UNM INTERNAL MEDICINE
RESIDENCY PROGRAM HOSPITALIST TRAINING
TRACK
Meeting 2
28 September 2015
Charles Pizanis, Christopher Bartlett
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
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
Needs Assessment
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.
Who Did We Contact?
All UNM Internal Medicine graduates within the past
3 years who are currently employed as an academic
and/or community hospitalist physician.
Hospitalist Training Track - Needs Assessment Results
ID
Q1
Q2
Q3
Q4
Q5
1
4
Neuro, ID, Consult
4.0
3.0
3.0
2
5
Hosp Admin, Periop,
Overseeing Res Teams
3.0
4.0
1.0
3
3
QI, Consult, Rehab Services
(WC, PT), Financial Aspects of
Medicine
5.0
4.0
2.0
4
4
Financial Aspects of Medicine,
High Value Care, Private
Practice Exposure
5.0
4.0
1.0
5
5
Hosp Admin, Conflict
Resolution/Team Building,
Neuro (CVA+Seizure), Med
Education
5.0
5.0
4.0
6
4
Procedure Team, High Value
Care, ID, QI
4.0
5.0
2.5
7
4
Medical Economics, Procedure
Team, Neurology
5.0
3.0
2.5
8
4
Cardiology, Neurology,
2.0
1.0
1.0
9
4
Scholarly Activity, QI
4.0
4.0
1.0
What Did We Learn?
Question 1:
Internal Medicine residency at the University of New Mexico fully
prepared me to become a hospitalist physician.
7
6
# of Responses
6
5
4
3
2
2
1
1
0
1
2
3
4
5
Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree
A majority of respondents agree or strongly agree that their residency
experience fully prepared them for careers in hospital medicine.
What Did We Learn?
Question 2:
In which aspects of your job as a hospitalist today do you wish you had
received more training during residency?
Neurology
22%
44%
Infectious Disease
Consultative/Perioperative
Medicine
44%
22%
Medical Education
Medical Economics
22%
33%
Hospital Administration
Quality Improvement/High
Value Care
33%
33%
Procedure Team
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?
Question 3:
A Hospitalist Pathway could have filled these gaps?
5
4
# of Responses
4
3
3
2
1
1
2
3
1
0
1
4
5
Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree
A majority of respondents agree of strongly agree that a Hospitalist
Pathway could have filled perceived gaps in their education.
What Did We Learn?
Question 4:
I would have considered participating in a Hospitalist Pathway?
5
4
# of Responses
4
3
2
2
2
1
1
0
1
2
3
4
5
Perception – 1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree
A majority of respondents agree of strongly agree that they would have
considered participating in a Hospitalist Pathway.
What Did We Learn?
Question 5:
How many electives per year would you have been willing to exchange in
order to take part in a Hospitalist Pathway?
5
# of Responses
4
4
3
2
2
1
1
1
1
3
4
0
1
2
2-3
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?
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.
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
Mentorship
• Paired hospitalist mentor
• Career mentoring
• Leadership mentoring
• HTT director mentor
Didactic Curriculum
• Small group meetings
• Online Society of Hospital
Medicine (SHM) modules
• Online Institute for Healthcare
Improvement (IHI) Open School
curriculum
Track Basics
• 2-4 track participants per year
• Application process to begin in PGY1 year
• Track to occur over PGY2 - PGY3
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 2
PGY 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
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
Small Group Curriculum
• Format
• Topics brainstorm
• Journal Club
• Schedule
• Monthly vs every-other month
Any Additional Elements We Should
Include?
Timeline of Rollout
2015
• November meeting
• September meeting
• Review track curriculum
• Decide on rotations,
• December meeting
format of small group
• Finalize track curriculum
curriculum, additional
• Dec 31
elements
• Completed curriculum,
• Start work on curriculum
structure, materials for
• October – retreat
rotation
• Report back on progress
of additional elements
2016
• Solicit speakers for topics
• January - applications
• Solicit QI/research
mentors
Thanks!