Richard Mink, MD, MACM CoPS Fellowship Start Date Action Team

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1 Fellowship Start Date Richard Mink, MD, MACM CoPS Fellowship Start Date Action Team

2 Fellowship Start Date Multi specialty Action Team organized in Nov 2013 CoPS Richard Mink James Bale, Jr APPD Grace Caputo Dena Hofkosh Assoc of PD in Internal Med Ethan Fried Assoc of Specialty Professors Elaine Muchmore Assoc of PD in Surgery Dan Vargo Fellowship Council (Surg) AuroraPryor DIOs Julia McMillan Khanh van Le Bucklin

3 3 rd Year Residents Pursing Fellowship Conducted through APPD in June respondents Estimated 30% response rate

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6 Comments by Residents Honestly, anything you could do to give us some time between end of residency and beginning of fellowship would be helpful. I have to drive 450 miles and then Bam! start fellowship. I am going to be drop dead tired. It makes no sense for fellowships to start on 7/1, when we are contracted to work as resident until 6/30. Somehow we have to move after a work day and then need to start work in a new location the following day. The current system is not logical. A delay in start date would be very helpful! It is extremely difficult to move to a new state and start fellowship orientation before residency finishes. I would not be able to be without health insurance.

7 Fellowship Program Directors Conducted by CoPS in August respondents Response rate 56%

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9 Comments by FPDs Things work fine right now. Why to fix something that is not broken? This survey was rigged to get the answer you apparently want. We have no trouble with the current date, nor have we had for the entire time of our fellowship. I do not support a change. Why to change? This has been working OK in the majority of programs for the past 25 years. Insurance and other benefits would be the biggest issue in the gap between jobs.

10 Comments by FPDs I am a fellowship director for our pediatric orthopedic surgery fellowship. We have always started our fellowship on August 1. Residents complete their residency at the end of June. They can spend time studying for and taking Part 1 of the American Board of Orthopedic Surgery Exams in July. They can relocate to their new location and start their fellowship on August 1. I am completely satisfied that this works well. I am surprised that Pediatric subspecialties do not do it this way. It makes no sense

11 Recommendation #1 Beginning with the2017 appointment year, Pediatric Subspecialty Fellowships should start no earlier than July 7 82% of FPDs selected July 7 or later 1 week gap in income acceptable to most residents COBRA health insurance available but can be purchased only if needed visas can be transferred budgets already accommodate off cycle trainees

12 Recommendation #2 Orientation should not be scheduled before July 5 over 1/3 of trainees currently attend orientation before June 30

13 Recommendation #3 Implementation should involve an aggressive educational campaign aimed at FPDs to make them more aware of the problem and to clearly communicate the desires of the trainees 50% of FPDs did not think the fellowship start date was a problem when informed of resident preferences, selection of July 1 by FPDs significantly decreased

14 New Action Team Members Association of American Medical Colleges Miriam Bar on Maryellen Gusic Janis Orlowski Organization of Program Director Associations Keith Armitage Tara Uhler Council on Resident Education in Ob/Gyn Tony Ogburn Mark Woodland (ECFMG)

15 What About the Other Specialties? Surgical Fellowships moving to Aug 1 in 2016 Internal Medicine discussing but undecided Ob/Gyn proposing a delay to July 7 with formal vote this July

16 Implementation No one organization regulates the start date Educate the Pediatric Community FPDs/Chairs/DIOs Publications J Pediatrics Pediatrics Journal of Graduate Medical Education Oral and Poster Presentations ti APPD PAS

17 Implementation Action Team DIO Subcommittee working on a document to operationalize the move orientation health insurance budgets Implementation needs support of entire Graduate Medical Education community

18 Why Do It? TO IMPROVE TRAINEE WELL BEING!