GRADUATE MEDICAL EDUCATION COMMITTEE
CC 3
Greenville Health System
8:00 AM – 10:00 AM, Thursday, 1/22/2015
GMEC Responsibilities Legend
AO- Accreditation Oversight of Programs
C&E- Curriculum and Evaluation
Minutes
ATTENDANCE:
GME Admin:
House Staff:
Family Medicine:
Sports Medicine:
Surgery:
MIS:
Colorectal:
Vascular
Internal Medicine:
Med/Peds:
OB/GYN:
Mat. Fetal:
Ortho:
OSM/Total Joint:
Peds:
JP Genetics
Dev Peds:
Psychiatry:
Child Psych.:
Emergency:
Quality:
Education Assessment:
Academic Develop:
Guests:
☒Edward W. Bray III, MD
☒Laura Copeland, MD
☒R. Bruce Hanlin, MD
☐Kyle Cassas, MD
☒Dane Smith
☒Alfredo Carbonell, DO
☐Jay Crockett, MD
☒Chris Carsten, MD
☒J Michael Fuller, MD
☒Russ Kolarik, MD
☒Sharon Keiser
☒Amy Picklesimer, MD
☒Scott Porter, MD
☒Richard Hawkins, MD
☒Kerry Sease, MD
☒Robert Saul, MD
☒Desmond Kelly, MD
☒Julius Earle, MD
☐Kenneth Rogers, MD
☒Camiron Pfennig, MD
☐Robert Mobley Jr, MD
☒Ryan Otto,
☐Brenda Thames
☒Latonya Garrett
☒Ann Griffith
☐Shannon Burgess, MD
☐Jeffrey Swartz, MD
☐Franklin Sease, MD
☐David Cull, MD
COM- Communication with Medical Staff
☒Derek Payne
☐Richard Gurich, MD
☒Irfan Asif, MD
C/PD- Communication w/Program Directors
DH - Duty Hours & Related Issues
IA Mgmt- Institutional Accreditation Mgmt.
Inno- Innovative Projects/Experimentation
IRP- Internal Review Process & Reporting
PC- Program Changes prior to ACGME
PQ- Patient Safety & Quality
☐Mark Call, MD
☐William Schmidt, MD
☒Jeffrey Elder, MD
☒Kyle Jeray, MD
☐Brian Burnikel, MD
☐Jennifer Hudson, MD
☐Peter Tilkemeier, MD
R&C- Reductions & Closures
RC/B- Resident Compensation/Benefits
☒Thomas Wheeler III, MD
RS- Resident Supervision
R Stats- Resident Status
VI- Vendor Interactions
☐Jon Lucas, MD
CLE- Clinical Learning Environment
☐John Williams, MD
☐Ben Griffeth, MD
☒Melissa Janse, MD
☐Greg Hawkins
☒Kitty Wilcott
☒Kinneil Coltman
DIALOGUE
Welcome & Review Minutes
Dr. Edward Bray
Duty Hours Report Review
Dr. Edward Bray
Dr. Bray called the meeting to order at 8:15 am. December minutes were approved.
Dr. Bray introduced and welcomed Drs. Camiron Pfennig. Dr. Pfennig is the Program Director
for the Emergency Medicine Residency.
Dr. Bray stated that the Duty Hours were good except for Surgery who had 58% and
Orthopaedics who had 75% reporting compliance. He stated that this may have been due
to the Holiday; however he asked both Directors to speak to their residents.
OUTCOME/
ASSIGNMENTS
Minutes were approved
GMEC
CODE
IA Mgmt
AO
DH
IA Mgmt
AO
PQ
House Senate Report
Dr. Laura Copeland
ACGME Communications
Dr. Edward Bray
Resident Salary Approval
Edward Bray, MD
Kitty Wilcott
Dr. Copeland stated that the Business in Medicine financial workshop and disability
insurance policy information was well received by the House Staff. Dr. Copeland reported
that there is a big gap in what residents perceive and what the GHS institution perceives
regarding patient safety issues. She spoke specifically about the number of lost orders or
lost and deleted labs. She would like to obtain a description of circumstances and identify
the scope of circumstances regarding these areas. Dr. Copeland asked the program
directors to encourage residents to document any complaints regarding this issue.
Dr. Kerry Sease asked if they are to be using event reporting shouldn’t this information be
captured that way? Dr. Copeland answers that she is not discouraging the use of event
reporting system, but she doesn’t think that investigations are taking place especially with
orders.
Dr. Scott Porter stated having residents use event reporting system and another tracking
method would cause redundancy.
Dr. Sharon Keiser stated someone that works with event reporting system needs to present
to GMEC so this issue can be communicated.
Dr. Bray stated that a representative from the events reporting system will need to attend
the House Staff Senate Meeting to discuss this issue.
Dr. Russ Kolarik stated that he does not receive any reports after something is submitted
in events reporting system. He would like for them to come back to GMEC and address this
issue.
Dr. Copeland states that she was told that the residents should be following up to ensure
orders and labs are done. She states that this is not practical with the work load.
Dr. Bray said that this was a major issue in the CLER report and we will have a citation if
no improvements are made.
Dr. Bray relayed to the group that ACGME had continued the full accreditation of
Orthopaedics (Dr. Scott Porter) and Orthopaedic Sports Medicine (Dr. Richard Hawkins).
Dr. Porter also stated that were approved for an increase of 1 compliment.
Dr. Bray reported that ACGME are beginning a new system and they are contacting each
program with regard to the process.
Someone from the
Events Reporting
System will present at
GMEC and to the
House Senate
Meetings.
Kitty Wilcott reported that after comparison of resident salaries and discussion with Dr.
Bray, there is recommendation for raises for PGYI, PGYII and PGYIII.. Ms. Wilcott stated that
according to the national compensation rates from AHEC that GHS salaries are lower than
average. As a result, a 1.35% pay increase is proposed as of last GMEC meeting. The
Program Directors asked for additional benefit comparison information which they did
receive and has been posted on GMEC SharePoint.
GMEC voted to approve the proposed salary increase of 2% for the first 3 PGY years then
1% following that.
GMEC voted to
approve the proposed
salary increase. No
one opposed the
increase.
IA Mgmt
AO
IA Mgmt
AO
IA Mgmt
AO
C/PD
RC/B
2
Academic Council Update
Derek Payne
CLER Moment: Quality
Interactions Demo
Kinneil Coltman
Derek Payne reported that the Physician Assistant Program for North Greenville has
been put on hold until 2020. The nursing program with Clemson is scheduled to start
in the Fall 2015. Mr. Payne stated that Clemson Advisory Board was being established
and will include the partnering institutions and community members. He reported the
first meeting will take place Feb. 3rd. Mr. Payne spoke regarding the financials
submitted for expansions and states that a budget will be compiled in March.
Ms. Kinneil Coltman, Chief Executive Diversity Officer, discussed a new computer based
training (CBT) option for residents and interns that would provide realistic evidencebased case experience in diversity and cross cultural care. Ms. Coltman facilitated a
demonstration of the CBT with the assistance of Dr. Joseph Betancourt of Harvard
Medical School and Massachusetts General Hospital. Ms. Coltman explained that unlike
other CBTs this training is totally interactive where the resident can propose different
care options and receive evidence-based guidance regarding their proposal of care.
IA Mgmt
C/PD
Com
C&E
Ms. Coltman will gather
more information
regarding the proposed
as well as other CBT
or programs offered
for this quality
requirement.
C&E
C/PD
PQ
CLE
Dr. Betancourt is the Director, The Disparities Solutions Center, Massachusetts General
Hospital and the Co-Founder of Quality Interactions, Inc. Dr. Betancourt explains that
Quality Interactions has developed technology-based educational e-learning programs.
He added that this set of learning programs that have been utilized in over 130,000
trainings across the country. In explanation, he described that the program provides
targeted training through interactive exercises where residents learn the key principles
that include mistrust and communication styles, language and interpreters, health
literacy, health beliefs, and cross-cultural negotiation. The program provides situational
examples of communication, religious beliefs, social and cultural background issues
that patients and residents have that may create barriers to receiving high quality
care. Dr. Beckencourt presented several of the slides within the on-line training. +
Ann Griffith asked what level of resident does the training target? Dr. Betancourt
answered by explaining the many differing varying courses that are offered for prelims
up to 3rd year residents.
Dr. Bray emphasized that this is a quality requirement of CLER that will be
implemented.
Dr. Kerry Sease asked if this requirement could be completed prior to attending
Orientation? Ms. Coltman responded yes. GHS could monitor whether the training was
done but hopes this training is more longitudinal and something continued as they
progress as residents.
Dr. Dane Smith asked about the cost or subscription to this CBT? Ms. Coltman stated
there is costs by the participant but she willing to add partial expense to her budget.
She also stated that there is some negotiating room with the charges of $11,000$12,000. Ms. Coltman continued to say that the training program is set up almost in
an a la carte manner so we could say we only want to budget 2 hours of training
because there are many levels of training to choose from. Dr. Smith added the
program appeared to be well prepared and highly versatile.
3
CLER Moment: Quality
Interactions Demo-Cont’d.
Kinneil Coltman
GME Expansion Reviews
Edward Bray, MD
Dr. Richard Hawkins stated that there was not a lot of information or supporting
randomized measured studies to show the effectiveness of this program. Ms. Coltman
stated that there is a book named “Unequal Treatment” which is a research study
completed that looked thoroughly at this program.
Dr. Dane Smith stated that there is not a study with true metrics available to meet
the requirement. Ms. Coltman reiterated that this is her specialty field and in her
opinion this is the best tool available.
Dr. Scott Porter wants to ensure that this isn’t just the easiest thing to do to meet
this requirement but something effective. Ms. Coltman stated that the cross cultural
complaints that she receives are real and training of some sort is needed.
Dr. Irfan Asif informed the group of another program used by Northwestern that could
also be reviewed.
Dr. Desmond Kelly asked that the vote to approve the usage of this CBT be tabled
until next month to receive more information or other program options could be
reviewed.
Dr. Bray stated that a preliminary approval was needed by GMEC for all expansion
programs. Programs then would be reviewed by Academic Council (AC) and Resource
Council (RC) and sent back to GMEC for final approval. Dr. Bray introduced Dr. Robert
Saul who has been appointed as the Program Director for Joint Pediatric Genetic
Fellowship.
Dr. Robert Saul stated that he has been with GHS for 2years and before that worked
at the Genetic Center at Greenwood serving as Program Director from 1989 until 2013.
He explained Joint Pediatric Genetic Fellowship is a 4-year program with 1 resident per
year enrollment. Once completed the Resident would be eligible for joint certification
in Pediatrics and Genomics. The genetic program at Greenwood is national and
internationally recognized and this joint program will be 1 of only 16 programs in the
country. He further explains that this will be a positive gain financially for the
institution because it uses 1 categorical spot for Pediatrics that is already approved in
their budget and Greenwood Genetic Center (verbal agreement only to date) would pay
for half of that spot. Dr. Desmond Kelly asked what happens if the spot is not used.
Dr. Kerry Sease explained that the categorical spot would be a flex spot so if no
Genetic applicants applied then it would be filled in Pediatrics. GMEC scored the
Residency as a 10 for Motivation and 0 for Barriers. GMEC voted by a show of hands
to recommend this Residency.
Dr. Bray introduced Dr. Amy Picklesimer who has been appointed as the Program
Director for Maternal Fetal Fellowship. Dr. Amy Picklesimer stated that this will be a 3
year/ 1 fellow per year fellowship sub-specialty of the OB/Gyn Program. She adds
that the Maternal-Fetal Medicine (MFM) Fellowship is not accredited by ACGME but by
the American Board of Obstetrics and Gynecology (ABOG). MFM Fellowship will be 50%
research and 50% clinical to create research scholars. The financial piece of it will be
generated by the fellows by night calls which will cover about half the cost. There is a
demand for staff to cover multiple requests to replace faculty time even at satellite
locations.
Voting to approve
deferred until February
GMEC Meeting
Ms. Coltman will
provide links to Ms.
Griffith to the on-line
training for the
Program Directors to
review further and
search for additional
evidence or research
that has been done
regarding outcomes.
IA Mgmt
AO
C&E
GMEC scored and
voted to recommend
Maternal Fetal
Fellowship and Joint
Pediatric Genetic
Residency to Academic
Council
IA Mgmt
AO
PC
4
GME Expansion ReviewsCont’d.
Edward Bray, MD
Dr. Desmond Kelly questioned if ABOG would be ok with the night call work to
generate funding? Dr. Picklesimer answered that this is the practice all over the
country. Dr. Bray stated that this is a wash with no additional budget needs. Dr.
Picklesimer stated that she was very liberal with budget forecasting including $20,000
expenditure for research.
GMEC scored the Fellowship as a 10 for Motivation and 0 for Barriers. GMEC voted by
a show of hands to recommend the Fellowship.
GMEC also voted for
final approval for the
Emergency Medicine
Residency as it has
been approved by the
AC and RC.
Dr. Bray stated that Emergency Medicine had already been recommended by GMEC
last year. Mr. Derek Payne stated that the Resource Council has now passed funding
that was previously repudiated. Dr. Porter asked why the complement changed from 6
to 10 as previously discussed. Dr. Dane Smith stated that the optimal complement
would be 14 so they are starting with 10 per year. Dr. Melissa Janse also added that
if the residency started with a relatively small number that it would appear that the
program may not be supported by the institution primarily. There is support for this
number because we have the largest ER in the state. Dr. Pfennig added that if we
start with a number too low it really goes against establishing ourselves as a
teaching/ academic community especially if faculty only has a resident every now and
then. GMEC voted to approve Emergency Medicine Residency.
Dates to Remember
Dr. Edward Bray
Match Deadline: Jan. 31 11:59 pm Quota Change/Rank Order List Feb. 25
Dr. Bray stated that Program Directors must attend to any correspondence from the
NRMP and ACGME as they are very important.
ACGME Annual Meeting: Feb 26- March 1, 2015 Drs. Porter and Pfennig and Ms.
Griffith will be attending the National ACGME Meeting.
C/PD
AO
IA Mgmt
AHME Institute National Meeting: May 13-15, 2015
February:
Program Director Sharing: Roadmap to Milestone Tracking and Spider Diagram
Reporting – Kerry Sease, MD
Other Business
Dr. Edward Bray
Dr. Kyle Jeray reported that 1 resident due to bad decision-making had been reported to
the State Board. Dr. Jeray states that the resident has apologized and they are waiting to
hear from the State regarding decisions made of his misjudgement.
Resident Status
Reports
R Stats
IA Mgmt
AO
C/PD
Dr. Kerry Sease stated that 1 resident has received written remediation after having verbal
warnings for tardiness and professional issues. Dr. Sease added that explanation regarding
another occurrence will result in probation.
Dr. Alfredo Carbonell stated that he has a fellow that is also receiving 8 week remediation
for technical improvement.
5
Other Business-Cont’d.
Dr. Edward Bray
Dr. Bray reminded Program Directors that documentation is imperative to cover legal
recourse with remediation and probation.
Dr. Irfan Asif requested a motion to vote for approval of Dr. Irfan Asif to take over as
Interim Program Director replacing Dr. Robert Hanlin in the Family Medicine Residency. The
vote was approved, no one opposed.
Dr. Asif requested a motion to vote for approval for Dr. Vincent Green to take over as
Interim Program Director replacing Dr. Kyle Casass in FM Sports Medicine Fellowship. Dr.
Asif added that Dr. Green has been a Program Director for over 12 years at Laurens
Hospital. The vote was approved, no one opposed.
Adjourn
Dr. Edward Bray
There being no further business, the meeting adjourned at 9:50 AM.
Next Meeting:
2/26/2015; 8:00 AM in CC3.
GMEC voted and
approved Dr. Asif as
Interim Program
Director for Family
Medicine Residency
and Dr. Green as
Interim Program
Director for FM Sports
Medicine Fellowship.
IA Mgmt
AO
C/PD
PC
AO
IA Mgmt
C/PD
6