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RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE
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RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE

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  1. RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5496 • www.acgme.org PROGRAM INFORMATION FORM FOR TRANSPLANT HEPATOLOGY FOR CONTINUED ACCREDITATIONINSTRUCTIONSREVIEW OF AN ACCREDITED PROGRAM OR RE-ACCREDITATION OF A PROGRAM: If the ProgramInformation Form (PIF) is being completed for a currently accredited program, follow the provided instructions tocreate the correct form. Go to the Accreditation Data System found on the ACGME home page (www.acgme.org)under Data Collection Systems. Using your previously assigned User ID and password, proceed to the PIFPreparation section on the left hand menu and update the Common PIF data. Most data in the Common PIF areupdated through annual updates, but some information is required at the time of site visit only. Once the dataentry is complete, under Print/Preview PIF, select Generate PIF to review and print the Common PIF (either inHTML or PDF format). Next proceed to the section under the RRC for Internal Medicine to retrieve the SpecialtySpecific PIF for continued accreditation. Complete the Specialty Specific PIF using your preferred wordprocessor (only after the Common PIF has been completed). Enter page numbers for the Specialty Specific PIFin the bottom center for each page that consecutively follows the Common PIF numbering, combine the CommonPIF and the Specialty Specific PIF and complete the Table of Contents (found with the Specialty Specific PIFinstructions)Once the forms are final and ready for signatures, print the entire PIF in either the printer-friendly HTML version orPDF version. After the original has been signed, make two copies. They must be identical and final. Draft copiesare not acceptable. The forms should be submitted bound by either sturdy rubber bands or binder clips. Do notplace the forms in covers such as two or three ring binders, spiral bound notebooks, or any other form of binding.Mail the original and two copes of the PIF and requested attachments to: 1Ms. Cleo Whitfield Systems Administrator Residency Review Committee for Internal Medicine 515 North State Street, Suite 2000 Chicago, Illinois 60610For questions/problems regarding: - the site visit, contact the writer of the letter announcing the site visit. - the completion of the form (content), contact the Accreditation Administrator. - the Accreditation Data System data entry, email WebADS@acgme.org.For a glossary of terms, use the following link – http://www.acgme.org/acWebsite/GME_info/gme_glossary.aspThe forms are designed for use by single institution as well as multi-institution programs. The Program Director isresponsible for the collection of data and other information from each participating institution. All the informationis to be consolidated and reported on a single set of forms which must be signed by the Program Director andDesignated Institutional Official. If more space is required to respond to an item, expand the text boxes asnecessary. The information provided should be complete but concise and should not include unrequestedmaterial such as reprints, brochures, computer printouts, catalogs, or lengthy CVs.SPECIALTY SPECIFIC INSTRUCTIONSFACULTY DATA: List alphabetically and by site the physician faculty to include the following: a minimum of twokey clinical faculty, including the program director, who devotes at least 10 hours per week to fellow education. Ifthe program is approved for more than four positions, list additional faculty if required based on the requirementfor a minimum faculty to fellow ratio of 1:1.5. In addition, supply a one page CV for each faculty listed.residency-review-committee-for-internal-medicine920.doc
  2. Please have the following documents available for the site visitor:References to Common Program and Institutional Requirements are in parentheses. 1. Policy for supervision of residents (addressing resident responsibilities for patient care, progressive responsibilities for patient management, and faculty responsibility for supervision) (CPR IV.A.4) 2. Program policies and procedures for residents’ duty hours and work environment (CPR II.A.4.j) 3. Moonlighting policy (CPR II.A.4.j; CPR VI.F) 4. Documentation of internal review (date, participants’ titles, type of data collected, and date of review by the GMEC) 5. Overall educational goals for the program (CPR IV.A.1) 6. Competency-based goals and objectives for each assignment at each educational level (CPR IV.A.2) 7. Current Program Letters of Agreement (PLAs) (CPR I.B.1) 8. Files of current residents who have transferred into the program, if applicable (including documentation of previous experiences and summative competency-based performance evaluations) (CPR III.C.1) 9. Evaluations of residents at the completion of each assignment (CPR V.A.1.a) 10. Evaluations showing use of multiple evaluators (faculty, peers, patients, self, and other professional staff) (CPR V.A.1.b.(2)) 11. Documentation of residents’ semiannual evaluations of performance with feedback (CPR II.A.4.g; V.A.1.b. (4)) 12. Final (summative) evaluation of residents, documenting performance during the final period of education and verifying that the resident has demonstrated sufficient competence to enter practice without direct supervision (CPR V.A.2) 13. Completed annual written confidential evaluations of faculty by the residents (CPR V.B. 3) 14. Completed annual written confidential evaluations of the program by the residents (CPR V.C.1.d.(1)) 15. Completed annual written confidential evaluations of the program by the faculty (CPR V.C.1.d.(1)) 16. Documentation of program evaluation and written improvement plan (CPR V.C) 17. Documentation of resident duty hours (CPR II.A.4.j; VI.D.1-3) 18. Files of current residents and most recent program graduates 19. Documentation (one-page, print screen from ABIM website) of Program Director, Key Clinical Faculty (minimum required) current ABIM-certification.residency-review-committee-for-internal-medicine920.doc
  3. 1RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5496 • www.acgme.org PROGRAM INFORMATION FORM FOR TRANSPLANT HEPATOLOGYProgram Name:TABLE OF CONTENTSWhen you have the completed forms, number each page consecutively in the lower center. Enter pagenumbers for the Specialty Specific PIF in the bottom center for each page that consecutively follows the CommonPIF numbering. Report this pagination in the Table of Contents and submit this page with the completed PIF. 1Common PIF Page(s)Accreditation Information Citation InformationParticipating SitesFaculty/Teaching Staff Physician Faculty Roster Physician Curriculum Vitae Non-Physician Faculty RosterResident Appointments Number of Positions Actively Enrolled Residents List of Residents On Leave Faculty to Resident ratio Aggregated Data on Residents Completing or Leaving the Program Residents Completing Program Transferred, Withdrawn, and Dismissed ResidentsEvaluationResident Duty Hours Specialty Specific Page(s)Background InformationFacilities and Resources for TrainingAdministration of the Transplant Hepatology Fellowship ProgramOther Professional Faculty in the Transplant Hepatology Fellowship ProgramRotation/Assignment DescriptionEducational ProgramAmbulatory ExperienceTransplant Hepatology ResearchNarrativeresidency-review-committee-for-internal-medicine920.doc
  4. RESIDENCY REVIEW COMMITTEE FOR INTERNAL MEDICINE 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5496 • www.acgme.org SPECIALTY SPECIFIC PROGRAM INFORMATION FORM FOR TRANSPLANT HEPATOLOGYI. BACKGROUND INFORMATIONA. Sponsoring Institution/Single or Limited Residency Institution (see ACGME Institutional Requirements – if applicable) For those institutions with multiple residencies accredited by the same Residency Review Committee, the institutional review will be conducted in conjunction with the review of the program. Only programs in this category are to complete the following institutional questions. Complete only if "single/limited site sponsor" field under Participating Site section is YES. 1. Provide an institutional statement that commits the necessary financial, educational and human resources to support the GME program(s) and provide documentation that the statement has been approved by the governing body, the administration and the teaching staff (Appendix A). 2. Describe the formal method by which a periodic evaluation of the program’s educational quality and compliance with the program requirements occurs. Explain how fellows and faculty in the program are involved in the evaluation process. 3. Describe how the institution complies with the Institutional Requirements regarding “Resident Eligibility and Selection” and the development of appropriate criteria for the selection, evaluation, promotion and dismissal of fellows in accordance with the Program and Institutional Requirements. 4. Summarize how the institution complies with the ACGME Institutional Requirements regarding fellow support, benefits and conditions of employment to include the details of the resident contract or agreement as outlined in the ACGME Institutional Requirements. (Do not append the resident contract/agreement to the PIF but state when it is given to the residents and applicants. Have a copy available for verification by the site visitor on the day of the survey with the various items required by the ACGME numbered according to the Institutional Requirements.) 5. Describe in detail the grievance (due process) procedure(s) that is available to fellows, including the composition of the grievance committee, and mechanisms for handling complaints and grievances related to actions which could result in dismissal, non-renewal of a resident’s contract, or other actions that could significantly threaten a fellow’s intended career development.residency-review-committee-for-internal-medicine920.doc
  5. II. FACILITIES AND RESOURCES FOR TRAININGUse the institution numbers and names as they appear in the Participating Sites section under the Common PIF.to complete this facilities checklist for all participating institutions used for routine rotations.Checklist Institution #1 Institution #2 Institution #3 Institution #4 Institution #5Number of liver transplantsperformed each yearNumber of liver biopsiesperformed each yearNumber of allograft liverbiopsies performed each yearUNOS-approved transplant ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOprogramInterventional radiologyfacilities to:Perform balloon angioplasty ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOPerform transjugularintrahepatic portal systemic ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOshuntAre the following available:Fellow office ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOOutpatient clinic facilities ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOAdequate clinic support staff ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOOn-site medical library ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOAfter-hours access to reference ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOmaterialsAccess to electronic medicaldata base and computerized ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOliterature searchAccess to medical records at ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOtime of outpatient visitAccess to medical recordsavailable to inpatient teaching ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOservice in a timely mannerOn-call facilities:Sleeping rooms ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOFood facilities ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NO ( ) YES ( ) NOAccredited programs in:Internal Medicine ( ) YES ( ) NOGastroenterology ( ) YES ( ) NO1. Interactions with Other Disciplines: a. Do fellows and faculty share patient co-management responsibilities with transplant surgeons from the preoperative phase to the outpatient period?......................................................................( ) YES ( ) NO b. Does the program ensure close interactions and education with an experienced liver transplant pathologist? ........................................................................................................................( ) YES ( ) NO c. Does the program use a multidisciplinary approach to issues in donor selection and evaluation and in recipient criteria? ................................................................................................................( ) YES ( ) NO2. Will fellows be provided autopsy reports after autopsies are completed on their patients? .......( ) YES ( ) NOresidency-review-committee-for-internal-medicine920.doc
  6. III. ADMINISTRATION OF THE TRANSPLANT HEPATOLOGY FELLOWSHIP PROGRAM1. Is there is a single program director responsible for the transplant hepatology fellowship program? ...................................................................................................................................................( ) YES ( ) NO2. Does the sponsoring institution provide adequate salary support for the program director for the administrative activities of the program?...........................................................................................................( ) YES ( ) NO3. Does the salary support prevent the program director from the need to generate income to support the administrative activities of the program?....................................................................................( ) YES ( ) NO4. Are there adequate inpatient facilities (e.g., conference rooms, on-call rooms) for the transplant hepatology fellowship program? ..................................................................................................................( ) YES ( ) NO5. Are there adequate facilities in the ambulatory settings (i.e. exam rooms, meeting/conference room, work area) for patient care and the educational components of the program? ..................................( ) YES ( ) NO6. Does the program director have sufficient authority to: a. Determine number of fellows?.............................................................................................( ) YES ( ) NO b. Determine fellow rotations – including amount of fellow off-site time?.................................( ) YES ( ) NO c. Control fellow work load – including number of patients – on all rotations at principal teaching hospital?..... ............................................................................................................................................( ) YES ( ) NO d. Control teaching space and other facilities relevant to the training program?......................( ) YES ( ) NO e. Select teaching attendings based on fellow evaluations?....................................................( ) YES ( ) NO f. Determine fellowship curriculum, including content of conferences fellows usually attend?( ) YES ( ) NOIf the answer to any of the above questions is no, please explain below.residency-review-committee-for-internal-medicine920.doc
  7. IV. OTHER PROFESSIONAL FACULTY IN TRANSPLANT HEPATOLOGYProvide the following information for all other PHYSICIAN faculty who will participate in the transplant hepatology program but devote less than 10 hoursper week, on average, to the training program. Duplicate page if necessary.residency-review-committee-for-internal-medicine920.doc
  8. NAME SPECIALTY 1 YEAR CERT SPECIALTY 2 YEAR CERT SPECIALTY 3 YEAR CERT HRS/WK WKS/YR ROLE IN PROGRAM: NAME SPECIALTY 1 YEAR CERT SPECIALTY 2 YEAR CERT SPECIALTY 3 YEAR CERT HRS/WK WKS/YR ROLE IN PROGRAM: NAME SPECIALTY 1 YEAR CERT SPECIALTY 2 YEAR CERT SPECIALTY 3 YEAR CERT HRS/WK WKS/YR ROLE IN PROGRAM: NAME SPECIALTY 1 YEAR CERT SPECIALTY 2 YEAR CERT SPECIALTY 3 YEAR CERT HRS/WK WKS/YR ROLE IN PROGRAM: NAME SPECIALTY 1 YEAR CERT SPECIALTY 2 YEAR CERT SPECIALTY 3 YEAR CERT HRS/WK WKS/YR ROLE IN PROGRAM:residency-review-committee-for-internal-medicine920.doc
  9. V. ROTATION/ASSIGNMENT SCHEDULE1. Instruction: Provide a rotation schedule that describes the rotations for a typical fellow. Do not include vacation blocks. Use a distinct title for each rotation that allows the Committee to understand the educational nature of the rotation, e.g., Inpatient Liver Transplant. Do not use abbreviations or local terminology (e.g. “Blue 1”). Please define all required experiences. Indicate elective rotations with the term “elective”. 1 2 3 4 5 6 7 8 9 10 11 12 Rotation Institution/Site Duration of Experience (weeks or months)Average Number ofHours on Duty per WeekNumber of Full Days off per week During thisRotation/Assignment Frequency of In House Night Call(Q3, Q4, etc.) Direct PatientResponsibility (Yes or No)2. Provide a rotation schedule narrative that accurately describes each rotation in your program. Duplicate table as necessary.Rotation Name:Rotation Narrative:Rotation Name:Rotation Narrative:residency-review-committee-for-internal-medicine920.doc
  10. VI. EDUCATIONAL PROGRAMA. Curriculum 1. Is there a written curriculum for the fellowship program? ....................................................( ) YES ( ) NO 2. Does the written curriculum define the educational goals and objectives of the rotation/assignment based on the Competencies?.........................................................................................................( ) YES ( ) NO 3. Is there a written curriculum for each major rotation or learning experience?......................( ) YES ( ) NO 4. Will the written curriculum be distributed to fellows and faculty?.........................................( ) YES ( ) NO 5. Will the rotation goals and objectives be reviewed by faculty with the fellows at the start of each new rotation and assignment?....................................................................................................( ) YES ( ) NOB. Required Conferences 1. Provide information about the following required conferences: Monthly Frequency Core curriculum conference series Clinical case conference Research conference Journal club 2. Does the program include instruction in the following topics either as separate presentations or integrated into the core curriculum conference series? a. Clinical ethics......................................................................................( ) YES ( ) NO b. Medical genetics..................................................................................( ) YES ( ) NO c. Quality assessment and improvement.................................................( ) YES ( ) NO d. Patient safety.......................................................................................( ) YES ( ) NO e. Risk management................................................................................( ) YES ( ) NO f. Preventive medicine............................................................................( ) YES ( ) NO g. Pain medicine......................................................................................( ) YES ( ) NO h. End-of-life care....................................................................................( ) YES ( ) NO i. Physician impairment..........................................................................( ) YES ( ) NO j. Critical assessment of medical literature.............................................( ) YES ( ) NO k. Medical informatics..............................................................................( ) YES ( ) NO l. Clinical epidemiology...........................................................................( ) YES ( ) NO m. Biostatistics.........................................................................................( ) YES ( ) NOresidency-review-committee-for-internal-medicine920.doc
  11. VII. EDUCATIONAL PROGRAMA. Subspecialty ExperienceIndicate how fellows will obtain experience and if they will be required to demonstrate competence in the followingprogram content areas: Formal Clinical Demonstrate Instruction Experience Competence SPECIFIC PROGRAM CONTENT (Y/N) (Y/N) (Y/N) Prevention, evaluation and management of acute and chronic end stage liver disease (includes genetic disorders involving the liver, alcoholic and non-alcoholic steatohepatitis) Comprehensive management of critically ill patients awaiting transplant with complications including: Refractory ascites Hepatic hydrothorax Hepato-renal syndrome Hepatopulmonary and portal pulmonary syndromes Refractory portal hypertensive bleeding Diagnosis and management of hepatocellular carcinoma and cholangiocarcinoma including transplantation, non-transplantation, surgical and non-surgical approaches Management of chronic viral hepatitis in the pre-, peri- and post- transplantation settings Management of fulminant liver failure Psychosocial evaluation of transplant candidates, in particular those with history of substance abuse Transplant immunology including blood group matching, histocompatibility, tissue typing and malignant complications of immunosuppression Drug hepatotoxicity Interaction of drugs with the liver Nutritional support of patients with liver disease Use of interventional radiology in diagnosis and management of portal hypertension, as well as biliary and vascular complications Ethical considerations relating to liver transplant donors Performance of at least 30 percutaneous liver biopsies Indications, contraindications and complications of liver allograft biopsies Interpretation of at least 200 native and allograft liver biopsies Appropriate use of ultrasound localized, laparoscopy-guided and transjugular liver biopsiesresidency-review-committee-for-internal-medicine920.doc
  12. B. Subspecialty Didactic Experience 1. Will fellows receive formal didactic instruction in the following content areas: Formal Instruction SPECIFIC PROGRAM CONTENT (Y/N) Pathogenesis, manifestations and complications of end-stage liver disease and hepatic transplantation Appropriate use of laboratory tests and procedures Anatomy, and physiology related to the liver and biliary tract Pharmacology related to the liver and biliary tract Pathology related to the liver and biliary tract Molecular virology related to the liver and biliary tract Natural history of chronic liver disease Factors involved in nutrition and malnutrition and its management Cost-effective use of special instruments, tests and therapy in the diagnosis and management of liver disorders Principles and practice of pediatric liver transplantation Principles and application of artificial liver support Clinical research issues and transplant hepatology Principles of living donor selectionC. Subspecialty Clinical Experience Will each fellow (Y/N) Participate in the primary evaluation, presentation and discussion of at least 10 potential transplant candidates? Provide follow-up for at least 20 new liver transplant recipients for a minimum of 3 months from the time of transplantation? Actively participate in the transplant recipients’ medical care including the management of acute cellular rejection, recurrent disease, infectious diseases and biliary tract complications? Serve as an integral member of the transplantation team? Participate in making decisions about immunosuppression? Participate in the follow-up of 20 or more liver transplant recipients 1 year post-transplant? Provide a minimum of six month follow-up for each of these liver transplant patients? Acquire a working knowledge of the organizational and logistic aspects of liver transplantation including the role of nurse coordinators and other support staff, organ procurement , and UNOS policies? Learn the principles of donor selection and rejection? Participate as an observer in one deceased donor procurement and three liver transplant surgeries?D. Inpatient and Consultation Teaching 1. What is the total teaching time that will be spent in combined management and teaching rounds per week? _________________residency-review-committee-for-internal-medicine920.doc
  13. VIII. AMBULATORY EXPERIENCE1. Provide information for the fellows continuity experience and patient distribution. List each experience indicating the name of the experience (e.g. Continuity Clinic), the hospital or other training site identifiers, duration of the experience, number of sessions per week per fellow, average number of patients per session, average number of other trainees and teaching attendings and whether faculty supervision will be provided for each experience. Name of Experience ID Duration Sessions Avg # Avg # Avg # Faculty Per Week Patients Other Teaching Supervision Seen Per Trainees Attendings/ On Site Session Present Session (Yes/ No)2. Provide a narrative which describes how fellows will gain experience in the longitudinal care of patients seen in consultation.residency-review-committee-for-internal-medicine920.doc
  14. IX. TRANSPLANT HEPATOLOGY RESEARCH 1. What percentage of the key clinical faculty (listed in the Common PIF) participate in research in the fellowship program? 2. What is the number of papers published in peer-reviewed professional journals by key clinical faculty members from the transplant hepatology program during the last three years? (Please do not include: Case reports, abstracts, presentations, papers submitted/ not published, publications in non-peer-review journals, or publications published more than three years ago. Count each paper only once. Count each book chapter only once. Peer review publication = indexed in Pub Med (or Medline). If not in Pub Med, program must supply evidence of peer review) 3. What is the number of peer-reviewed grants by the key clinical faculty in the past three years? 4. Will all fellows who participate in a research project have a faculty preceptor?......................( ) YES ( ) NOresidency-review-committee-for-internal-medicine920.doc
  15. X. NARRATIVE1. List the outstanding or special features of the program.2. List those aspects of the program and/or its component institutions/other training sites and faculty that warrant strengthening.residency-review-committee-for-internal-medicine920.doc

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