Preventive Medicine Review Committee Update

Transcription

1 Accreditation Council for Graduate Medical Education Preventive Medicine Review Committee Update Beth Baker, MD, MPH Chair, Review Committee for Preventive Medicine Preventive Medicine Program Directors Workshop Wednesday, February 24, 2016

2 Disclosures Chair, Review Committee for Preventive Medicine No conflicts of interest to report

3 Objectives for today s session 1. Summarize the work of the Review Committee for Preventive Medicine in the past year. 2. Describe data elements the Review Committee has used in the second annual review of Preventive Medicine programs in the Next Accreditation System (NAS). 3. Describe changes effecting preventive medicine programs related to: Single GME accreditation system Revision of Program Requirements Plans for revision of ACGME Common Program Requirements Milestones V.2.0

4 Review Committee members Beth A. Baker, MD, MPH Chair Tarah Castleberry, DO, MPH Marie Dotseth, Public Member Yvonne Farnacio, MD, MPH Resident Member Tina C. Foster, MD, MPH, MS Kurt T. Hegmann, MD, MPH Denece Kesler, MD, MPH, FACOEM Vice Chair Samual Sauer, MD, MPH

5 ACGME Staff Susan Day, MD Medical Director, ACGME-I Review Committee staff Lorraine C. Lewis EdD RD Executive Director

6 Work of the Review Committee Feb 1, 2015 to Feb 1, Continued annual review of all Preventive Medicine programs in The NAS 2. Proposed revision of program requirements for Preventive Medicine 3. Reviewed applications for 2 new residency programs both granted Initial Accreditation

7 How the Review Committee conducts the annual review of programs Step 3. Step Key annual data elements used to screen programs Step Additional information requested (site visit, clarifying information) 3. Requested additional information reviewed

8 Data elements in the NAS Key data elements Board pass rate Faculty and resident scholarly activity Resident Survey Other data elements Missing or incomplete information Faculty Survey Attrition

9 Data elements in NAS Information the Review Committee uses is from : a. the Annual Update submitted in September and reflecting the previous academic year, and b. data from ABPM for exams taken during the previous academic year So for example In January 2016 the Review Committee reviewed Annual Update submitted prior to September 2015 and ABPM data from October 2014 exam

10 Review of programs 2014/2015 academic year Step Key annual data elements used to screen programs Results: 13 programs failed 2 or more indicators 10 programs had citations issued after July 1, programs on consent agenda with no additional review 13 programs on consent agenda were issued Areas For Improvement (AFIs)

11 Failed indicators Low pass rate on certifying exam Citations issued for 5-year average first time pass rate of less than 75% Significant negative trends in Resident survey results Resident and faculty scholarship

12 Why do programs get an AFI? Key data elements were trending downward Example 3-year average pass was low, but 5-year average pass rate was acceptable Information was missing or judged to be incomplete Only 1 key indicator was non-compliant Example faculty scholarly activity was low and all other indicators acceptable

13 AFIs issued 2014/2015 No core faculty listed 5 programs Faculty or resident scholarship 3 programs 2015 Resident Survey results 3 programs 2015 Faculty Survey results 1 program 3-year pass rate on certifying exam 1 program

14 Who are core faculty? evaluate the competency domains; work closely with and support the program director; assist in developing and implementing evaluation systems; and teach and advise residents. Program directors cannot be designated as core faculty.

15 What do I do if I get an AFI? AFIs are not addressed annually like citations; HOWEVER, They should be addressed. Some ideas: Include analysis of the issue in the Annual Program Evaluation If applicable, discuss with Residency Advisory Committee (RAC) as part of curriculum review Track and evaluate results of any planned intervention Minutes of Program Evaluation Committee (PEC) and/or RAC should document discussion and planning

16 What do I do if I get an AFI? DO NOT IGNORE The Review Committee will review the same ADS data next year

17 How the Review Committee conducts the annual review of programs Step Additional information requested (site visit, clarifying information) Results: 2 requests for clarifying information 2 focused site visits 1 full site visit

18 ACGME changes & Preventive Medicine Single GME accreditation system Focused revision of Program Requirements Revision of ACGME Common Program Requirements Milestones 2.0

19 DO Eligibility for preventive medicine residency programs Program Requirement III.A.1. Prior to appointment in the program, residents must have successfully completed at least 12 months of clinical education in a residency program accredited by the ACGME, Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians of Canada

20 Beginning July 1, 2015 AOA-approved programs can apply for ACGME accreditation and receive the status of pre-accreditation Any ACGME-accredited program can seek Osteopathic Recognition Program Requirements have been approved and are on the website Osteopathic Recognition is not needed to accept DOs

21 Beginning July 1, 2016 Residents who have completed prerequisite training in programs that have received ACGME accreditation or preaccreditation at the time a resident was enrolled will be eligible for entry into preventive medicine residencies. No grandfathering

22 Residents currently in AOA prerequisite clinical programs The Review Committee for Preventive Medicine understands that during this one-year transition period, programs may wish to consider applicants currently enrolled in an AOA approved pre-requisite program that is not yet pre-accredited or accredited by the ACGME. Core programs will not jeopardize their accreditation status if they accept these individuals. Programs should check with the American Board of Preventive Medicine regarding certification eligibility.

23 Program Requirements for Preventive Medicine Focused Revision Program Requirement III.A.1.a).(1) To be eligible for appointment at the PM-1 level Prior to appointment in the program, residents must have successfully completed at least 12 months of clinical education in a residency program accredited by the ACGME, RCPSC, or the CFPC. (Core) Program Requirement III.A.1.a).(1).(a) Resident experience must include at least months of direct patient care in both inpatient and outpatient settings. (Core)

24 Program Requirements for Preventive Medicine Focused Revision Program Requirement III.A.1.a).(2) To be eligible for appointment at the PM-2 level, residents must have completed: a) an ACGME-accredited residency program; and, (Core) b) at least 50 percent of the requirements for a Master s degree. (Core)

25 Program Requirements for Preventive Medicine Focused Revision Program Requirement III.A.1.a).(3) An individualized education plan must be developed for a resident entering the program at the PM-2 level that ensures the resident will complete all curricular requirements and have educational experiences needed to attain all required competencies. (Core)

26 New FAQ What documentation is required to appoint a resident at the PM-2 level? written or electronic verification of previous educational experiences; a summative evaluation issued upon completion of the previous residency program; transcript of master s-level courses completed prior to entry to the PM-2 year; and, an individual educational plan developed upon entry to the PM-2 year.

27 New FAQ What is required in a resident s individual educational plan when he/she enters the residency at the PM-2 level? The program director and the resident entering at the PM-2 level should review the resident s prior educational experiences to identify any competency gaps normally covered by the program s PM-1 year.

28 New FAQ, continued The plan should include: all the required curriculum components of the program s PM-2 year, along with any additional educational experiences needed to close those gaps identified; that prior to completion of the residency program, the resident appointed at the PM-2 level must complete a master of public health degree (MPH) or equivalent degree; and, all the required graduate-level courses listed in the Program Requirements.

29 Program Requirements for Preventive Medicine Focused Revision Program Requirement IV.A.3.a) Residents must complete Whether through a Master s in Public Health or other equivalent degree prior to completion of the residency program. (Core)

30 Program Requirements for Preventive Medicine Focused Revision Program Requirement IV.A.3.b).(3) Residents should complete the following graduate-level courses prior to completion of the program: public health and general preventive medicine: advanced applied epidemiology (to include acute and chronic disease); advanced biostatistics; advanced health services management; clinical preventive services; and risk/hazard control and communication. (Detail)

31 Program Requirements for Preventive Medicine Focused Revision Program Requirement IV.A.5.b).(2) in programs with a concentration in public health and general preventive medicine, must demonstrate knowledge of principles of: a) advanced health services management; (Outcome) b) risk/hazard control and communication; and, (Outcome) c) clinical preventive services. (Outcome)

32 New FAQ How can a program ensure that its residents have opportunities to attain knowledge of clinical preventive services? If a program has established coursework that covers knowledge of clinical preventive services, it can retain those courses. Additionally, the program can use lecture series, workshops, multi-specialty conferences, or other didactic experiences to provide opportunities for resident to gain knowledge of clinical preventive services.

33 Program Requirements for Preventive Medicine Focused Revision Program Requirement V.C.4. Each program must have a Residency Advisory Committee (RAC), which must consist of faculty members, external members who have primary affiliation outside the sponsoring institution, supervisors, and at least one resident representative, and must include the program director as an ex-officio member. A majority of the members must have their primary affiliation outside the sponsoring institution. The RAC must meet at least semiannually.

34 Program Requirements for Preventive Medicine Focused Revision Program Requirements V.C.6. and 7. At least 50% of those completing their education in the preceding five years must take the American Board of Preventive Medicine certifying examination. (Outcome) 75 precent of a program s graduates from the preceding five years who took the certifying examination for preventive medicine for the first time must have passed. In those programs having fewer than 10 graduates in the past five years, at least 75% of the 10 most recent graduates must have passed. (Outcome)

35 Revision of Common Program Phase 1 Requirements Review of data to determine changes in duty hour requirements Comment period April 2016 ACGME Board approval June 2016 Implementation 2016/2017 academic year Phase 2 Common Program Requirements Section I through V

36 What about Milestones?? Not currently used as screening indicator Useful data for programs to use as part of Annual Program Evaluation Program Requirement V.C.2. The program, through the PEC, must document formal, systematic evaluation of the curriculum at least annually, and is responsible for rendering a written and Annual Program Evaluation Useful information to be included in RAC Program Requirement V.C.4.b).(2) The RAC must advise and assist the program director to develop educational experiences and clinical rotations

37 Questions and Discussion