events) are for reporting an event that does not follow safety best practices in patient care and in our workplace.

− Report at https://shcconnect.stanfordmed.org/depts/QPSED/SAFE/Pages/SAFE.aspx

Anonymously report a concern for issues such as: illegal actions, financial reporting, internal accounting controls, audit, fraud, waste, and abuse.

− Phone 1-800-216-1784

− Web https://med.stanford.edu/gme/gme_team/contact.html#anonymously_reportaconcern

Confidential – For Discussion Purposes Only

GME Communities

Confidential – For Discussion Purposes Only

Other Groups Diversity Committee

− Diversity LGBTQI subcommittee

Women in Medicine

Medical Student and Resident Recruitment Steering Committee

For more info visit https://med.stanford.edu/gme/housestaff/join.html

Confidential – For Discussion Purposes Only

Program Expansion & Funding

Confidential – For Discussion Purposes Only

Program Expansion & Funding Opportunity for Program Expansion & Funding is done annually in August.

Process:

− Submit application by deadline

− Application is reviewed by Expansion & Funding Committee

− Results will be decided by November and decision is effective July of next year.

Application and more information -https://med.stanford.edu/gme/program_portal/program/exp-fund.html

Confidential – For Discussion Purposes Only

ACGME Website

Confidential – For Discussion Purposes Only

ACGME Home page https://www.acgme.org/

Confidential – For Discussion Purposes Only

ACGME WebADS - Homepage Accreditation Data System (ADS)

https://www.acgme.org/Data-Collection-Systems/Overview

Confidential – For Discussion Purposes Only

ACGME WebADS - Surveys ACGME Survey – to be delivered in July/August

Confidential – For Discussion Purposes Only

ACGME WebADS - MilestonesMilestone Submission

Confidential – For Discussion Purposes Only

ACGME WebADS - SummaryACGME WebADS – view and edit

Confidential – For Discussion Purposes Only

GME Website

Confidential – For Discussion Purposes Only

GME Site Residency & Fellowship Programs

Residents/Fellows

− Incoming & Rehired residents/fellows

− Current Chief Residents

− See topics relevant to all house staff

Program Portal

− Forms, Templates, & Examples

− Program

GME Community

Policies & Procedures

Our Team

https://med.stanford.edu/gme.html

Confidential – For Discussion Purposes Only

GME Site

Confidential – For Discussion Purposes Only

Resources

Confidential – For Discussion Purposes Only

Essential Resources GME’s Welcome Packet

Director Monthly Meeting:

− 2nd Thursday of each month 12-1pm H3210

Director email lists (programdirectors@lists.stanford.edu) & (ACGMEprogramdirectors@lists.Stanford.edu)

ACGME’s Program Requirements

MedHub’s Help Portal

GME Website:

− Program Portal -> Forms, Templates, & Examples

Review recording at

− https://med.stanford.edu/gme/program_portal/pd/orientation.html

Feel free to contact GME Office anytime you have questions!

Confidential – For Discussion Purposes Only

MedHub

Confidential – For Discussion Purposes Only

MedHub Work Hour review

Evaluations

Program Accreditation

Guidebook for Annual Program Evaluation (APE)− https://med.stanford.edu/content/dam/sm/gme/gme_community/APE/APE%20Guidebo

ok%202.1%20(v2020).xlsx

Confidential – For Discussion Purposes Only

Other Evaluations Transition-of-Care evaluation

− At least once per year

− Standard evaluation form available to copy from GME in MedHub

− Training available in MedHub -> Resources/Documents/** Transitions of Care (Handoff) Training

− Evaluation Form -https://med.stanford.edu/content/dam/sm/gme/gme_community/toc/TOC_Sign-Out_Evaluation_Tool_GME.docx

Sharp training

− Once per year

− MedHub -> Resources/Documents/Sharps Training Checklist-Sign Off

− https://med.stanford.edu/content/dam/sm/gme/gme_community/sharps_training/74446_sharps_training_checklist.pdf

Confidential – For Discussion Purposes Only

Timeline

Confidential – For Discussion Purposes Only

Tasks JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN

WebADS opens xxx for 1st

Group

WebADS opens xxx for 2nd Group

Milestones

Submit Milestone Reports to ACGME.

Clinical Competency Committee

Semi-Annual Evaluations

GME House Staff Survey for Residents/Fellows

Survey results posted in MedHub.

ACGME Survey for Faculty and Residents/Fellows

Survey results posted in MedHub.

Program Evaluations for Faculty and Residents/Fellows

GME delivers confidential

program evaluations.

Evaluations posted in MedHub.

Final Evaluations

Final Evaluation to be verified for incoming

PGY2/fellows/transfers.

Complete form at end of training.

Program Evaluation Committee / Annual Program Evaluation (APE)

Upload APE documen-tation in

MedHub by 7/31/19

Program Expansion & Funding RequestSubmit

application if needed to GME

Duty Hours

GME Special Review

Site Visit

Self Study

CLER

ACGME - External

GME - Internal

Hard Deadline Tasks

Tasks

ACGME delivers confidential survey.

Schedule, Meet & Upload meeting minutes in MedHub.

Survey Window.GME delivers confidential

survey.

WebADS

APE must be complete and uploaded to MedHub before starting WebADS

ACGME & GME Education Timeline July 1, 2020 - June 30, 2021July 2020 June 2021

Group 1: Prepare WebADS updates. Send to GME by xxx for review.

Submit GME-approved WebADS to ACGME.

Group 2: Prepare WebADS updates. Send to GME by xxx for review.

Submit GME-approved WebADS to ACGME.

Meet with resident. Document in MedHub.

Meet with resident.Document in MedHub.

Send out milestone-based evaluations of residents/fellows to attending physicians.Submit Milestone Reports to

ACGME.Send out milestone-based evaluations of residents/fellows to

attending physicians.

Meet, Review, Finalize in MedHub's Milestone Management section.

Submit to ACGME

Meet, Review, Finalize in MedHub's Milestone Management section.

Submit to ACGME.

Monthly Ongoing: Review all violations.

Occurs at any time with an ACGME notification (minimum 30 days prior to visit).

Occurs approximately every 10 years. Advance notice will be posted in ADS (ACGME Self Study letter of notification).

Occurs any time at GME's discretion.

Takes place every 18 months.

Confidential – For Discussion Purposes Only

Q/A