ACOS Memo May 2008

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Memorandum

 Date:               May 29, 2008

 To:                  ACOS Program Directors

 From:             Don Kaveny, Director, Post Doctoral Training

 Subject:          Changes in ACOS/AOA Resident Training Programs

 In March we asked program directors to provide the ACOS with their OGME-1R rotation schedules and to complete and return an ACOS Residency Program Director Questionnaire (Attached) regarding curriculum.  As of this date, there are many rotation schedules and questionnaires outstanding; please return them to the ACOS as soon as possible.  OGME-1R rotation schedules are due at the ACOS by June 2, 2008.

OGME-1R

As explained in the February Newsletter, the ACOS Resident Evaluation and Standards Committee (RESC) met January 25 – 26, 2008 in Alexandria, Virginia.  An item on the committee’s agenda was to revisit the OGME-1R rotations and add a disclaimer to ensure that program directors have the autonomy to better determine who they accept into their programs and what requirements are necessary to prepare the OGME-1R resident for the ensuing course of training.  Unfortunately, the AOA COPT voted to eliminate the verbiage which would do that.  Last November the COPT declined to act on the request from neurological surgery residency program directors to modify the OGEM-1R rotations for their programs.  The following changes were sent to the COPT for approval, but changed (See the Strikethroughs):    

The first year of the residency program general surgery, urological surgery, and neurological surgery should follow the following rotations.  These rotations may be scheduled as 12 one-month rotations or 13 four-week rotations or any combination thereof. These guidelines may be altered at the discretion of the director, with the approval of the sponsoring institution’s GME Committee and Director of Medical Education, and the RESC to better serve the experience of the resident.  Programs not complying with the OGME-1R Guidelines must provide their actual rotation schedule to the RESC and a rationale for the variance for approval. 

These proposed changes must now go to the AOA BOE and BOT for approval.  Programs are reminded that the previously approved rotation guidelines for OGME-1R for general surgery, neurological surgery, and urological surgery, still go into effect July 1, 2008.

The approved rotation guidelines are:

1. Rotations for ½ day per week, for 46 weeks, in an out-patient clinic or office.*

2. Two months of general internal medicine

3. One month of ICU

4. One month of emergency medicine

5. One month of female reproductive medicine

6. One month of pediatrics, if available, or other primary care specialty, at the discretion of the training institution

7. Four months of general surgery

8. Two months of electives to include any of the following areas:

a. Urology

b. Orthopedics

c. Anesthesia

d. ENT

e. General Surgery

f. Vascular Surgery

g. Neurosurgery

h. Cardiovascular Thoracic Surgery

i. Plastic and Reconstructive Surgery

j. Radiology

            * Note that “primary care” has been removed from this requirement.           

 The ACOS is aware that some programs may have difficulty during this period of transition in accommodating this rotation schedule and it will continue to review the guidelines and make every effort to accommodate variations on a program-by-program basis. 

 Please provide the ACOS with your proposed OGME-1R rotations by June 2^nd.

From the outside, it may appear to most viewers that there have been no changes in the first year of training for osteopathic surgical residents.  Program directors should be working with their DMEs and OME committees to ensure that residents are receiving the best training experience possible.  The program directors should be monitoring the training of the OGME-1R resident and “signing off” on those rotations.  For your information and use, I am providing some information from the ACOS model curriculums to assist program directors in monitoring and documenting the OGME-1R training year.  (See CT Rotation Tracker and AOA Form Attached. )  DME offices should have documentation in place to assist them in the tracking of first-year, postdoctoral trainees and should continue to use those forms.

The DME and offices of medical education will still be responsible for the administrative portion of the training and make the necessary notifications to the AOA upon completion of the first year of postdoctoral training.  The ACOS has received many inquiries regarding the use of the Surgical Oplog program.  Programs and OGME-1R residents may use the Oplog system, but the RESC will not be reviewing any individual documentation from first year residents.  The Oplog system might be just one form of tracking for the rotations of the OGME-1R resident.  Don’t hesitate to contact the ACOS office if you have any questions or need any further information.

Scholarly Activity

Programs are required to keep records for each resident to evidence that the “scholarly activity” requirement is being fulfilled.  Documentation of scholarly activity is required to be made available to the site visitor when the program is reviewed.  As part of the Resident’s Annual Report the resident must include a short narrative explaining their scholarly activity.  This narrative should support the narrative which will be part of the program director’s evaluation of the resident.  The Program Director’s Evaluation of the Resident can be found on the ACOS website at www.facos.org.  Letters regarding annual report documents have been sent to residents with copies provided to program directors.  Please assist your residents by reminding them to get their annual reports in on time to avoid paying a $250 late fee!  Annual reports for training year ending June 30, 2008 are due in the ACOS office by July 31^st.  Additionally, there is a $250 review fee for residents who are not members of ACOS for the training year to be reviewed.  Membership fee for residents is $150 for training year ending June ’08 and will increase to $175 for the next training year. Residents who are not ACOS members at the present time cannot apply for membership for the ’07-’08 training year. 

Scientific Poster Presentations may be used to by residents to meet the scholarly activity requirement if previously approved by the program director.  Posters used to satisfy the scholarly activity requirement for residents are due at the ACOS by June 16, 2008.

Resident Awards and Posters at the ACA

Resident Achievement Awards and the Robert C. Erwin Awards deadlines are rapidly approaching. 

Resident Achievement Awards are presented annually to up to five outstanding resident members in recognition of their clinical ability, patient/resident manner, resident/staff relationships, and resident/community involvement. These awards may be presented to residents in the general, general vascular, neurological, orthopedic, plastic and reconstructive, cardiothoracic, and urological surgical specialties. Each award includes a plaque and a cash award of $2,000 - Application

Robert C. Erwin Literary Awards are presented annually to ACOS resident members who have authored outstanding scientific manuscripts. Each award includes a plaque and a cash award for first, second, third, fourth or fifth place - Manuscript Guidelines

Poster Presentations -- A poster presentation provides an opportunity for an in-depth exchange of information on a one-to-one basis and is an excellent medium for unusual or multiple clinical case presentations. Simply prepared with photographs and laboratory information, poster presentations encourage the exchange of findings and treatment results in an inexpensive manner. Any aspect of surgery may be presented in a poster presentation.

Scientific Exhibits -- A scientific exhibit is a significantly expanded version of a poster presentation. Scientific exhibits encourage audience involvement and offer an expanded base of educational opportunities and instructional formats over poster presentations (i.e., videotapes, slides, x-ray view boxes, etc.) If you are interested in having a scientific exhibit during the ACA, please contact Kendra Smith for information and application forms at (800) 888-1312 x106 or ksmith@facos.org.

Resident Achievement Awards are due at ACOS by June 2, 2008 and the Robert C. Erwin Awards are due by June 16^th.  For additional information on the awards go to the ACOS website at www.facos.org:  click on “Membership” and then go to “Awards.”  For additional information regarding scientific poster presentations, go to the ACOS website at www.facos.org and click on ACA.

Surgical Educators Seminar

The ACA is rapidly approaching. Program and Site Directors are required to attend at least one Surgical Educators Seminar every three years.  The next Surgical Educators Seminar will be held September 13^th in conjunction with the ACA in Boca Raton, Florida.  Dr. Franklin Medio and Dr. John Gimpel, D.O. from NBOME and a professor at UNE/COM in Maine will be the presenters for the didactic portion of the session.  RESC members will be available to discuss issues affecting our programs.  Look for meeting materials and program descriptions to be sent in the next few weeks. 

AOA COPT News (Excerpts from the COPT Newsletter dated April 2008)

The Council on Postdoctoral Training (COPT) met as a part of the American Osteopathic Association (AOA) cluster meetings of Councils and Bureaus, in conjunction with DO Day activities in Washington, DC on April 25th 2008. All members were present and the agenda was filled with new policy resolutions and Basic Standards amendments in preparation for the intern ship residency restructuring for July 2008.

The following are summaries of actions taken by COPT. All new Basic Standards and policy changes will be published for the required 60 day comment period in addition to requiring approval by the Bureau of Osteopathic Education (BOE) and the AOA Board of Trustees.

Work (Duty) Hours

The COPT Subcommittee on Work flours chaired by Darrell F. Lovins, DO, reported on their evaluation regarding whether out-of-hospital on call schedule should count toward the 80 hour limit. The recommendation supported by COPT was that only in-hospital time will count. All out-of-hospital hours do not count toward the maximum 80-h our limit. If the resident is called into the hospital the clock begins.

The AOA will discuss collaboration with the Accreditation Council for Graduate Medical Education (ACGME) regarding the Agency on Healthcare Research and Quality (AHRQ) request to the Institute of Medicine to evaluate resident work hours, patient and resident safety and the British and European reduced hours.