Anesthesiology SIG Transitional/Prelim Year Meeting 8.18.15



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Anesthesiology SIG Transitional/Prelim Year Meeting 8.18.15 Panel Dr. Fick St. Vincent Transitional Year and Prelim Medicine Program Director Dr. Choi IU General Surgery and Surgery Prelim Program Director Dr. Costello Ball Memorial Transitional Year Program Director Dr. Pitre IU Methodist Transitional Year Program Director Dr. Nakata IU Anesthesiology Program Director Dr. Choi Surgery prelim is usually not everyone s first choice Dr. Choi will try to keep you out of University Hospital if you match there Benefits of Surgery Prelim Year o Learn broad based pt care o Good opportunity for people who want to stay in Indy If you are interested in IU surgery prelim position, they will not be in touch until January, so don t worry if don t hear back in October o If you have not heard back by mid- January, do not hesitate to contact Dr. Choi directly o Dr. Choi and Dr. Ceppa conduct the interviews Four to eight spots at IU and variety of factors involved with this Interview advice for IU surgery prelim o If you don t look like your ERAS picture, that s not good o Dress appropriately o Approach interviewer professionally, always address as Dr. _ o Be prepared for different kinds of questions: teamwork, ethical, difficulties in working with teams (how would you behave in this situation?) Dr. Fick (lbfick@st.vincent.org) What is a transitional year or prelim (med or surg) year? o ACGME requires a Clinical Base Year of training for anesthesia, PM&R, neurology, derm, rads, rad onc, ophtho, and others o Transitional Year Own dedicated ACGME Residency Program Own set of RRC (Residency Review Committees), requirements Max 6 weeks of nights Must have 4 weeks of ambulatory Etc o Preliminary Year (Med or Surg) A first year of Medicine (no continuity clinic) or Surgery You do what the PGY- 1s do TY vs Prelim o Both satisfy Clinical Base Year requirements

o Slight difference based on rotations/curriculum o Differ based on which program you choose ie, St. Vincent prelim medicine is different than IU prelim medicine o Key is to find training program that suits your advanced training o Sample rotation differences Transitional Year Preliminary Medicine Year 2 months Internal Medicine Wards 3 months Internal Medicine Wards 2 months ICU 1 nights, 1 days 2 months ICU 1 nights, 1 days 1 month Emergency Medicine 1 month Emergency Medicine 1 month IM Nights/Consult Medicine 1 month IM Nights 1 month Pediatrics, Internal Medicine 1 month Pediatrics or Cardiology Wards or General Surgery 1 month Family Medicine Clinic 4 months electives 4 months electives What effect will Marian University have on competitiveness of TY programs in Indiana? o Currently MS3s so no impact on the Match this year o Nationally, there are more applicants than spots (and worsening), so every year is more competitive St. Vincent Programs o Transitional Year 18 positions o Prelim Medicine 6 positions o No prelim surgery positions Dr. Costello What should I look for in a TY program? o Curriculums are generally very similar, since they must meet minimum standards for accreditation set for by ACGME o Differentiating factors Location Salary/benefits Size, must be at least 4 spots Facility characteristics/age of buildings/number of sites o Electives Minimally, the TY must have 8 weeks of electives Different programs may set aside more time for electives o Other things to consider Leadership opportunities Chief Resident Service on committees Community involvement Evaluation methods (how programs evaluate you)

All programs use Milestones a milestone is a significant point in development. For accreditation purposes, the milestones are competency- based developmental outcomes that can be demonstrated progressively by residents and fellows form the beginning of their education through graduation to their unsupervised practice of their specialties. Don t forget to talk to current or past residents o Rotation characteristics: there may be strengths and weaknesses in rotation by history, e.g., more ICU vs more trauma At least for anesthesia, some programs will allow you to enter PGY- 2 with credit for ICU months, so you won t need to do them again o Is the program cooperative or competitive? If TY residents are just tagged on to teams, this is not as good as being an integral part of the teams Has the ACGME made any changes to TY programs that we should be aware of? o Short answer: No o But, on 2/26/14, the ACGME, American Osteopathic Association, and American Association of Colleges of Osteopathic Medicine announced an agreement that outlines a single graduate medical education accreditation system for residency and fellowship programs in the US 7/1/15: AOA- approved programs can submit the application for ACGME accreditation online from this date thru 6/30/2020 ACGME says there will be DO and MD on committees Ball Memorial TY Program o 10 transitional year spots Dr. Pitre (cpitre@iu.edu) How many TY programs should I apply to? o On average, applicants rank 6.5 programs o Per 2014 NRMP data, there were 3087 applications for 868 TY positions o 833 matches (96% fill) Do I need a dedicated personal statement + letters for TY programs? o In polling residents at Methodist, most used the same personal statement and letters of recommendation as for their advanced programs o Some tweaked their personal statement to reflect why they wanted to do a transitional year o The best thing to do is look up the specific program s requirements and ask your advisor what applicants typically have done in the past

Dr. Nakata Must submit ERAS application on the first day (September 15 th ), barring any glitches with the system like last year Make sure the picture you attach with your application is professional Be a member of the national society of your specialty (e.g., be a student member of ASA for anesthesiology) Letters of recommendation: He advises students to get 4 in case one of the letter writers does not pan out (most programs will require 3 letters) The NRMP is serious about their rules with the Match o Although the Match Agreement does not prohibit either an applicant or a program from volunteering how one intends to rank the other, it is a violation of the Match Agreement for either party to request such information or for a program director to require applicants to identify programs to which they have or may apply. If you re applying to anesthesia, don t hesitate to contact Dr. Nakata (danakata@iupui.edu) Q&A What are some unique characteristics of each of your programs? Dr. Fick (St. Vincent) - You can start a month early in June instead of July, so that you end on May 31st of the following year, and then have a month off before PGY-2. Also, St. Vincent offers 1-month electives and up to $1000 in funding to residents who would like to travel to underserved areas around the world. Dr. Costello (Ball Memorial) - Ball has group of about 65 total residents (including IM and FM), so the culture is a better fit for people who enjoy smaller, more tight-knit programs where everyone knows everybody. Dr. Pitre (IU Methodist) - The IU TY is robust in the number of electives to choose from. There are many unique electives that you won t find at other programs, and more opportunities to do electives applicable to your future specialty. What are you looking for in applicants (besides being hard-working)? Dr. Fick - Don t be arrogant, don t be a jerk, and don t be weird, especially in your personal statement. On interview day, show some enthusiasm and energy. Dr. Costello - Remember that programs interviewing you are just as excited about you as you are about them. Is it important to submit the ERAS application right when it opens up on September 15th? Dr. Nakata - As long as you submit your application on September 15th, it doesn t really matter what time of the day you submit it.

Dr. Fick - St. Vincent actually does not place a ton of importance on having the application submitted on the first day, because some people will apply to certain transitional year programs later based on where they get interviews for advanced positions. How can you tell if programs are cooperative or competitive in nature? It s hard to say until you go there, but when you interview, you ll get a feel for the culture of the program. How important is the Unique Characteristics section of the MSPE? Dr. Fick - For many people, it ends up being a lot of the same information that is already part of the personal statement or CV, so it does not tend to add (or take away) much from the application. For St. Vincent, do you apply and interview for the transitional year and prelim medicine year separately? Dr. Fick - St. Vincent asks that you apply to one or the other (TY or prelim med), and then if you re offered an interview, that interview will count for both the transitional year and prelim medicine year. St. Vincent submits the exact same rank list for the transitional year and prelim medicine programs. So you can rank the transitional year and prelim medicine year programs based on which one you d prefer when you make your rank list.