scholarly journals Results From a Transitional-Year Program Director Survey: Identifying Crucial Issues and Concerns

2012 ◽  
Vol 4 (1) ◽  
pp. 28-33
Author(s):  
Steven R. Craig ◽  
Hayden L. Smith ◽  
Matthew W. Short
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Administrative Support ◽  
Program Directors ◽  
Program Director ◽  
Community Hospitals ◽  
Graduate Medical ◽  
Program Coordinators ◽  
Critical Issues ◽  
Preparatory Year

Abstract Background Transitional Year (TY) programs meet an important need by preparing residents for specialties that accept individuals after an initial preparatory year. To our knowledge, no surveys to date have been conducted to identify attributes of TY programs and concerns of TY program directors. Purpose The purpose of this study was to review TY program characteristics and identify critical issues and concerns of TY program directors (TYPDs). Methods A web-based, 22-question survey was sent to all 114 TYPDs of programs accredited by the Accreditation Council for Graduate Medical Education between January and April 2011. The survey included open-formatted and closed-formatted questions addressing program and institution demographics, program director time, administrative support, satisfaction, and future plans. Results The survey response rate was 86%. The median age of TY programs was 28 years, with few new programs. More than 80% of TY programs were conducted at community hospitals and university-affiliated community hospitals. Of the responding TYPDs, 17% had served less than 2 years, and 32% had served 10 years or more. Common sponsoring TY programs included internal medicine (88%), general surgery (42%), family medicine (25%), emergency medicine (24%), and pediatrics (18%). Overall, TYPDs were satisfied with their positions. They expressed concerns about inadequate time to complete duties, salary support, and administrative duties assigned to program coordinators. Forty-nine percent of TYPDs reported they planned to leave the position within the next 5 years. Conclusions Our survey provides useful information to assist institutions and the graduate medical education community in meeting the needs of TYPDs and strengthening TY programs.

scholarly journals Evaluating the Evaluators: Implementation of a Multi-Source Evaluation Program for Graduate Medical Education Program Directors

2016 ◽  
Vol 8 (4) ◽  
pp. 592-596 ◽  
Author(s):  
Mary Ellen J. Goldhamer ◽  
Keith Baker ◽  
Amy P. Cohen ◽  
Debra F. Weinstein
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Assessment Tools ◽  
Completion Rates ◽  
Source Evaluation ◽  
Graduate Medical ◽  
Medical Education Program ◽  
Academic Year

ABSTRACT Background Multi-source evaluation has demonstrated value for trainees, but is not generally provided to residency or fellowship program directors (PDs). Objective To develop, implement, and evaluate a PD multi-source evaluation process. Methods Tools were developed for PD evaluation by trainees, department chairs, and graduate medical education (GME) leadership. Evaluation questions were based on PD responsibilities, including Accreditation Council for Graduate Medical Education (ACGME) requirements. A follow-up survey assessed the process. Results Evaluation completion rates were as follows: trainees in academic year 2012–2013, 53% (958 of 1824), and in academic year 2013–2014, 42% (800 of 1898); GME directors in 2013–2014, 100% (95 of 95); and chairs/chiefs in 2013–2014, 92% (109 of 118). Results of a follow-up survey of PDs (66%, 59 of 90) and chairs (74%, 48 of 65) supports the evaluations' value, with 45% of responding PDs (25 of 56) and 50% of responding chairs (21 of 42) characterizing them as “extremely” or “quite” useful. Most indicated this was the first written evaluation they had received (PDs 78%, 46 of 59) or provided (chairs 69%, 33 of 48) regarding the PD role. More than 60% of PD (30 of 49) and chair respondents (24 of 40) indicated trainee feedback was “extremely” or “quite” useful, and nearly 50% of PDs (29 of 59) and 21% of chairs (10 of 48) planned changes based on the results. Trainee response rates improved in 2014–2015 (52%, 971 of 1872) and 2015–2016 (69%, 1276 of 1837). Conclusions In our institution, multi-source evaluation of PDs was sustained over 4 years with acceptable and improving evaluation completion rates. The process and assessment tools are potentially transferrable to other institutions.

AOA ophthalmology and otolaryngology program closures as a model to highlight challenges of maintaining GME in high need areas

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Harris Ahmed ◽  
Kim Vo ◽  
Wayne Robbins
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Administrative Support ◽  
Surgical Care ◽  
Neck Surgery ◽  
Institutional Commitment ◽  
Surgical Specialty ◽  
Graduate Medical ◽  
Surgical Subspecialty ◽  
Hospital Administrative

Abstract Context While 90% of former American Osteopathic Association (AOA) residency programs transitioned to Accreditation Council for Graduate Medical Education (ACGME) accreditation, surgical subspecialty programs such as ear, nose, and throat (ENT, 62%) and ophthalmology (47%) struggled to gain accreditation. Doctors of Osteopathic Medicine (DOs) actively participate in serving underserved communities, and the loss of AOA surgical specialty programs may decrease access to surgical care in rural and nonmetropolitan areas. Objectives To determine the challenges faced by former AOA-accredited surgical subspecialty programs during the transition to ACGME accreditation, particularly ENT and ophthalmology programs in underresourced settings. Methods A directory of former AOA ENT and Ophthalmology programs was obtained from the American Osteopathic Colleges of Ophthalmology and Otolaryngology-Head and Neck Surgery (AOCOO-HNS). A secured survey was sent out to 16 eligible ENT and ophthalmology program directors (PDs). The survey contained both quantitative and qualitative aspects to help assess why these programs did not pursue or failed to receive ACGME accreditation. Results Twelve of 16 eligible programs responded, com-prising six ophthalmology and six ENT PDs. Among the respondents, 83% did not pursue accreditation (6 ophthalmology and 4 ENT programs), and 17% were unsuccessful in achieving accreditation despite pursuing accreditation (2 ENT programs). Across 12 respondents, 7 (58%) cited a lack of hospital/administrative support and 5 (42%) cited excessive costs and lack of faculty support as reasons for not pursuing or obtaining ACGME accreditation. Conclusions The survey results reflect financial issues associated with rural hospitals. A lack of hospital/administrative support and excessive costs to transition to the ACGME were key drivers in closures of AOA surgical specialty programs. In light of these results, we have four recommendations for various stakeholders, including PDs, Designated Institutional Officials, hospital Chief Medical Officers, and health policy experts. These recommendations include expanding Teaching Health Center Graduate Medical Education to surgical subspecialties, identifying and learning from surgical fields such as urology that fared well during the transition to ACGME, addressing the lack of institutional commitment and the prohibitive costs of maintaining ACGME-accredited subspecialty programs in underresourced settings, and reconsidering the Centers for Medicare & Medicaid Services (CMS) pool approach to physician reimbursement.

scholarly journals The ecology of program director leadership: power relationships and characteristics of effective program directors

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bharat Kumar ◽  
Melissa L. Swee ◽  
Manish Suneja
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Power Relationships ◽  
Main Body ◽  
Power Bases ◽  
Power Structures ◽  
Graduate Medical ◽  
Medical Environment ◽  
Academic Medical

Abstract Background Program directors are often perceived as strong and independent leaders within the academic medical environment. However, they are not as omnipotent as they initially appear. Indeed, PDs are beholden to a variety of different agents, including trainees (current residents, residency applicants, residency alumni), internal influencers (departmental faculty, hospital administration, institutional graduate medical education), and external influencers (the Accreditation Council for Graduate Medical Education (ACGME), medical education community, and society-at-large). Altogether, these agents form a complex ecosystem whose dynamics and relationships shape the effectiveness of program directors. Main body This perspective uses management theory to examine the characteristics of effective PD leadership. We underline the importance of authority, accessibility, adaptability, authenticity, accountability, and autonomy as core features of successful program directors. Additionally, we review how program directors can use the six power bases (legitimacy, referent, informational, expert, reward, and coercive) to achieve positive and constructive change within the complexity of the academic medical ecosystem. Lastly, we describe how local and national institutions can better structure power relationships within the ecosystem so that PD leadership can be most effective. Conclusion Keen leadership skills are required by program directors to face a variety of challenges within their educational environments. Understanding power structures and relationships may aid program directors to exercise leadership judiciously towards fulfilling the educational missions of their departments.

Minimally Invasive Training During Surgical Residency

2011 ◽  
Vol 77 (7) ◽  
pp. 902-906 ◽  
Author(s):  
Gokulakkrishna Subhas ◽  
Vijay K. Mittal
Keyword(s):  
Medical Education ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Graduate Medical Education ◽  
Invasive Surgery ◽  
Program Directors ◽  
Accreditation Council ◽  
Surgery Training ◽  
Graduate Medical ◽  
Laparoscopic Procedures

The field of postgraduate minimally invasive surgery training has undergone substantial growth and change. A survey was sent to all program directors in surgery. Minimally invasive training patterns, facilities, their views, and performance of residents were examined. Ninety-five directors (38%) responded to the questionnaire. Of these, 51 per cent (n = 48) had a program size of three to four residents and 33 per cent (n = 31) had a program size of five to six residents. In 3 per cent of programs (n = 3), residents could not achieve the minimum Accreditation Council for Graduate Medical Education required numbers for advanced laparoscopic cases. Only 47 per cent of programs (n = 45) had dedicated rotations in minimally invasive surgery, ranging from 2 to 11 months. Up to 10 per cent (n = 9) of program directors felt that the current training in minimally invasive surgery was insufficient. Fifty-five per cent (n = 52) felt that laparoscopic adhesiolysis was an advanced laparoscopic procedure, and 33 per cent (n = 31) felt that there should be a separate minimum requirement for each of the commonly performed basic and advanced laparoscopic cases by Accreditation Council for Graduate Medical Education. Fifty-six per cent (n = 53) of programs were performing robotic surgery. Minimally invasive surgery training for surgical residents needs to increase opportunities so that they are able to perform laparoscopic procedures with confidence. There should be specific number requirements in each category of individual basic and advanced laparoscopic procedures.

scholarly journals Formal Versus Informal Judgments: Faculty Experiences With Entrustment in Graduate Medical Education

2018 ◽  
Vol 10 (5) ◽  
pp. 537-542 ◽  
Author(s):  
Karsten A. van Loon ◽  
Pim W. Teunissen ◽  
Erik W. Driessen ◽  
Fedde Scheele
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Faculty Members ◽  
Extensive Experience ◽  
Faculty Experiences ◽  
Graduate Medical ◽  
Medical Education Program ◽  
Technical Competencies ◽  
Competency Based

ABSTRACT Background  Entrustment of residents has been formalized in many competency-based graduate medical education programs, but its relationship with informal decisions to entrust residents with clinical tasks is unclear. In addition, the effects of formal entrustment on training practice are still unknown. Objective  Our objective was to learn from faculty members in training programs with extensive experience in formal entrustment how formal entrustment relates to informal entrustment decisions. Methods  A questionnaire was e-mailed to all Dutch obstetrics and gynecology program directors to gather information on how faculty entrusts residents with clinical independence. We also interviewed faculty members to explore the relationship between formal entrustment and informal entrustment. Interviews were analyzed with conventional content analysis. Results  Of 92 programs, 54 program directors completed the questionnaire (59% response rate). Results showed that formal entrustment was seen as valuable for generating formative feedback and giving insight into residents' progress in technical competencies. Interviewed faculty members (n = 12) used both formal and informal entrustment to determine the level of resident independence. Faculty reported they tended to favor informal entrustment because it can be reconsidered. In contrast, formal entrustment was reported to feel like a fixed state. Conclusions  In a graduate medical education program where formal entrustment has been used for more than a decade, faculty used a combination of formal and informal entrustment. Informal entrustment is key in deciding if a resident can work independently. Faculty members reported being unsure how to optimally use formal entrustment in practice next to their informal decisions.

scholarly journals International electives in neurological surgery training: a survey of program directors from Accreditation Council for Graduate Medical Education–approved neurological surgery programs

2020 ◽  
pp. 1-7
Author(s):  
Christopher Miller ◽  
Paige Lundy ◽  
Sarah Woodrow
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Educational Opportunities ◽  
International Training ◽  
International Elective ◽  
Graduate Medical ◽  
Regulatory Barriers ◽  
Neurological Surgery ◽  
International Rotation

OBJECTIVEThe burden of neurosurgical disease in low- and middle-income countries (LMICs) has emerged as a significant factor in global health. Additionally, calls have been growing for first-world neurosurgeons to find ways to help address the international need. Allowing residents to pursue international elective opportunities in LMICs can help alleviate the burden while also providing unique educational opportunities. However, pursuing international work while in residency requires overcoming significant logistical and regulatory barriers. To better understand the general perspectives, perceived barriers, and current availability of international rotations, a survey was sent out to program directors at Accreditation Council for Graduate Medical Education (ACGME)–approved residencies.METHODSAn anonymous survey was sent to all program directors at ACGME-approved residencies. The survey included branch points designed to separate programs into program directors with an existing international rotation, those interested in starting an international rotation, and those not interested in starting an international rotation. All participants were asked about the perceived value of international training and whether residents should be encouraged to train internationally on a 5-point Likert scale. The survey ended with open-response fields, encouraging thoughts on international rotations and overcoming barriers.RESULTSForty-four percent of recipients (50/113) responded; of the 50 programs, 13 had an established international elective. Of programs without a rotation, 54% (20/37) noted that they were interested in starting an international elective. Key barriers to starting international training included funding, the Residency Review Committee approval process, call conflicts, and the establishment of international partners. Perceived learning opportunities included cultural awareness, unique pathology, ingenuity, physical examination skills, and diagnosis skills. The majority of respondents thought that international rotations were valuable (74%, 37/50) and that residents should be encouraged to pursue international educational opportunities (70%, 35/50). Program directors who maintained an existing international rotation or were interested in starting an international elective were more likely to perceive international rotations as valuable.CONCLUSIONSRecent calls from The Lancet Commission on Global Surgery for increased surgical interventions in the developing world have been expanded by neurosurgical leadership to include neurosurgical diseases. Resident involvement in international electives represents an opportunity to increase treatment of neurosurgical disease in LMICs and develop the next generation of international neurosurgeons. To increase opportunities for residents at international sites, attention should be focused on overcoming the practical and regulatory barriers at a local and national level.

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