Family Practice ResidencyAnnual Orientation

Gail Feinberg, DO, FACOFP, M.Ed

Director of Medical Education

2014

Objectives

• Review program and updates

• Brief review of program training manual

• Brief description of expectations• Didactics

• Clinic hours

• Call

• Other information regarding the residency

Residency Manual

• Has now been e-mailed. Should have provided a signed copy of receipt form

• OLBH employee handbook

• Given at OLBH New Employee Orientation

• July 14, 8am-4pm, Bellefonte Center 5th Floor boardroom for Dr. Smith

Manual Highlights

• Program Director Description – superseded by agreement between OLBH/Feinberg and Howard

• Research

• Moonlighting

• Prescription writing

• Even with full license and DEA only preceptor/attending can write for narcotic rx in clinic

• Requirements for Promotion/Graduation

Professionalism

• Cell phone

• Dress Code

• Attendance

• Addressing Preceptors

• Parking

Other

• Wiki• www.olbh.pbworks.com• Quarterly evaluation (by PD/DME)

• Clinical Preceptor Evaluation

• Evaluation of service by resident

• Time sheet

• Logs

• ACOFP paperwork (done by DME)• SOLE survey (for MSOPTI)

Other

• OMM eval expectations for hospitalized patient• OMM glossary

• OMT coding

• Written in admission note

• Research information

• Resident Job Description

• Standards of Practice for Resident

Didactics• Journal Club• IM • FIRST Thursday of the month

• Residents responsible for selection of articles

• Refer to Wiki (and/or printed list in resident lounge) for who is on what month and the topic

• MUST have them to DME office 1 week before

• Will pull Saturday call if not turned in on time

• No peds or OB articles.

• Can only use NEJM once during the year

• FP• THIRD Thursday of the month

• Students responsible for selection of articles

Didactics

• Attendance expectation

• What does 80% mean?

• Chief to collect sign in

• Unexcused attendance

• paper on topic discussed

• More than 2 unexcused

• Will meet before Medical Education Committee for formal discussion

Didactics

• Tumor Board• Mandatory

• Thursdays, noon

• Will be on weekly schedule when planned

• Watch for e-mail on Thurs if cancelled

• MSOPTI lectures• Mandatory

• Although given live Tues noon and Thurs 8am, we watch them taped

• Once a quarter live OMT (dinner provided)

Didactics

• Resident Teaching• Run all Yale one month• Resident will lecture on “bread and butter” ambulatory care

topic• Give topic to Chief Resident and/or DME for posting on Wiki

• …to avoid duplication

• Resident Grand Rounds• Resident lead – in front of room• Presentation of case admitted the night before or interesting

case on “days”• Find teaching elements• Not power point format • Attending physicians are in room as proctors/hecklers

Didactics

• Other Live Lectures • Mandatory attendance

• Based on resident requests/wish list

• Also include Pulm/Sleep medicine, pharma sponsored speakers, ER lectures, FP lectures, Peds lectures

• OK for residents to recruit live lectures

• Practice Management Series• Mandatory

• 20 total hours during 3 year residency

Didactics

• Other

• M&M

• Will be given by resident the month AFTER either ICU or Inpatient Medicine Days

• Residents – it’s ok to recruit speakers for live lectures

• Just not 1st or 3rd Thursday morning.

• Monthly calendar availability

Curriculum

1 2 3 4 5 6 7 8 9 10 11 12

I IM IM nights

IM nights

ER OB SURG PEDS NEURO

CARDIO ICU DERM ELECT

II ER IM PEDS GYN NICU OPHTH BEHAV RHEUM

RADIO GI IM Nights

ELECT

III PEDS GYN NEPH ID ENDO

PODIATRY

ALLERGY

IM ORTHO ELECT**

ELECT ELECT

Elective rotations

• 5 electives

• OGME 1 – 1

• OGME 2 – 1

• OGME 3 - 3

• If felt more time needed on a specific rotation (eg IM Days), medical education committee may “assign” one of the electives as another month (hence the **)

Other rotations required by ACOFP

• Behavioral Health

• Community Medicine

• Hope’s Place

• Free clinic

• Occupational Medicine

Other rotations required by ACOFP

• Sports Medicine

• Impact Program

• School pre-participation physicals

• Geriatrics

• Longitudinal in years 2 and 3

• Resident is first call

Resident Teaching Expectations

• Medicine/ICU

• Bread and Butter

• Grand Rounds

• WVSOM education days

• Presentation counts as “Statewide” presentation for Residency Project

• Table trainers for OMT

• Assist with clinical skills labs (August/September)

WVSOM education days

• Third Friday of each month

• At OLBH/SMMC alternately

• 3-4x/yr “COILS” – OMM presentation• Will be at SMMC but residents invited and

encouraged to be table trainers

• Skills labs – can come to teach/update yourselves

• If stay entire day – will be asked to review student lecture presentations

Other Mandatory Activities

• WVSOM midwinter Resident seminar

• Hinting at changing that to spring or summer for better weather

• WVSOM simulated patients

• Once during residency in Lewisburg or Charleston

• Residency to pay for mileage/gas whichever is less

• KOMA Resident Saturday

• DME will give notice if NOT mandatory at least 1 month prior to conference

• Residency will pay for registration. CME for hotel if stay more than 1 day.

Other Mandatory Activities

• Annual Orientation

• Residency Graduation

• Nursing Home rounds

• ACLS/BLS

• Morning Didactics if rotation is not linked to another hospital

MSOPTI lectures

• Telehealth/Youtube

• One Thursday/mo 8-9am*

• One Tuesday/mo noon*• * will be shown recorded at 7-8am

• One OMM session with lab each quarter Thurs 6-8pm

• Mandatory

• Expected to watch webinar if not present at time of presentation if not excused.

MSOPTI

• Library facilities

• Through WVSOM

• Procedures Consult

•Chief Resident’s council

• Mid Winter Seminar

•Research assistance

Core competencies

• Medical Knowledge

• OMM

• Patient Care

• Professionalism

• Interpersonal/communication

• Practice based learning/improvement

• Systems based practice

OSCE (but it’s not)

• NOT a PE exam

• Clinical skills • Also can look at professionalism,

cultural issues, etc.

• Part of core competency evaluation

•Mandatory in either 1st or 2nd year (repeat in 3rd if poor performance)

Requirements for promotion

• PGY1 to PGY2

•Must have Kentucky license

• Can remain on rotations but will still be considered PGY1

• Once have IP license will get pay increase to PGY2

Requirements for promotion• PGY2 to PGY3

• Passage of COMLEX 3

• MUST show proof to DME – copy for your residency file

• Will be removed from rotations at conclusion of PGY2 rotations (per AOA requirement)

• Leave without pay

• Request that you take COMLEX 3 before 6 month mark of 2nd year

Requirements for promotion

• SOLE survey

• Attendance at ACOFP

• Once in either 2nd or 3rd year

• Something in writing for residency file

• Research project

• ALL hospital and office work completed

Requirements for promotion/graduation

• ? Numbers of ambulatory patients seen

• May need to take another elective to meet requirements

• Receipt of “diploma” does not guarantee completion of program

• Still have to file forms with ACOFP

• ACOFP has to provide final verification to program

Continuity Clinic

• OLBH Primary Care FLATWOODS

• 2420 Argillite Road

• (606) 836-3900 or 836-1900

• Dr. A. Lobach

• Dr. Kevin Howard

• Lisa Pennington, PA-C

Clinic Hours

• Flatwoods primary site

• Dr. Kevin Howard supervising physician

•½ day a week PGY 1

• 3 separate ½ day sessions PGY 2/3

•AM hours start 8:00am - Noon

• PM hours start 1:30-5:30pm

Chart Documentation

• Every Hospital Admission

• OMT eval expected and MUST be in your H&P

• FULL H&P

• Preventive measures in ROS

• epss/USPSTF

• Every Office Chart

• Must be co-signed by preceptor

• Document health maintenance

• Assessment in chart must match diagnosis on billing sheet exactly

Chart Documentation

•MUST let Medicare know that this is a residency clinic• Billing and coding separate lecture…

however…• GE modifier – you saw the patient on your

own (will NOT apply for the first 6 months of PGY1)• GC modifier – the preceptor saw the patient

after you did and performed their own exam• First 6 months of PGY1 year

• ANY 99204 or 99214 or greater visit

Other Information

•Geriatrics

• Continuity starts midway through PGY 2

• Derek Jones, DO

• Patient panel of 7-8 residents of Trinity Station

• Electives

• Sooner select the better

• Request 2 months in advance or may end up on vacation

Other Information

• Vacation

• Ignore paycheck information re vacation and sick time

• 15 days per year plus any days program assigns for conference (e.g., KOMA, WVSOM Doctor Days)

• Use it/loose it

• Space it out – can’t use all at end of academic year

• NO vacation last 2 weeks of June

• No more than 5 days consecutively

• Not while on Medicine rotations

• MUST request 3 months in advance

Other Information

• CME $$

• Use it/loose it

• Licensing

• Will pay for KY licensing

• WV license fees would come out of your CME allowance

• Watch timing for filing information

• 1st year under watch of OLBH

Program does NOT cover

• Licensing other than KY

• ACOFP conference

• Board fee (for board certification)

• Salary over 12/36 months of mandatory rotations

Important Numbers

•Door codes

• Mail Room 24282

• Call room 0710

•Key to Education Classroom

• Located at switchboard #61

Important Numbers• Feinberg• Cell (606) 922-8598

• ERC office (606) 833-3171• Fax (606) 833-2280

• gail_feinberg@bshsi.org

• SMMC office (304) 399-7592• Fax (304) 399-7593

• gfeinberg@osteo.wvsom.edu

• Flatwoods (606) 836-3900

• Howard• Kevin_howard@bshsi.org