Updates from the Residency Review Committee for Pediatrics
Transcript of Updates from the Residency Review Committee for Pediatrics
Updates from the Residency Review Committee for Pediatrics
Jerry Vasilias, PhD, Executive Director
Caroline Fischer, Associate Executive Director
RRC Composition• 3 appointing organizations - AAP, ABP, AMA• 10 voting members; due to workload increase to 13• members serve a term of 6 years -- except resident• Generalists and subspecialists
+ Critical Care Medicine, Hematology/Oncology, Pediatric Emergency Medicine, Gastroenterology, Neurology, Nephrology, Rheumatology
• Geographic Distribution – CA, CT, DC, GA, MI, MD, OH, PA, WA
• Ex-officio members from each appointing organization (non-voting)
RRC Review of Programs• Peer Review – 2 reviewers• Reviewers use the following information to determine
whether program is in compliance with the requirements: - Program Information Forms (PIF) - Site visitor’s report - Board scores
• Program Directors: this is an open book test - Questions in PIF correspond to program requirements
• Reviewers present program to Committee• Committee assigns accreditation status along with review
cycle, range of 1-5 years
Review Cycle of Cores and Subs
• Historically: Review cycle of sub was aligned with core. - If core has a three year cycle, sub had a three year cycle.
- The cycle of the sub did not exceed that of the core
• Now: ACGME has allowed RRC to un-couple subs cycle from core. - Subs are still considered dependent, but the cycle of the sub can
exceed that of the core.
• Continued with warning status- If receive a 2 year cycle warning language is included in letter
• New subspecialty applications: - Do not require a site visit- Maximum of a three year cycle
Citation
Citation = the program has not documented/provided evidence of substantial compliance with the minimum requirements, or, an area identified by the site visitor as non-compliant
Summary of Activities in 2006
• The RRC meets twice a year – Spring and Fall
+ Workload per meeting in 2006: approximately
- 30 core programs- 120 subspecialty programs
- 15 progress reports
Core20%
Subs80%
Accreditation Decisions in 2006 --Subspecialties of Pediatrics
Types of Review Cycles
2 yrs19%
3 yrs27%
5 yrs25%
4 yrs24%
1 yr5%
15Proposed Adverse Actions
236 Total
7Accreditation Withheld
9Voluntarily Withdrawal
182Continued Accreditation
22Accreditation
Types of Status Decisions in 2006
Most Frequent Citations in 2006 – Subspecialties of Pediatrics
2612. Evaluation of Faculty – not being done; not confidential
3411. Goals and Objectives – not being rotation and level specific
4310. Institutional Support – internal review; facilities issues; personnel issues
489. Responsibilities of the PD – providing accurate info; sufficient time to the prog
528. Qualifications of Faculty – not ABP certified; no evidence of on-going scholarship
537. Didactic Components – conference attendance; particular curriculum lacking
616. Procedural Experience – lack required # of procedures; lack logging of procedures
715. Evaluation of Fellows – semi-annually; not written; competent and independent
854. Curricular Development – general curriculum issues; research methodology, etc
1003. Evaluation of the Program – no documentation (minutes); don’t include fellows
1192. Patient Care Experience – lacking adequate patient population
1331. Research and Scholarly Activity – faculty and fellow lacking
1 Programs Reviewed for a Status Decision Total of 963 citations -- about 5 citations/program
New General Subspecialty RequirementsWent into effect January 1, 2007
+ Competencies!
- “Companion document”
+ Collaboration between programs - Documented semi-annual meetings b/w subs and core - Departmental approach to common educational issues (core curriculum,
competencies, evaluation, SOC etc).- Message: Don’t reinvent the wheel!
+ New language for administering and managing a subspecialty program
General Subspecialty Requirements (cont)
+ Research and scholarly activity - Faculty:
> must have ongoing scholarship – peer reviewed funding and pubs> scholarly environment outside of the training program can supplement, but does
not replace within program
- Fellow: > must design + conduct a scholarly project in sub w/ guidance of PD and mentor
- Program: > must identify a mentor and scholarship oversight committee to oversee fellow’s
progress related to scholarly activities
+ Board Score Information- Deficient if over 6 yrs LT 75% take, of those who take LT 75% pass it. - Exceptions will made for programs with small # of fellows
• Revised Common Program Requirements go into effect July 1, 2007+ Review language for PD duties and responsibilities; appointment
of PD; participating sites; competencies
• Changes to the PIF+ Common requirements questions will migrate to ADS --
Electronic PIF + More information will be provided from ACGME on this in the
near future
Common Requirements
www.acgme.orgwww.acgme.org • Staff contact information • ACGME Policies & Procedures• Competencies/Outcomes Project• ADS/List of accredited programs• Duty hours Information/FAQ• Affiliation Agreements FAQ• General information on site visit process and your site visitor
Pediatrics Webpage• Resident complement increase• Application timeline• Frequent citations• Program Requirements• PIFs• Archive of RRC Updates/Email Communications
Resident Survey• New survey
+ Heavily vetted – residents, RRCs + implemented in waves starting in January - May
+ contains elements of the common requirements, not just duty hours
• Who participates:+ All core programs and subspecialty programs with 4 or more
residents/fellows
• Survey programs every other year • Programs are notified directly – not residents • 70% compliance required
ACGME’s Strategic PlanIn November 2005, ACGME endorsed 4 strategic priorities.
1) Foster innovation and improvement in the learning environment
2) increase the accreditation emphasis on educational outcomes3) Increase efficiency and reduce burden from accreditation4) Improve communication and collaboration with key internal
and external stakeholders
Many of the changes ACGME has implemented in the recent past and will continue to roll out in the future can be seen from the vantage point of the 4 strategic priorities.
Innovations and Improvements to the Learning Environment• Conference on Educational Re-Design• ACGME focus on innovation• Portfolios• Innovation within the RRC
+ R3P
+ “Companion Documents”
Increase Emphasis on Outcomes
• RRC has been front-runner with competencies + Core requirements – January 1, 2006+ Subspecialty requirements -- January 1, 2007+ Competency PIF questions
+ “Companion documents”
+ Competency citations
• New common requirements• Competencies modules are available on outcome
webpage
Increase Efficiency and Reduce Burden -- ACGME • E-mail status of programs on RRC agenda
- Within 3-5 days of RRC meeting will receive an email with the accreditation status and review cycle.
• E-mail to notify you that your notification letter is posted on ADS. - Will no longer send notification letters.
• Standard letters of notification• New ADS features
- Field to response to citations- Making complement, PD, VW and participating institutions- This will feed directly into part 1 of the PIF
Increase Efficiency and Reduce Burden -- RRC• New PIF for core and subs
- Streamlining the document and making it less onerous to complete- More checkboxes and forced choice responses - Narrative sections remain, but there is a limit on amount allowed
• No Competencies Assessment Form• Collaboration stressed in requirements • Collaboration with CoPS for PIF
Improve Communication and Collaboration • Email updates from RRC are posted on website • Collaboration in the requirements• Engaging CoPS on PIF construction for new
requirements• [email protected]
Requirements
Effective July 1, 2006Combined Training in Internal Medicine/Pediatrics
Effective July 1, 2007 Requirements to be RevisedAdolescent Medicine Developmental-BehavioralCritical Care Medicine EndocrinologyPediatric Cardiology GastroenterologyPediatric Emergency Medicine Infectious DiseasesPediatric Hematology-Oncology NephrologyNeonatal-Perinatal Medicine PulmonologyPediatric Rheumatology Sports Medicine