Council Meeting Honolulu, Hawaii May 4, 2008


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  • Today’s presentation will cover a lot of ground in a short amount of time, but at the end of the presentation, I want you to know two things: MOC was designed by and for pediatricians to be a meaningful and clinically relevant pathway to continuously improving your professional image, knowledge and practice performance. As we developed MOC for pediatrics, we made very deliberate decisions that in the end would reduce redundancy in the myriad of quality requirements while at the same time accelerating improvement. I’ll share more about this today. A tremendous amount of collaboration went into what you’ll see here today. Had it not been for the guidance of ABMS, lock-step collaboration with the Primary Care Boards and of course, a highly collegial relationship with the Academy, I would not be bringing you this exciting update today.
  • The American Board of Pediatrics sets standards of excellence in knowledge and performance. Maintenance of Certification supports and accelerates your efforts to continually advance quality care in pediatrics. That’s precisely why ALL Boards are adopting a four-part Maintenance of Certification process. It is an ABMS-wide action plan for quality that meets the IOM imperative to improve across all domains of health care. We fundamentally believe MOC will lead to better care, and while no physician ever thinks they provide sub-optimal care, there’s no question we can all get better – quality of care can and will be improved when we systematically engage in i mprovement and continuous learning . Today we are working diligently to ensure that MOC provides recognition in various forms – from payers, regulatory and accrediting bodies - for the value you are adding to your practice by being involved in MOC.
  • Throughout the development process, we have engaged our Board of Directors and member pediatricians in the design of what will become a very flexible program that you can tailor to your practice. Over time, as technology advances and market demands for quality accelerate, MOC will evolve into a much more continuous process. Our intent is to make sure it syncs up with other regulatory, credentialing and accrediting requirements. In particular, we will ensure MOC does its job in assuring the public that pediatricians have the knowledge and skills to provide high quality care. You can see here the transition into a more continuous process. For instance, if your certificate expires in 2008 or 2009, all you need to do to recertify is have a valid license (Part 1) and take the examination (Part 3). If a diplomate has a certificate that expires in 2010 thru 2015, they will need to complete all four parts of MOC, but the requirements, as you can see here, for Parts 2 and 4 are FIXED. Meaning, everyone has to do the same activities. However, starting in 2010, individuals will have a menu of options to choose from for Parts 2 and 4. I’ll go over this in more detail in a minute. Notice that the ABP will begin offering 5-year certificates beginning in 2010. This is really intended to make MOC more continuous and more relevant to your practice by assuring that you are more continuously engaged in Part 2 and 4 activities. The GREAT news is that the exam is being moved to 10 years (it’s at 7 right now).
  • Let’s go into a little more detail about the 4-part MOC process. First, it’s important to recognize that MOC has at its foundation the six core competencies that are evaluated during residency and fellowship training (see slide). However, we have now transitioned away from traditional recertification to a flexible process in order to help you provide evidence in 4 key areas: 1) Professional Standing, 2) Knowledge Assessment, 3) Cognitive Expertise (the secure exam), and 4) Performance in Practice. The new MOC process goes beyond just an examination – referred to as Part 3 – to include measures of knowledge improvement and quality care improvement – Parts 2 and 4.
  • Part 1, currently requires that pediatricians maintain a valid and unrestricted medical license in the state in which you practice. Through an electronic database system set up by the Federation of State Medical Boards (FSMB), the ABP now receives alerts on disciplinary actions taken against medical licenses in the United States. If the action results in a loss or restriction of licensure, certification may be revoked by the ABP. This is just one more way that we can assure the American Public that board-certified physicians are professional AND competent. If a diplomate loses certification, once they remedy the cause of revocation, they can become certified again by completing the MOC process.
  • The two newest parts to MOC – self-assessments and performance in practice – provide tools to help pediatricians maintain competence in knowledge and practice. For instance, Part 2 activities will help you enhance your knowledge and skills in areas that are important to your practice. The ABP and others – such as the Academy – have developed tools that you can access online. Completion of these activities will not only result in meeting requirements for MOC Part 2 but most will provide you with CME at little or no additional cost. We anticipate at least 18 online self-assessments will be available by the end of the year (2008). This slide shows you how the menu for Part 2 will look in the next year or two.
  • Recertification has seen many changes over the past few decades. It was really not embraced by the AMBS until 1969, and it wasn’t until 1980 that the ABP began to offer voluntary recertification by secure examination to those wishing to show continued professional development. In 1993, the secure exam was changed to a non-secure ‘open-book’ type of educational process that was required once every 7 years in order to maintain one’s certificate. However, in 2003, the examination returned to a secure, proctored process once every 7 years. The return to a secure examination represents the ABP’s responsibility to assure the American public (including patients, parents, payers, hospitals and regulatory agencies) that the physician taking the test presents appropriate identification documents. Pass rates for the examination continue to be high as we expected. The exam is really intended to test you on those areas that you should be familiar enough with without the need for reference materials – results of this exam prove that pediatricians are remaining current with this general fund of knowledge. In 2010, you will see the exam will be required only once every 10 years, rather than every 7 as it is currently. This change is an example of the evolution of the MOC process and the hard work that volunteer pediatricians and ABP staff have done listening to diplomate feedback.
  • Part 4 – Performance in Practice Activities – specifically, are being designed to drive measurable results in improvement. Like Part 2, Part 4 will also have a menu of options to choose from. This is an example of several currently approved QI activities, including AAP’s eQIPP modules. We anticipate this menu will expand as the ABP approves more activities.
  • We have made very deliberate decisions along the path of MOC development to try and reduce redundancy in the quality requirements that you’re accountable. In collaboration with several other Primary Care Boards (Medicine and Family Medicine), we have made significant advances in making sure that MOC adds value to your practice – instead of taking away your already limited resources. We are actively engaging in discussions with numerous organizations to ensure your participation in MOC is recognized as a marker of quality……
  • Not only have the Primary Care Boards worked side-by-side to advocate for recognition for MOC, but we have been sharing our resources and knowledge to develop self-assessment and improvement tools for your use. As I said, a tremendous amount of collaboration has gone into everything you’ve seen here today. Equally important, our highly collegial relationship with the Academy – one that few societies and boards enjoy – has resulted in some news that I’d like to share with you today. To-date the ABP has approved 3 self-assessment activities developed by the Academy and we are currently working with Academy staff to develop a small menu (approx 6) of part 4 activities. Some really good news! The Academy has made it possible for diplomates of the ABP to receive CME credits for completion of all Part 2 and Part 4 activities (with one exception*). We hope to have CME ready to go in early 2008, allowing you to earn CME for improving care while meeting MOC requirements. By engaging in MOC activities on a routine basis, you can continually update your knowledge in a tailored environment AND earn CME for local credentialing requirements such as hospital privileges and state licensure. And any activity that is developed by the ABP is available to diplomates at NO additional charge. The ABP made the decision early on to have enough activities available to diplomates at no additional charge so that the overall cost to maintain certification does not appreciably increase with these new changes. *NOTE to SPEAKER: The General Pediatrics Knowledge Self-assessment carries no CME with it. The self-assessment is really designed to help diplomates gauge their preparedness for taking the secure examination and carries no feedback on performance.
  • In closing, this is the one slide you will want to remember. Secure, personal requirements are online in the Physician Portfolio . The Physician Portfolio is a secure web account somewhat similar to an web account (if you shop at Amazon). All you need to do is log in from the ABP Home page and the Portfolio will show you exactly what requirements you need to fulfill to maintain certification. To familiarize yourself with the Physician Portfolio, the ABP has developed a brief tutorial (sort of an on-line movie) of how the Portfolio works. You can access this tutorial from the Home page of the ABP web site ( ).
  • If you need additional information about MOC or details on the program, please contact Dr. Jim Stockman at this e-mail address. Thank you.
  • Council Meeting Honolulu, Hawaii May 4, 2008

    1. 1. Council Meeting Honolulu, Hawaii May 4, 2008
    2. 2. Welcome New Members <ul><li>Bruce A Boston, MD – Endocrinology </li></ul><ul><li>Mary Beth Fasano, MD - Allergy and Immunology </li></ul><ul><li>Robert Spicer, MD – Cardiology </li></ul><ul><li>Christine Barron, MD - Child Abuse </li></ul>
    3. 3. Maintenance of Certification – Pediatrics Executive Overview Setting standards of excellence in knowledge and performance.
    4. 4. Today’s Presentation <ul><li>Review the Maintenance of Certification process and our efforts to reduce redundancy and accelerate improvement </li></ul><ul><li>Preview how collaboration among the Primary Care Boards and with AAP adds value </li></ul>
    5. 5. Why Maintenance of Certification – Pediatrics? <ul><li>All Boards are adopting MOC </li></ul><ul><ul><li>ABMS-wide action plan for quality </li></ul></ul><ul><ul><li>Meets IOM imperative to improve quality of care </li></ul></ul><ul><li>MOC leads to better care </li></ul><ul><ul><li>MOC is a commitment to quality </li></ul></ul><ul><ul><li>MOC helps pediatricians perform more effectively </li></ul></ul><ul><ul><li>Helps you meet payer, regulatory and consumer demands for quality </li></ul></ul><ul><ul><ul><li>Greater efficiencies; Improved process; Better care for children </li></ul></ul></ul>
    6. 6. Designed BY and FOR Pediatricians <ul><li>MOC Committee designed a flexible program </li></ul><ul><li>Easily tailored to your practice </li></ul><ul><li>Evolving into a more continuous process </li></ul>
    7. 8. Part 1 – Professionalism in Practice <ul><li>Valid, unrestricted medical license </li></ul><ul><li>Disciplinary Action Notification System </li></ul><ul><ul><li>DANS notifies ABP of egregious actions resulting in loss or restriction </li></ul></ul><ul><ul><li>ABP can revoke certification </li></ul></ul>
    8. 9. Part 2 – Lifelong Learning & Self-Assessment <ul><li>Benefits </li></ul><ul><li>Options </li></ul><ul><li>Online access </li></ul><ul><li>CME credit </li></ul>
    9. 10. Part 3- Cognitive Expertise has evolved 1993 - 2002 1969 ABMS introduces Recertification 1980-1991 Closed Book (voluntary) 1993-2002 Open Book Exam (every 7 years) 2003-present Secure Exam (every 7 years) 2010+ Secure Exam (every 10 years)
    10. 11. Part 4 Menu of Options (example) * Developed and administered by the AAP; requires payment directly to AAP for access. **ABP-approved on-going quality improvement initiatives. Example MOC Points ADHD Performance Improvement Module 5 ADHD eQIPP Module* 15 Asthma Performance Improvement Module 5 Asthma eQIPP Module* 15 Nutrition eQIPP Module* 15 Vermont Oxford Network (Project 1)** 20 Vermont Oxford Network (Project 2)** 20 California Perinatal Quality Care Collaborative** 20 Blood Stream Infection Project** 20
    11. 12. Committed to Reducing Redundancy <ul><li>Joint Commission – MOC as a surrogate for quality requirements </li></ul><ul><li>Payers – Working with 20+ payers to encourage pay-for-improvement </li></ul><ul><li>Medicaid/CMS – Recognize MOC with financial incentives/reimbursement </li></ul><ul><li>Federation of State Medical Boards – Remove duplicate requirements; demonstrate how MOC meets 6 core competencies </li></ul><ul><li>Malpractice Carriers – Reduce malpractice premiums (the “Doctors Company” in CA) </li></ul>Role of Board Certification Goal: Align to reduce redundancy and accelerate improvement
    12. 13. Collaborating to Bring More Value <ul><li>Primary Care Boards share resources, knowledge to: </li></ul><ul><ul><li>jointly develop tools for MOC </li></ul></ul><ul><ul><li>present a united front to payers/health plans, regulators, and accrediting bodies </li></ul></ul><ul><ul><li>advocate for meaningful recognition/pay-for-improvement programs </li></ul></ul><ul><li>Long-time AAP and ABP relationship produces results: </li></ul><ul><ul><li>Jointly developed self-assessments </li></ul></ul><ul><ul><li>eQIPP modules for improvement approved by the Board </li></ul></ul><ul><ul><li>CME credit for participation in MOC starts in early 2008 </li></ul></ul>
    13. 14. Get Started Now: The Physician Portfolio Secure personal Web account
    14. 15. Questions? <ul><li>For Information: </li></ul><ul><li>Jim Stockman, MD </li></ul><ul><li>President/CEO </li></ul><ul><li>[email_address] </li></ul>MOC Committee Myles B. Abbott, MD Julian L. Allen, MD Laura M. Brooks, MD H. James Brown, MD Christopher A. Cunha, MD Aaron L. Friedman, MD Hazen P. Ham, PhD Kevin B. Johnson, MD Sarah S. Long, MD Thomas K. McInerny, MD Paul V. Miles, MD Robert H. Perelman, MD Julie K. Stamos, MD David K. Stevenson, MD James A. Stockman III, MD Michele J. Wall, MA
    15. 16. Financial Report <ul><li>At our inception in September of 2006, we received agreements for 2-3 years of support at $25,000/year from both AMSPDC and APPD (total of $50,000/yr). </li></ul><ul><li>First official financial and activity reports were made to AMSPDC and APPD in the first quarter of this calendar year, approximately 15 months into this arrangement. </li></ul>
    16. 18. Financial Report <ul><li>Costs of activities are expected to increase as our activities broaden. We must work to minimize these costs to Council while moving forward with our agenda. </li></ul><ul><li>In these reports, I outlined a number of potential mechanisms for CoPS to enhance its own support, including the initiation of a dues structure. </li></ul><ul><li>Also outlined a philosophy of partnership with organizations of FOPO while maintaining independence to act as needed to represent subspecialty pediatric needs. </li></ul>
    17. 23. Commitment
    18. 24. Task Force Reports <ul><li>Fellowship Application Process </li></ul><ul><li>Fellowship Core Curriculum </li></ul><ul><li>Advocacy </li></ul><ul><li>Communications </li></ul><ul><li>Relationships with Regulatory Agencies </li></ul><ul><li>Pipeline/Reimbursement </li></ul>
    19. 25. Fellowship Application Task Force: CoPS Hawaii May 4, 2008
    20. 26. The Charge and The Members <ul><li>Task Force Charge: </li></ul><ul><ul><li>Respond to the recommendations of FOPO </li></ul></ul><ul><ul><li>Consider delaying the start of fellowship application process </li></ul></ul><ul><ul><li>Proposed date: Fall of the 3 rd year of Residency </li></ul></ul><ul><li>Co-Chairs: </li></ul><ul><ul><li>Tom Abshire (Hematology-Oncology) </li></ul></ul><ul><ul><li>Sharon Oberfield (Endocrinology) </li></ul></ul><ul><li>Members: </li></ul><ul><ul><li>Judy Aschner (Neonatology) </li></ul></ul><ul><ul><li>Chris Kennedy (Emergency Medicine) </li></ul></ul><ul><ul><li>Josef Neu (Neonatology) </li></ul></ul><ul><ul><li>Steven Wassner (Nephrology) </li></ul></ul>
    21. 27. Task Force Recommendations <ul><li>Current ERAS participants </li></ul><ul><ul><li>Dec date: GI, Heme Onc, Rheum, Nephrology , Neonatal </li></ul></ul><ul><ul><li>July date: ER </li></ul></ul><ul><li>Current Match participants </li></ul><ul><ul><li>Spring match dates: Rheum, Heme Onc, Cardiology , GI </li></ul></ul><ul><ul><li>Fall match date: Neonatal, Critical Care , ER </li></ul></ul><ul><li>Encourage the use of ERAS for July 2009 academic year (2010 ERAS cycle) </li></ul><ul><li>Consider two match dates to coincide with ERAS: </li></ul><ul><ul><li>3 rd week in May of 2nd yr of residency </li></ul></ul><ul><ul><li>1 st week of December of 3rd yr of residency </li></ul></ul><ul><li>Offer date coincides with one of two match dates </li></ul><ul><li>Evaluate yearly </li></ul>
    22. 28. Questionnaire to CoPS Representatives <ul><li>Focus first on ERAS </li></ul><ul><li>Should fellowship programs utilize ERAS? </li></ul><ul><ul><li>If so, what release date? </li></ul></ul><ul><ul><li>December 1 (19 mos prior to starting fellowship) </li></ul></ul><ul><ul><li>July 15th (11 1/2 mos prior) </li></ul></ul><ul><li>Should there be a match (NRMP)? </li></ul><ul><ul><li>If so, which date? </li></ul></ul><ul><ul><li>Spring of 2nd yr (May, 14 mos prior) </li></ul></ul><ul><ul><li>Fall of 3rd yr (November, 8 mos prior) </li></ul></ul>
    23. 29. Survey: ERAS Participation <ul><li>Academic Peds: no - Genetics: no </li></ul><ul><li>* Adol Med: no - Heme Onc: yes </li></ul><ul><li>Allergy/Immunol: yes - * ID: no </li></ul><ul><li>Cardiology: no - Neonatal: yes </li></ul><ul><li>Child Abuse: no - Nephrology: yes </li></ul><ul><li>Child Psych: no response - Neurology: no </li></ul><ul><li>* Critical care: no - Pulmonary: no </li></ul><ul><li>Derm: no - Rheumatology: yes </li></ul><ul><li>Developmental: no - ER: yes </li></ul><ul><li>* Endocrine: no - GI: yes </li></ul>* Subspecialties in bold have interest in ERAS
    24. 30. B Li, Joe Neu Judith Campbell, Mary-Ann Shafer, Steve Feig CoPS Task Force on Fellowship Core Curriculum Fellowship Core Curriculum: Current issues
    25. 31. Outline <ul><li>How do we meet the ABP requirements? Do we go beyond it? </li></ul><ul><li>Fewer Gen-X fellows want the research path – do we need additional tracks? </li></ul><ul><li>How do we document competence? </li></ul><ul><li>Questions for the task force </li></ul>
    26. 32. Fellows core curriculum – < 5 <ul><li>Increasing mandated requirements </li></ul><ul><li>Less duplication between divisions </li></ul><ul><li>More efficient – in light of work hour restrictions </li></ul><ul><li>Use best people in department </li></ul><ul><li>Provide wider array of topics and skill development – career counseling, administrative and leadership skills </li></ul>
    27. 33. ABP Scholarly Requirements – <ul><li>Biostatistics, research methods, design </li></ul><ul><li>Prep for applications to IRB, for funding </li></ul><ul><li>Critical literature review, EBM </li></ul><ul><li>Ethical principles – in research </li></ul><ul><li>Teaching skills – principles of adult learning , teaching, curriculum development, provision of feedback and assessment (in a variety of settings) </li></ul>
    28. 34. ACGME 6 core competencies + … <ul><li>Patient care </li></ul><ul><li>Medical knowledge </li></ul><ul><li>Interpersonal skills (IS) </li></ul><ul><li>Professionalism (P) </li></ul><ul><li>Practice-based learning (PBL) </li></ul><ul><li>Systems-based learning (SBL) </li></ul><ul><li>Teaching skills </li></ul><ul><li>Scholarly skills </li></ul><ul><li>Other </li></ul><ul><li>Administrative </li></ul><ul><li>Leadership </li></ul><ul><li>Career development </li></ul><ul><li>Career counseling </li></ul><ul><li>Personal planning </li></ul>
    29. 35. The future – fellowship tracks? Pediatric Fellow Lab/trans research Clinical research Education Quality & Admini- strative Other: ethics, health policy NIH- funded researcher NIH- & non-NIH researcher Clinician educator Clinician admini- strator Clinician +
    30. 36. How to implement? <ul><li>Local strategies </li></ul><ul><ul><li>Coalesce current institutional offerings </li></ul></ul><ul><ul><li>Develop new coordinated core curriculum </li></ul></ul><ul><ul><li>Place curriculum on intranet (ANGEL) </li></ul></ul><ul><li>National strategies </li></ul><ul><ul><li>Develop shared web-based curricula </li></ul></ul><ul><ul><li>Increase offerings at PAS </li></ul></ul>
    31. 37. How to document competence? <ul><li>Record attendance </li></ul><ul><li>Pass local exam </li></ul><ul><li>Develop skill-based criteria </li></ul><ul><li>Pass national exam – 7% of ABP sub-specialty exam in 2010 will cover scholarly </li></ul><ul><li>Combinations of above </li></ul>
    32. 38. Questions <ul><li>What are the key FCC elements with in the 6 core competencies, teaching & scholarly curriculum, as well as out side it? </li></ul><ul><li>What is most useful strategy for pediatric departments that don’t have a ‘super’ fellowship core curriculum director? </li></ul><ul><li>What is an effective yet practical approach to documenting competence? </li></ul>
    33. 39. Example format: 2 hour sessions <ul><li>Introduction – background, why important </li></ul><ul><li>Didactic overview (  30 min) or panel discussion (1 hr) </li></ul><ul><li>Small group exercise or Q&A (1 hr) </li></ul><ul><ul><li>Case-based scenario, exercise, role playing </li></ul></ul><ul><li>Present solution to entire group (15 min) </li></ul><ul><li>Evaluation – identify top 3 points learned </li></ul><ul><li>Faculty debriefing </li></ul>
    34. 40. Advocacy Task Force
    35. 41. Charge <ul><li>Determine ways in which CoPS can be proactive in promoting child health and subspecialty activities </li></ul>
    36. 42. Fine Print <ul><li>The term &quot;advocacy&quot; is used broadly here, meaning not just representing ourselves to Congress and state legislatures, or speaking out publicly when necessary, but also to insure our participation with other organizations that make decisions pertinent to our patients and our subspecialties. Developing a standing approach to advocacy would thus permit CoPS to anticipate issues of importance to us and to influence their resolution. </li></ul>
    37. 43. Members H. William Schnaper Robert Perelman Marianne Felice Robert McGregor Richard Martini *Daniel Lee Coury Sharon E. Oberfield B U.K. Li Thomas Abshire Judy L. Aschner Ann Tilton Michael Henrickson Chris Harrison
    38. 44. “ Target” Organizations <ul><li>FOPO organizations </li></ul><ul><li>“ Adult” subspecialty societies </li></ul><ul><li>Government agencies </li></ul><ul><ul><li>Local </li></ul></ul><ul><ul><li>State </li></ul></ul><ul><ul><li>Federal </li></ul></ul><ul><li>The Public </li></ul>
    39. 45. Issues to Consider <ul><li>Funding of pediatric research and training grants </li></ul><ul><li>GME, especially for fellow training </li></ul><ul><li>Federal and state children's health care plans </li></ul><ul><li>Pharmaceutical/device industry interactions with academic medicine </li></ul><ul><li>Billing/coding/reimbursement </li></ul><ul><li>Linking of Quality of Care to reimbursement </li></ul><ul><li>Transition between pediatric and adult care: Medical Homes </li></ul>
    40. 46. Modus Operandi <ul><li>Model activities from pediatric subspecialty societies with strong advocacy programs </li></ul><ul><li>Collaborate with AAP, which has well-developed advocacy program </li></ul><ul><li>Also, work with corresponding “adult” subspecialty societies </li></ul><ul><li>Yet seek to find our own “voice” </li></ul><ul><li>Develop a list of priorities based upon both our greatest needs and synergy with other organizations </li></ul>
    41. 47. Operational Concerns <ul><li>We need to be comprehensive in our analysis of the issues but focused in our choice of priorities </li></ul><ul><li>We also should seek synergy with other pediatric organizations </li></ul><ul><li>It has been difficult to elicit a response after several e-mails </li></ul><ul><li>We need to select a more permanent task-force chair who is a voting member of CoPS </li></ul>
    42. 48. Communications Task Force <ul><li>Richard Mink, Chair </li></ul><ul><li>James Bale </li></ul><ul><li>Judith Campbell </li></ul><ul><li>Gail McGuinness </li></ul><ul><li>Paul Moore </li></ul><ul><li>Bruce Boston </li></ul><ul><li>James Perrin </li></ul><ul><li>David Rubin </li></ul><ul><li>Bruder Stapleton </li></ul><ul><li>Donald Vernon </li></ul><ul><li>Steven Wassner </li></ul>
    43. 49. Committee Charge <ul><li>to address the core needs of our organization to communicate effectively with ourselves and the memberships of our constituent subspecialties. </li></ul>
    44. 50. CoPS Communication Survey <ul><li>39 respondents </li></ul><ul><ul><li>some incomplete </li></ul></ul><ul><ul><li>36 voting members </li></ul></ul><ul><ul><li>3 non-voting members </li></ul></ul><ul><li>22 (56%) program directors </li></ul><ul><li>At least one representative from every subspecialty except Child Psychiatry </li></ul>
    45. 51. Number of Organizations <ul><li>How many different organizations/sections/ associations represent your subspecialty? </li></ul>
    46. 52. Membership in Organizations <ul><li>Are ALL subspecialists a member of at least one of these organizations? </li></ul><ul><li>For “NO” </li></ul><ul><ul><li>5: more than 95% </li></ul></ul><ul><ul><li>12: 75%-95% </li></ul></ul><ul><ul><li>2: 50%-74% </li></ul></ul>
    47. 53. Communication with Leaders <ul><li>Do you think that if CoPS corresponded through the leaders of these organizations, information would reliably be communicated to all members? </li></ul>
    48. 54. Program Director Organizations <ul><li>Does your subspecialty have an organization or association dedicated to fellowship program directors? If so, are ALL Program Directors members? </li></ul>
    49. 55. PD Communication with Leaders <ul><li>Do you think that information communicated by CoPS to the leader(s) of the organization(s) would be reliably distributed to the subspecialty program directors? </li></ul>
    50. 56. Communication with Leaders/PDs <ul><li>Would you prefer that CoPS communicate directly with the Program Directors or should all fellowship information be distributed by the leader of the organization, if one exists? </li></ul>
    51. 57. Communication of Fellowship Task Force Recommendations <ul><li>The Fellowship Application Task force distributed a draft of their recommendations prior to the fall meeting. Did you circulate this proposal to the Program Directors in your subspecialty prior to the meeting? After the meeting? </li></ul>
    52. 58. Who Should CoPS Represent? <ul><li>In your opinion, should CoPS communicate with all members of the specialty, even those that are not members of one of the subspecialty organizations? </li></ul>
    53. 59. Initial Recommendations <ul><li>communicate with all subspecialists </li></ul><ul><li>use e-mail as the predominate method of communication </li></ul><ul><ul><li>brief newsletters 2-3 times/year </li></ul></ul><ul><li>targeted communication to leaders of organizations and/or fellowship program directors </li></ul>
    54. 60. Dues Structure?
    55. 61. <ul><li>Departmental dues - $1,500 (5+ divisions) </li></ul><ul><li>Divisional dues - $300 (any division with training program) </li></ul><ul><li>Individual dues - $100 </li></ul><ul><li>Societal dues - $3,000 </li></ul>ASP currently has 922 members representing 78 medical schools and affiliated teaching hospitals: 875 departmental members representing 55 departments of internal medicine and 603 divisions. 43 divisional members representing 27 divisions. 15 societal members representing internal medicine specialty societies.
    56. 62. Dues Structure? <ul><li>Issues </li></ul><ul><ul><li>Goal setting: x% self-supporting by 20??. </li></ul></ul><ul><ul><li>Have’s vs. have not’s </li></ul></ul><ul><ul><li>Multiple organizations </li></ul></ul><ul><ul><li>Avoiding double-dipping (AMSPDC) </li></ul></ul>
    57. 63. New “projects” <ul><li>OPDA </li></ul><ul><li>Transition from residency to fellowship (timeline). </li></ul><ul><li>Workforce evaluations </li></ul><ul><li>Medical home </li></ul><ul><li>Pedialink revamp </li></ul><ul><li>Division head training </li></ul>
    58. 64. OPDA Organization of Program Director Organizations Council of Medical Specialty Societies
    59. 65. OPDA <ul><li>Promote the role of the residency director and residency program director societies in achieving excellence in graduate medical education </li></ul>
    60. 66. OPDA <ul><li>Peer interaction </li></ul><ul><li>Information sharing </li></ul><ul><li>Collaborative problem solving </li></ul><ul><li>Meetings on GME issues </li></ul><ul><li>Reports from AAMC, ACGME, NRMP, NBME, ECFMG, etc. </li></ul><ul><li>Meet in March and November at O'Hare </li></ul>
    61. 67. OPDA <ul><li>OPDA representative on NRMP Board of Directors </li></ul><ul><li>Ex-officio representative on ACGME Council of Review Committee Chairs </li></ul>
    62. 68. Fall meeting info <ul><li>Tuesday, September 16, 9am – 5pm Wednesday, September 17, 8am - 3pm </li></ul><ul><li>Alexandria, VA </li></ul><ul><li>(prior to APPD's meeting September 18-19) </li></ul><ul><li>$225 registration fee </li></ul><ul><li>Travel costs on own </li></ul><ul><li>100% representation </li></ul>