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    NIVERSITY OF NIVERSITY OF Document Transcript

    • UNIVERSITY OF MINNESOTA GRADUATE MEDICAL EDUCATION 2010 - 2011 FELLOWSHIP POLICY & PROCEDURE ADDENDUM Department of Medicine Pulmonary/Critical Care Fellowship Program 1
    • Introduction and Welcome to New Fellows On behalf of the faculty, staff, residents and fellows, welcome to the Department of Medicine at the University of Minnesota. We hope that the time you spend with us will be both educational and enjoyable. This Fellowship Addendum refers to policies and procedures specific to your training program. Please refer to the Institution Manual and the Program Policy Manual for your Department for further policies and procedures on the following: Student Services; Benefits; Institution Responsibilities; Disciplinary and Grievance Procedures; General Policies and Procedures and Administration. Should information in the Program Manual or Fellowship addendum conflict with the Institution Manual, the Institution Manual takes precedence. The Institution Manual can be found on the GME website at: http://www.gme.umn.edu/residents/parta/home.html The Internal Medicine Program Policy Manual can be found the GME website at: http://www.gme.umn.edu/directors/partb/home.html Fellows are responsible for: knowing and adhering to the policies and guidelines contained in this handbook. When in doubt, fellows are responsible for contacting the program coordinator or director. Again, welcome to the program! Department Mission Statement / Philosophy The mission of the Department of Medicine is to enhance the health of the people of Minnesota, the nation and the world, through innovation and research, education and patient care. It is the mission of the Department of Medicine to provide excellent training in the practice and science of Medicine by immersion in patient care, with emphasis upon critical reasoning, scholarship and professional responsibility, and to promote personal and professional satisfaction. The Pulmonary and Critical Care Fellowship Program Website address is: http://www.med.umn.edu/pacc/fellowship/pulmonary/home.html The Division of Pulmonary, Allergy, Critical Care and Sleep Website address is: www.med.umn.edu/pacc 2
    • SECTION I. STUDENT SERVICES (Please refer to Institution Policy Manual for Medical School Policy on the following: Academic Health Center Portal Access; Child Care; Computer Discount and University Bookstore; Credit Unions; Disability Accommodations; Legal Services; Library Services; Medical School Campus Maps; Resident Assistance Program; Tuition Reciprocity; University Card (U Card); University Recreation Sports Center; University Events Box Office). Pagers University pagers: Each fellow will be given an alpha numeric pager and unique pager number assigned only to him/her. Pagers have an 80-mile radius. Batteries for pagers are available at all Medicine Offices at each of the hospital sites. Fellows should turn in their pagers to the UMMC Information desk located in the Lobby if their pager needs repair, and a temporary pager will be assigned. First-year fellows must turn their pagers into their fellowship coordinator when not rotating at or doing call for UMMC. Failure to turn in their pager at the end of the rotation will result in an assessment for the daily cost of the pager. Second and third year pagers will be re-assigned their University pager. Regions: The first year fellow pager number is 651-629-0358. VAMC: The first year fellow pager number is 612-818-1674. HCMC: The first year fellow pager number is 612-336-0502. Email Fellows are assigned a University of Minnesota e-mail account at the beginning of their fellowship. Should you use another email service, you are required to forward your University email account to whichever email service that you use (Yahoo, hotmail, etc. You may do this by contacting the email helpline at help@umn.edu or by calling 612 – 301 – 4357. We regularly send announcements about the program via e-mail and we ask that you check email at least once a week. Campus mail Each Fellow has a campus mailbox located in the PACCS Division mail and copy room in 350 VCRC. Campus Mail Code is: MMC 276. Many important mailings are also sent directly to fellows’ homes. Fellows must ensure that the Fellowship coordinator always has their current address. Fellows must check their mail sent to their homes and campus mail addresses regularly. Any unclaimed campus mail will be forwarded to each fellow’s home address at the end of the rotation. Lab Coats: New Fellows Only: You will receive two embroidered lab coats on the day of your orientation. Returning Fellows: Please notify the Program Office if there is a need to replace your coat. 3
    • SECTION II. BENEFITS (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Boynton Health Services; Employee Health Services; Exercise Room at UMMC-F; FICA; Dental Insurance; Health Insurance; Life Insurance; Voluntary Life Insurance; Long-Term Disability; Short-Term Disability; Insurance Coverage Changes; Bereavement Leave; Family Medical Leave Act (FMLA); Holidays; Medical Leave; Military Leave; Parental Leave; Personal Leave; Professional Leave; Vacation/Sick Leave; Witness/Jury Duty; Effect of Leave for Satisfying Completion of Program; Loan Deferment; Minnesota Medical Association Membership; Minnesota Medical Foundation Emergency Loan Program; Pre-Tax Flexible Spending Accounts; Professional Liability Insurance; Stipends; Workers’ Compensation Benefits; Veterans Certification for Education Benefits). Vacation and Sick Policy In accordance with ABIM policy, all fellows will be given one month (i.e., four weeks) of leave, to be used for both vacation and sick leave. Any leave that exceeds one month will be unpaid and must be made up at the end of the training. There is no carry over of vacation or sick time from one year to the next. For details, please refer to the ABIM policy located on the web at www.abim.org. For sick time, Fellows must contact their fellowship coordinator. Sick leave will be approved for legitimate illness. Allotted vacation time is 3 weeks. Fellows are allowed to take one week of vacation at a time during the first year clinical rotations. One week means 5 weekdays Monday-Friday plus one weekend. If a holiday falls within the week of vacation, you do not get extra vacation days. Any exceptions to this one full week policy must be approved by the program director. Vacation days cannot be carried over to your next academic year. Please be aware that any request for vacation time which will necessitate clinic cancellation at any site must be submitted 35 days in advance to allow time for approval and submission to the scheduling offices (requires 28 days notice). As a courtesy to Faculty, any request for vacation time that will not necessitate clinic cancellation must also be submitted one month in advance. A specific vacation request will not be approved until the fellow has completed required paperwork which include, but are not limited to, evaluations, patient dictation, and RMS duty hour logs. A Leave Absence Request form must be filled out (in your orientation binder, on the website, and in the PACCS office 350 VCRC) and turned into the Director at your site. 1st year fellows: o Vacations should be split into 3 full weeks, with no more than one week at a specific hospital. 4
    • o Coverage for absences at UMMC will be assigned to your 2nd and 3rd year colleagues – please be kind and schedule vacations as far in advance as possible. o No vacation may be taken during the last week of the fellowship for first year fellows. o Only one first year fellow may be on vacation at a time - requests will be honored on a first-come, first serve policy. o One vacation request is due from first year fellows by the end of July. Senior fellows: Vacations should not be taken from clinical rotations, except under exceptional circumstances with special permission. Please fill in the appropriate form and turn it in as above. Once a vacation has been processed it cannot be changed. See your Internal Medicine Program Policy Manual for: Health Insurance Life Insurance Long-term Disability Insurance Short-term Disability Insurance Dental Insurance Professional Liability Insurance Parental Leave (Maternity and Paternity Professional and Academic Leave Usually first year fellows do not attend professional meetings. If you are presenting at a meeting please obtain permission, and if necessary, coverage and funding to attend the meeting. Sometimes funded special opportunities for meeting attendance are provided to the Division, we will distribute based on interest and trying to balance out everyone’s’ opportunities. For senior fellows, we expect fellows to attend one meeting per year – usually ATS, but this may vary depending on the type of research. Fellows are expected to present at least once during the two years, otherwise travel may not be reimbursed for a second meeting. Individuals paid by the training grant have travel money included in the grant. For individuals paid by other sources, each site has funds that help support travel to one meeting per year. Frequently we can obtain scholarships to support fellow attendance at meetings. Fellows have 5 days/year educational leave in the second and third years to attend meetings. Use of more than this requires written approval from the Program Director. Travel costs are expected to be minimized by sharing rooms, early registration, etc. For major meetings, we will set a reasonable standard amount of money that a fellow can expect to have reimbursed. Costs exceeding this may not be paid without written prior approval from the Program Director. All travel expenses must be documented by detailed original receipts – credit card statements are not sufficient. Alcohol will not be reimbursed. For all travel, there is a specified per diem amount that is established for each city and costs exceeding this amount will also not be reimbursed. Requests for reimbursement must be turned in within 30 days after travel. 5
    • Other Leaves Emergency leave, leave for examinations, or other absences may be authorized by the supervising faculty and the Program Director, depending on the circumstances. Unauthorized Leave Unexcused or unsupportable absences or unauthorized leave and therefore significant tardiness from any mandatory clinical or educational activity constitutes unprofessional conduct. Under your signed employment contracts, unprofessional conduct is one behavior which will subject the resident to discipline for non-academic reasons. Such discipline may be in the form of a written warning, probation, suspension or termination. Policy on Effect of Leave for Satisfying Completion of Program All fellows must meet the thirty-six month training requirements established by the American Board of Internal Medicine. Residents may miss one month per year or three months per fellowship, including vacations, sick leave, LOA, etc. Time in excess of three months, whether for vacations, sick leave, maternity or paternity leave must be made up to meet this requirement. Any request for an LOA should be considered carefully, as it will invariably create difficulties for the training program and your fellow residents. A requested LOA must be discussed with the Program Director. The Program Director must approve your request at least three months prior to the requested LOA date. Exceptions may be made if the request falls under the definition of the Family Medical Leave Act (FMLA). Please see Part A of this manual for the Medical School policy on FMLA. Do not assume that an LOA will be granted automatically. Obtain approval before making plans. Requests need to be submitted to the Program Director 3 months in advance. Stipends Salaries are paid every other Wednesday. (Please note that your first check may not be for a full pay-period depending on where your start date falls in the pay period). Also see Part B Manual, page 13-14, for stipend rates. Meal Tickets There is no allotment for meals to fellows in Pulmonary/Critical Care. Laundry Service Available at Fairview-University Hospital Parking Parking is provided for first year fellows at each hospital and 2nd/3rd year fellows on clinical rotations. Fellows can pick up their parking card from the PACCS Education desk in 350 VCRC on the first day of their rotation. Please notify fellowship coordinator if arrangements have been made to get parking card from fellow previously on that service. Parking cards MUST be turned in at the end of the last day of the rotation so that it may be given to the next fellow on the rotation. Return parking cards to a PACCS staff member that can verify receipt of the parking card and check you off the sign-in 6
    • sheet. If the parking card is not received promptly, the fellow will be assessed the daily cost of the division parking stamp ($12/day) that would have to be used by the next fellow until the parking card is returned. Conference parking Parking is also provided to attend required conferences. At HCMC, contact the secretary to obtain parking stickers. At UMMC, fellows can sign in and stamp your parking ticket at the PACCS Education Desk (You must park in the East River Road Ramp). At Regions, tickets will be provided at the conference. Research Expenses Fellows supported on the training grant have some dedicated money for their research. For non-lab investigators this can be used for computer software and books directly related to your research. This money can also be used to help supplement travel expenses. For fellows not on the training grant, research expenses should be provided by the Mentor and site. Some sites have special funds set aside for research support. Office Space C378 Mayo In-Service Exam Second-year fellows will take a computer based examination that is offered once yearly and has been constructed to assess knowledge in the fields of pulmonary and critical care medicine. It was developed to provide trainees in pulmonary and critical care medicine fellowship programs feedback regarding their individual knowledge base as they progress through their training. It was also developed to provide feedback for training program directors about the training program curricula. The examination has been developed as a "low stakes" examination and is not intended to be used as a basis for promotion during or graduation from the program. 7
    • SECTION III. DISCIPLINARY AND GRIEVANCE PROCEDURES (Please refer to Institution Policy Manual for Medical School Policy on the following: Discipline/Dismissal/Non-Renewal of Residents/Fellows; Conflict Resolution Process for Student Academic Complaints; University Senate on Sexual Harassment Policy; Sexual Harassment and Discrimination Reporting; Sexual Assault Victim’s Rights Policy; Resident Dispute Resolution Policy). SECTION IV. GENERAL POLICIES AND PROCEDURES (Please refer to Institution Policy Manual for Medical School Policy on the following: AHC Student Background Checks Policy; Appointment Documentation Requirements; Blood Borne Diseases Policy; Classification Policy; Compact Between Resident Physician and Their Teachers; Disaster Policy; Dress Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty Hours Prioritization of On-Call Rooms; Eligibility and Selection of Residents/Fellows; Essential Capacities for Matriculation, Promotion and Graduation; Evaluation Policy; Gift Policy; GME Core Curriculum Seminar Series; GMEC Resident Representative Policy; Health Insurance Portability and Accountability Act; Immunization and Vaccinations; Impaired Resident/Fellow Policy and Procedure; Institution Duty Hour Survey Policy and Procedure; Institution and Program Requirements; International Medical Graduates Visa Requirements; Licensure/Residency Permit Policy; Moonlighting Policy; Nepotism Policy; New Training Program Policy; Observer Policy; Post-Call Fatigue Cab Voucher Policy; Program Oversight; Registered Same Sex Domestic Partner Policy; Release of Resident/Fellow Contact Information Policy; Residency Closure/Reduction; Resident Management Suite (RMS) Resident/Fellow Responsibilities; Resident/Fellow Standing and Promotion Policy; Restrictive Covenants; Short Term Disability Policy; Stipend Level Policy; Supervision Policy; Transitional Year Policy/Procedure; USMLE Step 3 Policy; Voluntary Life Insurance Procedure; Without Salary Appointment Policy). Evaluations Most evaluations are generated electronically by the E-value system. www.e-value.net. Other evaluations are paper-based and require you to distribute to the intended evaluator. Fellows First-year fellows will be evaluated monthly during the basic clinical year. The evaluation will be conducted by your attendings for the month. All faculty are expected to complete their evaluations of fellows within four weeks of completion of the rotation. Faculty are also expected to provide end-of-rotation feedback to the residents. Please access and read your evaluations regularly! Second and third year fellows will be evaluated on their clinical rotations, research, and sub-specialty clinics (if applicable). All fellows will be evaluated on their continuity clinics. Fellows will also need to complete mini-CEX bronchoscopy evaluations. (First years must return two from each quarter). Faculty You will have an opportunity to evaluate each of the faculty members who are directly involved in your supervision each month. Please note that your evaluation is kept anonymous. 8
    • Program You will be required to evaluate the program at least twice during your training: 1. At the end of your clinical year, giving you an opportunity to express your views on the pros and cons of staff, faculty, curriculum, rotation site, etc. 2. At the end of your fellowship training providing an overall (exit) evaluation on the program. Patients and Clinic Staff Every fellow will be given copies of 360° Evaluations for the UMMC ICU, UMMC Consult Service, and UMMC Continuity Clinic (if applicable). Fellows are required to distribute these evaluations. Self addressed stamped envelopes are attached so that patients (and families) and clinic staff can return directly to our office. Program Director Meetings Each resident meets twice yearly with the Program Director to review evaluations, conference attendance, procedural logbooks, and to provide feedback to the program. These mid and year-end evaluations are also placed in the fellows' E-value file and are readily accessible for review. Your completed evaluation is one of the tools we use in improving the quality of our training program. In addition, after you graduate, we will periodically ask for feedback from you regarding your training. On Call Schedules There is no required in-house call. Beeper call from home varies, depending on the rotation. The schedule is distributed at the beginning of the year, with some sites scheduling weekends and night call on an ongoing basis. UMMC distributes the call schedule monthly by email. This schedule is frequently updated by email, so please check your email! Duty Hours Beginning times vary for each hospital but in general, it is 8:00 a.m. until the work is finished (usually around 6:00 p.m.). When averaged over any 4-week rotation or assignment, fellows must not spend more than 80 hours per week, or 30 continuous hours performing patient care duties. Please notify the program director if this occurs so that we can address this! Duty hours are defined as all clinical and academic activities related to the training program, i.e. patient care, administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities and scheduled academic activities such as conferences. Duty hours DO NOT include reading and preparation time spent away from the duty site. In compliance with ACGME guidelines, fellows will have one day off per week on average (weekends). The training program provides adequate time for rest and personal activities, which consists of a 10-hour time period provided between all daily duty periods. If you think these guidelines are being exceeded, PLEASE contact the program director. Insert ACGME Sample Resident/Fellow Survey. 9
    • Monitoring of Well-Being The program director will monitor duty hours, days off, and adequacy of rest at all sites by periodic questionnaires and informal communications. The attending physicians are responsible for monitoring the duty hours, days off and adequacy of rest, levels of stress for fellows under their supervision, and report any excesses to the program director. The program encourages fellows to recognize their own levels of stress also, and to seek the advice of their attending physician or program director if stress becomes too great. See your Internal Medicine Program Policy Manual for: On Call Rooms Support Services Laboratory/pathology/radiology services Medical Records Security/Safety Job Postings/ Information The PACCS Education office keeps a bulletin board posted with current academic job requests/position openings. Any job info sent to the program by email is forwarded to the fellows directly. Moonlighting Trainee Responsibility Trainees who wish to moonlight are required to obtain prospective permission from their program directors. Failure to provide this information is grounds for discipline under Section VI of the Residency/Fellowship Agreement. Trainees must report all external moonlighting hours to their Program Director on a regular basis. Professional Liability Moonlighting activities and any activities that are not part of the formal education program are not covered under the University of Minnesota professional liability policy. Visa Requirements Trainees on J-1 visas are not permitted to be employed outside the residency/fellowship program. Therefore they are not allowed to moonlight. A trainee on an H-1B visa wishing to moonlight must obtain a separate H1-B visa for each facility where the trainee works outside the training program. Other Requirements 10
    • Trainees engaged in moonlighting activities must be properly licensed and credentialed as determined by the organization where they moonlight. Moonlighting that occurs within the residency/fellowship program and/or the sponsoring institution or the non-hospital sponsor’s primary clinic site(s), i.e., internal moonlighting, must be counted toward the ACGME weekly limit on duty hours. Moonlighting must not interfere with the resident’s performance of patient care or educational responsibilities on any rotation during training. Moonlighting approval is contingent upon ongoing compliance with fellowship policies, including RMS duty hour entry. The Moonlighting Reporting Form is available in your orientation binder, on the PACCS website, and in 350 VCRC. Program Contacts PCC Fellowship Director Melissa King-Biggs, MD Kingx048@umn.edu; Melissa.B.KingBiggs@HealthPartners.com PCC Fellowship Coordinator Anna Subramian PACCSEDU@umn.edu PACCS Administrator (UMMC) Funmi Thompson Thomp014@umn.edu PCC Director (UMMC) David Ingbar, MD Ingba001@umn.edu PCC Director (HCMC) Con Iber, MD Iberx001@umn.edu PCC Coordinator (HCMC) Wendy Yates Wendy.yates@hcmed.org PULM Director (VAMC) Dennis Niewoehner, MD Niewo001@umn.edu PULM Coordinators (VAMC) Kelly Conrad Kelly.conrad@va.gov Cassandra Vaughn Cassandra.vaughn@va.gov PCC Director (RGHP) Avi Nahum, M.D. Avi.X.Nahum@HealthPartners.com PCC Coordinator (RGHP) Elizabeth (Bess) Farrell Elizabeth.A.Farrell@HealthPartners.com Department of Medicine Fellowship Program Directory http://www.med.umn.edu/dom/contact/home.html 11