Update from the RRC

1
Update from the RRC

• Margaret M. Grimes, MD
• Chair, Residency Review Committee
• 200-230
• Friday, July 29, 2005
• Mont-Tremblant, Quebec

2
The RRC Current Members

• M. Desmond Burke, MD
• Deborah J. Chute, MD
• Joseph C. Fantone, MD
• Margaret M. Grimes, RRC Chair
• Rebecca L. Johnson, MD, Vice-Chair
• Suzanne Z. Powell, MD
• Janet E. Roepke, MD
• Sharon W. Weiss, MD
• Ross E. Zumwalt, MD
• Betsy D. Bennett, MD, PhD, ex-officio

3
ACGME Activity

• General Competencies
• Instruction in 6 areas
• Resident evaluation in 6 areas
• Info request for site visits

4
RRC Activities

• New Fellowship PIFs This Fall
• MGP Revisions Proposed
• Citation Analysis
• Bone Marrow Change
• Case Log System Data

5
MGP Clarification
Institutions that do not sponsor an
ACGME-accredited residency in Medical Genetics
may request an exception to the accreditation
requirement that sponsoring institutions of MGP
fellowships should also sponsor accredited
programs in APCP and Medical Genetics. Programs
have now been approved in institutions that do
not sponsor medical genetics residencies.
6
Proposed MGP Revisions
MGP fellows who are pathologists will not be
required to participate in the direct patient
care of genetics patients. Rather, fellows who
are pathologists will be expected to gain an
understanding of the principles involved in that
care (through clinical conferences, for
example) Participation in direct patient care
will be optional but not discouraged.
7
Citation Analysis
Educational Program - Patient Care Educational
Program - Procedures Educational Program -
Didactics Evaluation of Residents Evaluation of
Program (See Attachment 1)
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Patient Care Category

• Most Frequent Citations
• Variety of autopsies
• Preview slides before sign out
• Complete autopsy (7 components)
• Review slides on cases grossed
• Number of OR consults

9
Procedure Category

• Most Frequent Citation
• Residents must develop initial competence in the
  performance of FNAs
• (qualitative eval, not just minimum )

10
Didactics Category

• Most Frequent Citations
• Laboratory management
• Faculty participation in sessions
• Structured ed in Clinical Path

11
Resident Evaluation Category

• Most Frequent Citations
• Formal eval at least semi-annually
• Final eval must confirm preparation for
  competent, independent work
• Eval in all six general competencies

12
Program Evaluation Category

• Most Frequent Citations
• Faculty resident eval meeting yearly
• Use resident evals in eval of program
• NOTE
• Confidential vs. Anonymous

13
Case Log Data, 2004-05
1,155 Residents Entered Data 22,252
Autopsies 6,028 FNAs 4,511 Bone Marrows (See
Attachment 2 for CPT Codes)
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Autopsy Data, 2004-05
22,252 Autopsies 3,931 Forensic 3,845
Stillborn/infant 11,492 with CNS Exam 2,985 w/out
CNS exam
15
Bone Marrow Data, 2004-05
4,511 Bone Marrows 955 Aspirations only 3,556
Biopsies
16
Bone Marrow Change
The RRC will no longer cite programs if residents
do not perform bone marrows. However, we will
continue to gather data regarding the resident
performance of the procedures in the Case Log
System
17
New Bone Marrow PIF Question
If residents do not perform bone marrow
aspirations and/or biopsies, how do you ensure
that they become familiar with the procedures and
the determination of the adequacy of specimens
and preparation techniques?
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RRC OFFICE INFORMATION

• 515 North State Street, Suite 2000
• Chicago, IL 60610
• Fax [phone]
• Steve Nestler312.755.5025, spn_at_acgme.org
• Billy Hart312.755.5026, bhart_at_acgme.org
• Nicole Felton312.755.5034, nfelton_at_acgme.org