Pediatric Fellowship Program Manual

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Pediatric Fellowship Program Manual

  1. 1. Pediatric Radiology Fellowship Program Policy Manual: 2009-2010 1/30/2015 1 | P a g e
  2. 2. i. INTRODUCTION DEPARTMENT OF RADIOLOGY PROGRAM MANUAL All physicians-in-training at the University are classified as either residents or fellows. The information contained in this Program Manual pertains to all residents in the Department’s programs except as otherwise identified in the Program Manual or addendum. This Manual outlines benefits, policies, guidelines and other regulations that apply to all resident training in the Department of Radiology. The Institutional Policy Manual contains policies, procedures and information that apply to all residents throughout the University of Minnesota Medical School. The Program Manual is specific to each program. All materials are intended to be written in accordance with the Accreditation Council for Graduate Medical Education (ACGME). Please note that the Institutional Policy Manual and the Department Program Manual are designed to work together. Information contained in Institutional Policy Manual may not be replicated in Program Manual. All information outlined in this Program Manual is subject to periodic review and change. All residents are subject to, and required to be familiar with and to comply with all policies and procedures of the University including the Institutional Policy and Department Program Manuals. Throughout this Manual, individual institutions will be identified as follows: - University of Minnesota Medical Center:UMMC - Hennepin County Medical Center: HCMC - Veterans Affairs Medical Center: VAMC 1/30/2015 2 | P a g e
  3. 3. ii. DEPARTMENT MISSION STATEMENT The mission of the Department of Radiology is to be a leader in enhancing the health of people through education, biomedical research, and clinical programs. iii. PROGRAM MISSION STATEMENT The Department of Radiology at the University of Minnesota School of Medicine, in conjunction with its affiliated institutions (including but not limited to the Veterans Affairs Medical Center and Hennepin County Medical Center) provides graduate medical education in Diagnostic Radiology and its subspecialties programs:  Breast Imaging Fellowship  Diagnostic Radiology Residency  Neuroradiology Fellowship  Nuclear Medicine Fellowship  Pediatric Fellowship  Thoraco-Abdominal Radiology Fellowship  Vascular and Interventional Radiology Fellowship Our educational mission is to provide an atmosphere of learning and academic curiosity, and to provide strong basic training in diagnostic radiology and its subspecialties including but not limited to breast, cardiac, abdominal, musculoskeletal, neuro-, pediatric, noninvasive vascular, and thoracic imaging, as well as nuclear radiology and ultrasound. Administrative oversight of these programs is provided by the ALRT Administrative Center - Departments of: Anesthesiology Laboratory Medicine and Pathology, Diagnostic Radiology Therapeutic Radiology The mission of the A.L.R.T. Administrative Center, as part of the University of Minnesota School of Medicine, is to provide uniform service delivery to our departments and institutes. These services consist of human resources, payroll, communication, education, grants management, financial reporting and budget. Our goal is to provide exceptional service while balancing the expectations of the multiple constituents. To achieve this goal we will foster a community based on communication, cooperation and expertise by drawing on our individual backgrounds, strengths and unique histories. 1/30/2015 3 | P a g e
  4. 4. TABLE OF CONTENTS SECTION i. INTRODUCTION Page 2 SECTION ii DEPARTMENT AND PROGRAM MISSION STATEMENTS Page 3 SECTION I. STUDENT SERVICES Universal University Pagers Page 6 E-mail and Internet Access Page 6 Weekly E-Newsletter Page 6 Campus Mail Page 6 Tuition and Fees Page 6 HIPAA Training & Data Security Page 7 USB Drives Page 7 Department USB Drive Page 7 SECTION II. BENEFITS Stipends Page 8 Paychecks and Pay Periods Page 8 Resident/Fellow Leave Page 8 Vacation Page 9 Illness Page 9 Other Leaves Page 9 • Personal Leaves of Absence Page 9 • Family Medical Leave Page 9 • Family Medical Leave Act (FMLA) Page 9 • Parental Leave for Childbirth Page 9 • Parental/Domestic Partnership Leave – Adoption Page 10 • Professional Leave Page 10 • Military Leave Page 10 • Jury Witness Duty Page 10 • Bereavement Leave Page 10 • Interview Time Off Page 10 Policy on Effect of Leave - ABR Certificate of Added Qualification Requirement Page 10 Holiday Schedule Block Out Dates Page 11 Page 12 Department Policy Regarding Pregnancy for Resident/Fellow & Radiation Page 12 Notary Service Page 12 Resident/Fellow Exercise Room Page 13 Health and Dental Insurance Page 13 Long-Term Disability Insurance Page 13 Short-Term Disability Insurance Page 13 Professional Liability Insurance Page 13 Life Insurance Page 13 Voluntary Life Insurance Page 13 Insurance Coverage Change Page 13 Worker’s Compensation Page 13 Meal/Food Services Page 13 Laundry Services Page 14 Parking Page 14 UMMC Page 14 HCMC Page 14 VAMC Page 15 Travel Fund Page 15 SECTION III. INSTITUTIONAL RESPONSIBILITIES Page 16 SECTION IV. DISCIPLINARY AND GRIEVANCE PROCEDURES Page 16 Discipline/Dismissal for Academic Reasons Page 16 Discipline/Dismissal for Non-academic Reasons Page 16 Grievance Procedure and Due Process Page 16 SECTION V. GENERAL POLICIES AND PROCEDURES Page 17 Program Goals Page 17 Program Curriculum Page 18 Program Schedules Page 19 1/30/2015 4 | P a g e
  5. 5. Program Requirements Page 19 Training/Graduation Requirements Page 19 ACGME Competencies Page 20 Duty Hours Page 20 RMS – Residency Management Suite • Duty Hour Approval Policy/Procedure Page 20 Duty Hours – Entering Hours Into RMS Page 20 On-call Activities Page 21 On-call Rooms Page 21 Support Services Page 21 Laboratory Medicine/Radiology Services Page 22 Medical Records Page 22 Security/Safety Page 22 Radiation Badges Page 22 Moonlighting Page 22-23 Supervision/Graded Responsibility Page 23 Steps in Evaluation Process Page 23 Evaluation System - Electronic Page 23 Completing Evaluations in RMS Page 24 Monitoring of Fellow Well-being Page 24 ACLS/BLS Certification Requirements Page 24 Travel Page 24 Libraries • Institutional • Departmental Page 25 Goals and Objective for Teaching Medical Students Page 25-28 SECTION VII. ADMINISTRATION CONTACT INFORMATION Page 28 Graduate Medical Education Directors and Coordinators Page 28 Site Addresses, Phone and Fax Numbers Page 29 ADDENDUM I: PROGRAM OBJECTIVES, GOALS, AND EXPECTATIONS Schedule of Pediatric Radiology Conferences Page 31 Rotation Schedule Page 31 Didactic Conference Schedule Page 32 Reading Room/General Radiography Page 33-35 Fluoroscopy Page 36-38 Ultrasound Page 39-41 Body Imaging CT/MRI Page 42-44 Neuroimaging Page 45-47 Nuclear Medicine Page 48-50 Vascular and Interventional Page 51-53 Recommended Reading Page54-58 Declaration of Duty Hours Page 59 Confirmation of Receipt of Program Manual Page 60 1/30/2015 5 | P a g e
  6. 6. SECTION I. STUDENT SERVICES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Academic Health Center (AHC) Portal Access; Child Care; Computer Discount/University Bookstore; Credit Unions; Disability Accommodations; Legal Services; Library Services; Medical School Campus Maps; Resident Assistance Program; Tuition Reciprocity; University Card (UCard); University Events Box Office; University Recreation Sports Center(s)) UNIVERSAL UNIVERSITY PAGERS Fellows are assigned UMMC-Fairview pagers at the beginning of their year. Contact the Trisha Pederson, Program Coordinator, 612-626-5548 or pede0220@umn.edu to report any missing or malfunctioning cards. E-MAIL AND INTERNET ACCESS As students at the University, all fellows are provided with a University E-mail/Internet access account. With this account trainees can access the Internet and E-mail from any of their assigned training sites. If you are using an independent ISP, you must forward your University E-mail account to your preferred E-mail account as required by the Medical School. Log on to http://www.umn.edu/validate to do so. (To learn the E-mail address assigned to you, go to the University’s web page, www.umn.edu, click on “People Search” then type your name into the “Search” box.) Information regarding the University of Minnesota School of Medicine, Graduate Medical Education and/or the Department of Radiology can be located at the following web sites: Medical School Web Site: http://www.med.umn.edu Graduate Medical Education Administration Web Site: http://www.med.umn.edu/gme Department of Radiology Web Site: http://www.radiology.umn.edu Trainees are required to maintain an E-mail account and to check their E-mail daily for Program, Medical School and University notices. CAMPUS MAIL DEPARTMENT MAILROOM: ROOM B-221, MAYO MEMORIAL BUILDING OUTGOING MAIL Can be left in the “Outgoing Hospital/Campus Mail” basket. INCOMING MAIL Fellows may receive professional related mail in their mailbox. DEPARTMENT MAILING ADDRESS 420 Delaware Street. S.E., MMC 292 Minneapolis, MN. 55455 Fellows are not to send or receive personal mail through the University system. Outgoing U.S. mail may also be placed in the United States Postal Service mailbox located just outside the main entrance of the University of Minnesota Medical Center (on Harvard Street). Fellows are required to check their mailboxes a WEEKLY basis for Program, Medical School and University notices. Fellows are also required to empty their mailboxes on a regular basis. TUITION AND FEES 1/30/2015 6 | P a g e
  7. 7. Tuition and fees are being waived at this time. Fellows who are enrolled in Graduate School pay tuition and fees. HIPAA AND DATA SECURITY TRAINING The University of Minnesota is required to remain in compliance with the training component of the Federal Health Information Portability and Accountability Act (HIPAA) privacy regulations and Data Security. All faculty, trainees and staff must be trained regarding this regulation as well as University-specific policies and procedures. Multi-media online training has been developed to facilitate this training as well as the required documentation in the regulation. Four courses have been developed and are available through the “My AHC” and “My U” portals. All University faculty, staff, student workers and health science students and volunteers are required to complete the following HIPAA Privacy and Data Security courses: HIPAA Privacy • Introduction to HIPAA Privacy Video • Privacy and Confidentiality in Research (for research faculty and staff) • Privacy and Confidentiality in Clinical settings (for clinical faculty and staff) HIPAA Data Security • Data Security in Your Job • Securing Your Computer Workstation • Using University Data • Managing Health Data Securely To access your HIPAA and Data Security Training and to complete the course(s), please follow this link: www.myU.umn.edu (log in with your x500). Please remember to LOG OUT of the portal when you are finished. If you leave the computer while you remain logged in, others could use your log-in to access your private information. SECURITY/PRIVACY COORDINATOR Sally Sawyer, Graduate Medical Education Manager, serves as the ALRT Center Privacy Coordinator. Questions and/or concerns can be directed to Sally at 612-625-3518 or sallyann@umn.edu. 1/30/2015 7 | P a g e
  8. 8. 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). STIPENDS Medical Fellows who meet Departmental, Medical School and University requirements are appointed to one-year training positions from July 1 through June 30 of the following year (unless otherwise agreed to in writing). Base stipend rates are posted at http://www.med.umn.edu/gme/directors/finance.html Medical Residents/Fellows are subject to withholding of Federal and State income taxes, as well as FICA taxes (Social Security). Medical Residents/Fellows pay insurance fees by payroll deduction over 26 pay periods. PAYCHECKS AND PAY PERIODS Biweekly paychecks are issued every-other Wednesday beginning July 1st , 2009. You are encouraged to have your checks automatically deposited to your banking institution to avoid loss or delay. Your pay statement can be viewed online at http://hrss.umn.edu. If you do not have direct deposit you will receive a check on payday. This check must be picked-up from ALRT Payroll (7th floor Mayo Building). It cannot be placed in your mailbox or mailed to your home. Please keep your pay statements for future reference, as they contain deduction amounts that you’ll need when you prepare your tax returns. The Department of Radiology keeps no record of your deductions. Payroll forms (i.e., automatic deposit, W4, duplicate W2, etc.), can be obtained online at http://hrss.umn.edu A new W4 form must be completed each time a name or address change occurs. CONTACT PERSON: Contact Sandy Connor at 612-6253682 or schap002@umn.edu regarding questions pertaining to payroll, taxes, deductions, W2s, etc. RESIDENT/FELLOW LEAVE (INCLUDING VACATION, ILLNESS AND OTHER TYPES OF LEAVE) Except for unexpected absence related to illness, all leave must be pre-approved. All leave must be documented in RMS duty hours. The Program Coordinator should be concurrently notified of leave requests by e-mail as soon as possible. The type of leave, as noted below, should be specified. Depending on scheduling considerations and in a timely manner,send an e-mail to the Program Coordinator including attached revised schedule noting changes for final approval by the Program Director. Unpaid Leave While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly). 1. VACATION Holiday schedule (including variation by location) and “block out dates” are indicated on page 12. Up to twenty (20) working days per year may be taken as vacation which is paid leave. Unused 1/30/2015 8 | P a g e
  9. 9. vacation time may not be carried over to the next year. Depending on rotation up to five (5) vacation days may be taken during a given month. Requests to exceed this limit must be approved by the Program Director in advance. No more than ten (10) total vacation days can be taken from any section during the fellowship without the Program Director’s approval. TERMINAL LEAVE IN THE EVENT THE GRADUATING FELLOW HAS VACATION TIME REMAINING, VACATION MAY BE REQUESTED DURING THE BLOCKED OUT TERMINAL LEAVE PERIOD AT THE END OF THEIR FELLOWSHIP. 2. ILLNESS Fellows must call in sick as soon as they know they are unable to show up for work because of acute illness of themselves or child/children. They must inform the Program Coordinator, Trisha Pederson (612-626-5548), and the rotation they’re on. They should speak in person with either the fellowship coordinator, or someone in their rotation. Days of absence due to illness are considered paid leave up to ten (10) days per year. Absence due to illness exceeding ten (10) work days in an academic year will be charged as vacation. There is no carryover from preceding years. In the event that a fellows has exhausted all of his/her vacation leave, this time will be charged as unpaid leave. While on unpaid leave, the fellow is responsible for payment of any insurance fellows on unpaid leave will be billed monthly). 3. OTHER LEAVES PERSONAL LEAVE OF ABSENCE If vacation time is used up for the year, and upon the approval of the Program Director, a fellow may arrange for a unpaid leave of absence away from the training program. While on unpaid leave, the fellow is responsible for payment of any insurance (residents on unpaid leave will be billed monthly). MEDICAL LEAVE An unpaid leave of absence for serious illness of the resident; serious health condition of a spouse, parent or child/children; shall be granted through formal request. The Program Coordinator should be concurrently notified of the leave request by e-mail as soon as possible. The length of leave will be determined by the Program Director based upon an individual’s particular circumstances and the needs of the department, not to exceed twelve (12) weeks in any 12-month period. Fellows taking family medical leave must submit the following documents to the Program Coordinator: FMLA: Certification of Health Care Provider FMLA: Leave Response/Notification The above forms can be accessed online in the Forms Library under “Human Resources” at http://www.fpd.finop.umn.edu/groups/ppd/documents/main/formhome.cfm. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly). FAMILY MEDICAL LEAVE ACT (FMLA) FMLA is intended to allow employees to balance their work and family life by taking reasonable unpaid leave for a serious health condition, for the birth or adoption of a child, and for the care of a child, spouse, and registered same-sex domestic partner provided for by the University, or parent who has a serious health condition. The Act is intended to balance the demands of the workplace with the needs of families, to promote the stability and economic security of families, and to promote national interests in preserving family integrity. http://www1.umn.edu/ohr/policies/leaves/fmla.html PARENTAL LEAVE FOR CHILDBIRTH A female fellow may, upon written request of the Program director copied to the Program Coordinator, take up to six weeks paid maternity leave related to the birth of her child. The paid leave must fall within the term of appointment and must be taken consecutively and without interruption. After using paid maternity leave and all unused vacation, any additional leave 1/30/2015 9 | P a g e
  10. 10. will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellow on unpaid leave will be billed monthly) A male fellow or a partner in a registered domestic partnership may upon formal request, take up to two weeks paid paternity/partnership leave related to the birth of a child. The Program Coordinator should be concurrently notified of leave requests by e-mail as soon as possible. All leave time must fall within the term of appointment and must be taken consecutively and without interruption. After using all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly) Disabilities associated with childbirth and pregnancy will be treated like any other disability. PARENTAL/DOMESTIC PARTNERSHIP LEAVE - ADOPTION A female fellow may, upon request, may take up to two weeks paid leave and up to two weeks leave without pay related to the adoption/birth of a child. All leave time must fall within the term of appointment. All leave must be taken consecutively and without interruption. After using all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly). A male fellow or partner in a registered domestic partnership may, upon request, take up to two weeks paid leave related to the adoption of a child. All leave time must fall within the term of appointment. All leave must be taken consecutively and without interruption. After using all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly). ACADEMIC/PROFESSIONAL LEAVE Up to five (5) working days per year may be taken as paid leave for academic leave and conferences. This time is in addition to regular vacation time and is at the discretion of the Program Director or Department Head. The Department may cover up to three days of reasonable expenses for fellows presenting at national meetings. MILITARY LEAVE Military leave is granted in full accordance with State and Federal regulations. The Program Director must be promptly notified in writing when a Medical Fellows requires military leave. JURY/WITNESS DUTY Jury duty and court leave will be authorized consistent with State and Federal Court requirements. The Program Director must be promptly notified in writing when a Medical Fellow requires jury duty or court leave. BEREAVEMENT LEAVE A fellow may request bereavement leave through formal request of the Program Director. Either sick or vacation time must be used. The Program Coordinator should be concurrently notified of leave requests by e-mail as soon as possible. INTERVIEW TIME OFF A senior resident may take up to five (5) calendar days of non-vacation time to interview for a job or fellowship position. POLICY ON EFFECT OF LEAVE FOR SATISFYING COMPLETION OF PROGRAM As is required by the American Board of Radiology (ABR), all fellow leave is reported to the ABR on an annual basis. Per the ABR, the following terms in regards to leave must be met in order to be eligible to sit for the Certifiecate of Added Qualification examination: “Leaves of absence and vacation may be granted to fellows at the discretion of the program director in accordance with local rules. 1/30/2015 10 | P a g e
  11. 11. Within the required period(s) of graduate medical education, the total such leave and vacation time may not exceed six calendar weeks (30 working days) for fellows in a program for one year.” ABR REQUIREMENTS: Requirements You must successfully complete one year of fellowship training (after residency) in a pediatric radiology program approved for such training and accredited by the ACGME or by the RCPSC (Canada). You must also complete one year of practice or additional approved training, with one-third of that year spent in pediatric radiology. Fellowship training must be documented by letter from the program director. Practice experience must be verified by letter from the chief of service or department chairman. Provide evidence of a current state medical license with an expiration date. HOLIDAY SCHEDULE AND BLOCK-OUT DATES Holiday schedules vary, depending on the institution. When rotating to a particular site, the holiday schedule for that institution must be followed. NOTE: Residents on UMMC rotations follow the UMMC Fairview holiday schedule, not the “U of MN Staff” holiday schedule. Residents on outpatient rotations will make themselves available for hospital coverage in the event that the outpatient location is closed and the hospital is not. The fellowship program also follows a schedule of Block-out Dates. These are dates during which staffing shortages are anticipated. Leave requests will not be granted during these periods without specific approval from the Program Director. Date Holiday UMMC HCMC VAMC Friday, July 3rd, 2009 Independence Day Yes Yes Yes Monday, September 7th , 2009 Labor Day Yes Yes Yes Monday, October 12, 2009 Columbus Day No No Yes Wednesday, November 11, 2009 Veterans Day No No Yes Thursday, November 26, 2009 Floating Holiday No No No Friday, November 27, 2009 Thanksgiving Day Yes Yes Yes Friday, December 25th , 2009 Christmas Yes Yes Yes Friday, January 1, 2010 New Year’s Day (Observed) Yes Yes Yes Monday, January 18, 2010 ML King Day (Observed) No No Yes Monday, February 15, 2010 No No Yes 1/30/2015 11 | P a g e
  12. 12. Presidents’ Day Monday, May 31, 2010 Memorial Day Yes Yes Yes BLOCK-OUT DATES Event From: Through: New Residents and Fellows July 1st, 2009 July 3rd, 2009 ABR Written Examinations September 10th , 2009 September 11th , 2009 Radiological Society of North America Meeting November 29th , 2009 December 4th , 2009 ACR In-training Examination February 4th , 2010 February 4th , 2010 Senior Hot Seat Review Courses TBA TBA Society for Pediatric Radiology Annual Meeting April 13th , 2010 April 17th , 2010 Association of University Radiologists Meeting March 23rd , 2010 March 26th, 2010 ACR Conference ABR Oral Examination May 29th , 2010 June 1st , 2010 Terminal Leave/Vacation (Only Seniors) June 21st , 2010 June 25th , 28th – 30th , 2010 DEPARTMENTAL POLICY REGARDING PREGNANCY FOR FELLOWS The Department of Radiology will not differentiate in the treatment of potentially pregnant or confirmed pregnant fellows. Specifically, on-call and fluoroscopy assignments will not be modified solely on the basis of a female resident being potentially pregnant or pregnant, in accordance with the official position of the American Association of Women in Radiology which states: “On the basis of available data, the elimination of fluoroscopy at any time during pregnancy cannot be justified on scientific grounds. Rationally, women of child-bearing age who enter the specialty of radiology should be willing to accept the theoretical risks involved in fluoroscopy.” NOTARY SERVICE • Shari Johnston Phone: 612.626.5589 Office: Mayo B-211 • Trisha Pederson Phone: 612.626.5548 Office: Mayo B-292 1/30/2015 12 | P a g e
  13. 13. RESIDENT/FELLOW EXERCISE ROOM The University of Minnesota Medical Center, Fairview Medical Executive Committee has graciously provided an exercise facility for use by University of Minnesota residents and fellows. Location: Room C-496 Mayo Memorial Building (Locker rooms/showers are located directly across the hall) Hours: The facility is open 24 hours a day, 7 days a week Access Code to Exercise Room and Locker Rooms: 9111 (Please do not share with anyone other than residents and fellows) The space also includes a small kitchenette area with refrigerator, microwave, coffeemaker and hot/cold water dispenser. HEALTH AND DENTAL NSURANCE COVERAGE Please refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator. FLEXIBLE SPENDING ACCOUNT Please refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator. LONG-TERM DISABILITY NSURANCE COVERAGE Please refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator. SHORT-TERM DISABILITY NSURANCE COVERAGE Please refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator. PROFESSIONAL LIABILITY NSURANCE COVERAGE Please refer to Institutional Policy Manual for further information. You may also contact the Risk Management Office: Office of Risk Management and Insurance 1300 South 2nd Street, Suite #208 WBOB Minneapolis, MN 55454 Phone: 612-624-5884 LIFE NSURANCE COVERAGE Please refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator. VOLUNTARY LIFE NSURANCE COVERAGE You may also contact the Program Coordinator. INSURANCE COVERAGE CHANGES You may also contact the Program Coordinator. WORKER’S COMPENSATION University employees must promptly report on-the-job injuries/illnesses to the employee's supervisor. Within 24 hours of the employee's report the supervisor shall complete the First Report of Injury and the Employee Incident Report forms and forward these to the University's vendor and a copy to the University Workers' Compensation Department. http://www.policy.umn.edu/groups/ppd/documents/policy/workers_comp Meals/Food Services Fellows on duty have access to adequate and appropriate food services at all institutions. UMMC Fellows 1/30/2015 13 | P a g e
  14. 14. may visit the Bridges Cafeteria (University campus) or the East Side Market Café (Riverside campus). There are no meal plans provided by the Department for Fellows. LAUNDRY SERVICES Two lab coats will be provided at the beginning of your fellowship. If you should require a replacement lab coat during your fellowship program, please contact, Trisha Pederson, Program Coordinator. No laundry services are provided for Radiology fellows. Scrubs are provided when you are on an appropriate rotation for scrubs. These are the property of the institutions and are to be used for this purpose only. - UMMC: Scrubs are available on a sign-out basis by using your UMMC identification badge in Room J2-104. The required bar code for the backside of your ID badge is provided by Kathy Monitor in Linen Services: 612-273-5793. PARKING UMMC The Department provides general parking at Oak Street Ramp C for fellows. Fellows receive a parking card during their department orientation at the beginning of the year. If you encounter a problem with your parking card, contact Trisha Pederson, Program Coordinator at 612-626-5548. DO NOT TAKE YOUR KEY CARD INTO ANY MRI FACILITY, AS THESE UNITS WILL ERASE THE CARD’S MEMORY. EXITING PARKING FACILITY WITHOUT SCANNING CARD WILL AUTOMATICALLY RESULT IN YOUR CARD BEING LOCKED ON-CALL PARKING: The Department covers parking expenses for residents taking departmental call. Those with departmental parking cards will use the same card for on-call parking as for daily parking when rotating to UMMC. AFTER-HOURS PARKING Parking validation is available to fellows for the sole purpose of attending Program-related conferences and activities while on rotations based away from UMMC (i.e., Diagnostic Radiology and Medical School Core Curriculum lectures, First-year Lecture Series, Physics Review, Senior Review and resident meetings). Parking tickets can be validated by the Program Coordinator. TRAVEL FUND Residents beyond their fifth clinical year are considered to be in fellowship positions and are not eligible for the reimbursement program. However, submission and acceptance of work to a national or international society meeting, notably Society of Pediatric Radiology or the Radiological Society of North America, will be the only exception. In that circumstance, all allowable expenses of the fellow in attending the meeting and presenting are paid by the Department of Radiology. Call your Program Coordinator, Trisha Pederson, with any questions at 612-626-5548. 1/30/2015 14 | P a g e
  15. 15. SECTION III. INSTITUTIONAL RESPONSBILITIES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: ACGME Resident Survey Requirements; ACGME Site Visit Preparation Services; Institution Affiliation Agreements; Program Letters of Agreement; Confirmation of Receipt of Program Policy Manuals; Duty Hour Monitoring at the Institution Level Policy and Procedure; Funding; GME Competency Teaching Resources and Core Curriculum; Graduate Medical Education Committee Responsibilities; Graduate Medical Education Committee Resident Council Responsibilities; Institution and Program Requirements; Internal Review Process; International Medical Graduates Visa Requirements; New Training Program Approval Process; Orientation; Registration Policy ). SECTION IV. DISCIPLINARY AND GRIEVANCE PROCEDURES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Discipline/Dismissal/Nonrenewal; Conflict Resolution Process for Student Academic Complaints; Academic Incivility Policy and Procedure; University Senate on Sexual Harassment Policy; Sexual Harassment and Discrimination Reporting; Sexual Assault Victim’s Rights Policy; Dispute Resolution Policy) Discipline/Dismissal for Academic Reasons Trainee academic performance is determined by a review of evaluations and examination scores (see Section IV: Steps in Evaluation Process). If resident performance is felt to be below an acceptable level, discipline and possible dismissal will follow guidelines set forth in the Institutional Policy Manual (see Disciplinary and Grievance Procedures). Procedures: The resident/fellow will be given verbal notice of performance deficiencies by the Program Director, an opportunity to remedy deficiencies, and the notice of possible dismissal or contract non-renewal if the deficiencies are not corrected, and a record of this will be placed in the trainee’s file. When the resident continues to demonstrate a pattern of marginal or unsatisfactory academic performance, they will be placed on academic probation as specified in the Institutional Manual. A Radiology Graduate Medical Education Committee will meet to discuss the outcome of the probation, and may recommend: Removal from probation with a return to good academic standing; continued probation with new or remaining deficiencies sited; Non-promotion to the next level of training; Contract non-renewal and/or dismissal. Discipline/Dismissal for Non-Academic Reasons Discipline/dismissal for non-academic reasons will follow the guidelines set forth in the Institutional Policy Manual. Grievance Procedure and Due Process Refer to the Institutional Policy Manual 1/30/2015 15 | P a g e
  16. 16. SECTION V. GENERAL POLICIES AND PROCEDURES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Academic Health Center (AHC) Student Background Study Policy; Background Study Policy and Procedure; Applicant Privacy Policy; Appointment Letter Policy and Procedure; Blood Borne Pathogen Diseases Policy; Certificate of Completion Policy; Classification and Appointment Policy; Compact for Teaching and Learning; Disability Policy; Disaster Planning Policy and Procedure; Documentation Requirements Policy; Documentation Retention Requirements for FICA Purposes Policy; Dress Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty Hours/Prioritization of On-Call Room Assignments; Effective Date for Stipends and Benefits Policy; Eligibility and Selection Policy; Essential Capacities for Matriculation, Promotion and Graduation for U of M GME Programs; Evaluation Policy; Health Insurance Portability and Accountability Act; Immunizations and Vaccinations; Immunizations: Hepatitis B Declination Form; Impaired Resident/Fellow Policy and Procedure; Licensure Policy: Life Support Certification Policy; Moonlighting Policy; National Provider Identification (NPI) Policy and Procedure; Nepotism Policy; Observer Policy; Post Call Cab Voucher Policy (UMMC-F; HCMC); Registered Same Sex Domestic Partner Policy; Release of Contact Information Policy; Residency Management Suite (RMS): Updating and Approving Assignments and Hours in the Duty Hours Module of RMS; Restrictive Covenants; Standing and Promotion Policy; Stipend Level Policy; Stipend Funding from External Organizations Policy; Supervision Policy; Training Program and/or Institution Closure or Reduction Policy; Transitional Year Policy; USMLE Step 3 Policy; Vendor Policy; Verification of Training and Summary for Credentialing Policy; Voluntary Life Insurance Procedure; Without Salary Appointment Policy ). PROGRAM GOALS AND OBJECTIVES This Program’s goal is to develop a sturdy medical knowledge/skill base and professional attributes that allow fellows to independently and competently practice Pediatric radiology with a life-long commitment to continued learning and excellence. “The training program in the subspecialty of pediatric radiology constitutes a supervised experience in the pediatric applications and interpretation of radiography, computed tomography, ultrasonography, angiography, interventional techniques, nuclear radiology, magnetic resonance, and any other imaging modality customarily included within the specialty of diagnostic radiology. The program is structured to enhance substantially the subspecialty fellows’ knowledge of the applications of all forms of diagnostic imaging to the unique clinical/pathophysiologic problems of the newborn, infant, child, and adolescent. The fundamentals of radiobiology, radiologic physics, and radiation protection as they relate to the infant, child, and adolescent will be reviewed during the pediatric radiology training experience. The program will provide fellows direct and progressively responsible experience in pediatric imaging as they advance through training. This training must culminate in sufficiently independent responsibility for clinical decision making such that the program is assured that the graduating resident has achieved the ability to execute sound clinical judgment.” [Accreditation Council for Graduate Medical Education Program Requirements for Residency Education in Pediatric Radiology] A. Duration of Training “Prerequisite training for entry into a diagnostic radiology subspecialty program should include the satisfactory completion of a diagnostic radiology residency accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the Royal College of Physicians and Surgeons of Canada (RCPSC), or other training judged suitable by the program director.” The Division of Pediatric Radiology in the Department of Radiology offers a one year ACGME accredited fellowship training program in Pediatric Radiology leading to eligibility for examination for the American Board of Radiology’s (ABR) Certificate of Added Qualification (CAQ) in Pediatric Radiology. Completion of the fellowship and of one subsequent year of further pediatric radiology fellowship training and/or of clinical practice experience in the field of Pediatric Radiology qualifies the individual for membership in the Society of Pediatric Radiology (SPR). 1/30/2015 16 | P a g e
  17. 17. B. Objectives and Goals Special training and skills, beyond those provided by residency training in diagnostic radiology, are required to enable the pediatric radiologist to function as an expert diagnostic and therapeutic consultant and practitioner. This program is designed to provide fellows with an organized, comprehensive, and highly supervised full time educational experience. It involves the selection, design, performance and interpretation of Pediatric Radiology examinations and procedures. Lastly, the fellowship will provide the development of skills and opportunities for research in the field of pediatric radiology. The Fellowship is designed so that, at its completion, a Fellow will be able to: 1. Understand the developmental and acquired disease processes of the newborn, infant, child, and adolescent that are basic to the practice of pediatric and adolescent medicine. 2. Perform and interpret radiological and imaging studies of the pediatric patient. 3. Supervise and teach the elements of radiography and radiology as they pertain to infants and children. 4. Understand how to design and perform research 5. Prepare material suitable for presentation and publication. The program provides the fellow with the opportunity to develop, under graduated supervision, progressively independent skills in the evaluation of the clinical diagnostic problem and the selection, design, performance and interpretation of pediatric radiological imaging studies and invasive procedures. At the conclusion of the fellowship, the fellow should be able to independently determine the appropriate diagnostic test for a given clinical problem, deliver a cogent consultation to clinical colleagues, accurately determine the choice of imaging modality, define the protocol for the appropriate study, conduct and/or supervise the performance of the examination and provide a complete and competent interpretation of the diagnostic findings on that study and the therapeutic implications of those findings. The training program must provide education in, and the fellow must be thoroughly familiar with, the physics of ionizing radiation and magnetic resonance; understanding of the theory and application of computerized image reconstruction techniques; knowledge of radiation biology of the infant and adolescent; and the pharmacology of radiographic and magnetic contrast materials. The fellowship program provides the fellow with an organized, comprehensive, and supervised full- time educational experience in the selection, interpretation, and performance of pediatric radiological examinations and procedures. With the aid of, and daily clinical exposure to, a large and varied population of patients in related clinical fields and contact (and correlation) with Pediatricians and Radiologists, the fellow should be capable of independent and accurate clinical decision making in all areas of Pediatric Radiology at the culmination of the year of training. The program provides the opportunity for fellows to consult, perform, and interpret, under close supervision with graduated responsibility, invasive diagnostic and therapeutic pediatric interventional procedures At the conclusion of the fellowship, the fellow should be thoroughly familiar with and knowledgeable in the indications and contraindications for such procedures; be able to select the appropriate needle, catheter, or device; safely position it under image guidance within the target; select and administer the appropriate dose of contrast or therapeutic material; and evaluate and manage the post-procedural condition and care of the patient. The Fellowship and evaluation of the fellow will also be centered around the six core competencies of the ACGME. Those competencies include: patient care, medical knowledge, interpersonal and communications skills, practice based learning and improvement, professionalism, and systems based practice. PROGRAM CURRICULUM Please see Addendum 1: Goals, Objectives, and Expectations starting on page 32 of the manual. 1/30/2015 17 | P a g e
  18. 18. PROGRAM SCHEDULES Please see Addendum 1: Goals, Objectives, and Expectations, page 33, of the manual. PROGRAM REQUIREMENTS All fellows are governed by the requirements in both the Institutional and Program Manual. This program is accredited by the Accreditation Council for Graduate Medical Education and follows the requirements set forth by the ACGME. To view these requirements, go to http://www.acgme.org. The Graduate Medical Education Committee, chaired by the Program Director, evaluates the progress of the fellows, and makes recommendations for advancement or disciplinary actions. The Program Director with advice from Graduate Medical Education Committee members, determines candidates for admission to the training program, fellows’ progress in the program, and fellows satisfactory completion of graduation requirements. Fellows are expected to successfully complete their monthly rotations. Fellows are required to comply in a timely manner with administrative directives including those from the Program Coordinator. This includes, but not limited to: • Proper notification of all time away • Weekly submission of duty hours in RMS • Record conference attendance in RMS Conference Module for UMMC Conferences • Prompt completion of RMS evaluations • Reading/Studying during regular work hours – must be patient care related • Compliance to USMLE policy (see below) • Regular attendance at conferences is a mandatory requirement of this program and trainees are required to document their attendance at appropriate conferences at their institution on days they are at work. Only those on call, post-call, ill, on leave, or attending the Armed Forces Institute of Pathology will be considered to have excused absences. • Fellows are required to attend Grand Rounds and Core Curriculum Conferences at the University on days they are at work, regardless of which institution they are working at. TRAINING/GRADUATION REQUIREMENTS This program is adheres to the training requirements set forth by the American Board of Radiology and the Accreditation Council for Graduate Medical Education. These requirements can be reviewed at http://www.theabr.org and http://www.acgme.org Graduation certificates are awarded to fellows who successfully complete all of the Program requirements, have shown satisfactory progress toward the competent, independent practice of Pediatric Radiology, and demonstrate professional and personal attributes dedicated to the life-long learning process associated with the practice of medicine. ACGME CORE COMPETENCIES All University of Minnesota Medical School Residency/Fellowship training programs define the specific knowledge, skills, attitudes, and educational experiences required by the ACGME/RRC to ensure its residents/fellows demonstrate the following: 1) Patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. 2) Medical knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. 1/30/2015 18 | P a g e
  19. 19. 3) Practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care. 4) Interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals. 5) Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. 6) Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value. DUTY HOURS Duty hours are defined as all clinical and academic activities related to the training program, i.e., patient care (both inpatient and outpatient), 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. - Duty hours are limited to eighty (80) hours per week, averaged over a 4-week period, inclusive of all in-house call activities. - Fellows are provided with one (1) day in seven (7) free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. - 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 and after in-house call. - Fellows track their duty hours through the RMS System. The duty hours reports are then reviewed by the Program Coordinator for any violations. - Violators will be notified and required to submit written documentation as to why violation occurred. Federal regulations mandates that GME programs account for all fellow hours worked in order to maintain Medical Education funding. In addition to these federal regulations, ACGME also mandates programs monitor duty hours to ensure compliance with duty hour requirements. This means that fellows must complete an online timecard of their hours worked in order to be compliant with these mandates and continue funding, accreditation, and flexibility of the program. Duty hour violations are prohibited. Residents are responsible for making the program aware of impending violations before they occur. RMS – RESIDENCY MANAGEMENT SUITE The Minnesota Medical Council of Graduate Medical Education mandates the University of Minnesota use RMS to track resident duty hours. The department also uses RMS as an evaluation tool. DUTY HOUR APPROVAL POLICY & PROCEDURE All activities performed by residents during their rotations are documented in an online system called Residency Management Suite (RMS). The data held within RMS is used to document and reconcile payments with the institutions where the fellows/residents rotate. Residents are required to enter their duty hours into RMS weekly and review for accuracy. Residents are responsible for making any changes such as; start time, duration, applying activities they participated in and indicating those activities they did not participate in with “Did Not Work”. Maintaining your duty hours is not only a GME requirement it is also a requirement for the completion of your degree. 1/30/2015 19 | P a g e
  20. 20. Note: Failure to ensure accuracy of your rotation activities will be considered an act of Medicare fraud. • Duty hours are to be entered by 7AM on the first working day of the month. We are granting you the weekend now to get things in order. • All fixes indentified by Program Coordinator must be corrected by the following morning. If the above do not occur: • Residents and Fellows on a U of M rotation will have their parking privileges revoked beginning the next day and will be in effect until the residency/fellowship office has cleared you. • Fellows will have a letter placed in their permanent file reflecting a lack of professionalism if pattern continues. Use of the New Innovations Residency Management Suite (RMS) Logging into RMS: • Use your browser to go to www.new-innov.com/login. Internet Explorer is the preferred browser. • Enter MMCGME for the Institution ID. • Enter your User Name and Password in the appropriate boxes. • Make sure that you have arrived at your Welcome Page. You should see your Department name in the upper left section of the screen, and your User Name will be listed just below that. Duty Hours – Entry and Approval or Modification of Already Entered Hours A) Entry of New Duty Hours 1. From the Main Menu, select Duty Hours. 2. Select the Add Duty Hours link and ensure that Graphical entry is selected. Select the date you wish to enter hours for and click Continue 3. Choose an Assignment from the drop down menu and “paint” in your hours by holding your left mouse button down and dragging across the grid. Click Save regularly to avoid loosing the hours entered. B) Approval or Modification of Already Entered Hours 1. Select the Approve Existing Hours link. 2. If necessary, enter a date range to restrict the unapproved or conflicting logged Duty Hours to display, and then click the Update Table button. 1/30/2015 20 | P a g e
  21. 21. 3. Where appropriate, place a check in one or more of the checkboxes located to the left of the entries. Then click the Approve Selected Entries or the Did Not Work button. Note: A red asterisk (*) indicates that the entry conflicts with an existing entry (time periods overlap). Note: Text in bold red indicates the entry has caused a Duty Hour rule exception. Note: Hours will not be automatically approved if they were logged for future dates or times, if they conflict with existing logged hours, or if they trigger a Duty Hour exception. Hours that trigger a Duty Hour exception CAN be approved, although you may want to enter an explanation in the Comment box. Conflicting Duty Hour entries must be resolved before the entry can be successfully approved. Duty hours logged for any time in the future cannot be approved. Tip: Click the Details link to the far right of a entry to see more information about the entry (see second screenshot below). Tip: Click the Comments link to view, edit, or delete any comments that are associated with the logged hour entry OR to add another (see third screenshot below). ON-CALL ACTIVITIES The objective of on-call and night float activities is to provide residents with emergency radiology experience, and is scheduled by the section after approval of the Fellowship Program Director and Chairman. Radiology fellows are assigned call at UMMC, HCMC and VAMC. Call averages no more than one-in- four, but can change on an as-needed basis. Scheduling of the fellows for call is the direct responsibility of the section with Program Director approval. ON-CALL ROOMS An on-call room within the Department of Radiology is available to residents taking departmental call or night float at both UMMC and HCMC, where fellows receive their in-house on-call experience. Any questions or concerns regarding departmental on-call rooms should be directed to your Program Director. On-call fellows are also eligible to use one of eighteen (18) Mayo Building call rooms provided by UMMC. All rooms have punch code security access changed daily, and a security monitor on duty daily from 2:00 PM – 7:00 AM. All rooms have a desk, television, radio clocks and air conditioning. Check-in can only occur during designated check-in hours: 2:00 PM – 7:00 AM. - Go to the check-in desk located in the Resident Lounge (Mayo C-496). The check-in desk is staffed by a security monitor during set hours seven (7) days/week and will require you to present your ID badge. - The security monitor will assign you a room, the room access code, and the locker room and lounge access codes. - All individuals must be out of their room by 8:00 AM. Housekeeping will begin cleaning by 7:00 AM. If you wish to sleep past 7:00 or 8:00 AM, make sure your “Do Not Disturb” sign is indicated on your door. SUPPORT SERVICES A full range of patient support services are provided in a manner appropriate to and consistent with educational objectives and patient care. These include but are not limited to Care Management Services, Cardiopulmonary Services, Employee Health Service, Health Information Management, Infection Control, Laboratory Medicine and Pathology, Nursing Administration, Nutrition Services, Patient Relations, Patient Transport, Pharmacy Services, Radiology Film File Services, Rehabilitation Services, Security Services, Social Services, Spiritual Health Services, and Shuttle Service between the Riverside and University campuses. 1/30/2015 21 | P a g e
  22. 22. LABORATORY / PATHOLOGY / RADIOLOGY SERVICES Federal and state regulations and regulatory agencies mandate competency validation for testing personnel (including physicians), documentation, quality assurance, quality control, etc. The regulations cover hospitals, clinics, physicians’ offices, nursing homes, and any site where testing is performed. Testing performed by physicians, practitioners, nursing staff, and laboratorians must meet regulatory guidelines. Failure to comply with the mandates can lead to suspension, revocation, or limitation of certification and denial of reimbursement. MEDICAL RECORDS - HEALTH INFORMATION MANAGEMENT A medical record system that documents the course of each patient’s illness and care is available at all times to support quality patient care, the education of residents, quality assurance activities, and provide a resource for scholarly activity. Additionally a provision of information systems is made for timely retrieval of medical records and radiologic information. To access please contact: UMMC Health Information Management Office at 612-626-3535. SECURITY / SAFETY Security and personal safety measures are provided to fellows at all locations including but not limited to parking facilities, on-call quarters, hospital and institutional grounds, and related clinical facilities (e.g., medical office buildings). UMMC Fairview Campus UMMC Riverside Campus HCMC VAMC University of Minnesota SECURITY 612-672-4544 612-672-4544 612-873-3232 612-467-2007 612-624-9255 RADIATION BADGES Radiation badges must be worn in controlled radiation areas under penalty of State law. You may be fined by the State Health Department if found not wearing a badge during an inspection. New badges will be placed in your mailbox at the institution to which you are assigned on the first working day of the month. Always keep your old badges until you get a replacement. Badges from the previous month must be returned to your mailbox by the 8th of each month. Under University policy, late badges will result in a fine of $50 per badge (unless replacement badges have not arrived in time to make the exchange). The amount of the fine will be deducted from your travel fund; if adequate funds do not remain, the fellow will be billed for the amount owed. Fellows who plan to be away during the exchange period are required to make arrangements with someone to exchange their badges in their absence. Lost or stolen badges must be reported to Pamela Hansen at 612-626-6638 or hanse032@umn.edu. MOONLIGHTING This policy does not acknowledge in any way, any departmental acknowledgement of the fellow’s ability to satisfactorily perform any moonlighting activities. Malpractice insurance is the responsibility of the fellow involved. Accreditation is up to the party hiring the fellow. Fellows are not required to engage in moonlighting. Because fellowship education is a full-time endeavor, moonlighting must not interfere with the ability of the fellow to achieve the goals and objectives of the educational program. Fellows are required to notify the Program Director of their moonlighting activities. They shall email the Program Coordinator the dates, times and locations of all moonlighting activities and will become a part of the fellows file. 1/30/2015 22 | P a g e
  23. 23. Moonlighting activities will not be allowed to conflict with the scheduled and unscheduled time demands of the educational program and its facility. The fellow’s performance will be monitored for the effect of these activities upon performance and that adverse effects may lead to withdrawal of permission. Internal moonlighting must be counted toward the 80-hour weekly limit on duty hours. Fellows on J1 visas are NOT permitted to be employed outside the fellowship program. A fellow on an H-1B visa wishing to moonlight must obtain a separate H1-B visa for each facility where the fellow works outside the training program. SUPERVISION / GRADED RESPONSIBILITY All patient care is supervised by qualified faculty. The Program Director ensures, directs, and documents adequate supervision of fellows at all times. Fellows are provided with rapid, reliable systems for communication with supervising faculty. Fellows are supervised by teaching staff in such a way that the residents assume progressively increasing responsibility according to their level of education, ability, and experience. On-call schedules for teaching staff are structured to ensure that supervision is readily available to fellows on duty. The teaching staff determines the level of responsibility given to each resident/fellow. Faculty, residents, and fellows are educated to recognize the signs of fatigue and adopt and apply policies to prevent and counteract the potential negative effects. Fellow participation at all of our institutions is one of active participation under direct (and graded) supervision of full-time teaching staff. However, at all times, final responsibility for patient care resides with the full-time staff. In this manner, the fellows receive excellent training in pediatric radiology with an appropriate degree of responsibility. STEPS IN EVALUATION PROCESS In a small program (maximum of 2 fellows per year), evaluation of the fellow’s capabilities and progress is mainly on an informal day-to-day basis, with immediate feedback. Formal written reviews are generated quarterly following one-on-one meetings between the Program Director and the fellow. These quarterly reviews are discussed with the remainder of the faculty both informally and at regular staff meetings. A quarterly review of the fellows’ case logbook will be done as well. Of course, the performance of graduates of our program in their post-fellowship positions and on the American Board of Radiology’s Certification of Added Qualification in Pediatric Radiology examination will provide additional quantifiable measure of our fellows’ performance - Monthly and 360 Evaluations: At the end of each clinical rotation, an evaluation of the fellow’s progress is prepared by the faculty member(s) in that area. This is done via RMS. Evaluations are accessible to fellows on-line. Fellows also evaluate their rotations at the end of each clinical rotation and faculty twice annually. EVALUATION SYSTEM - ELECTRONIC This Program has integrated a web-based electronic evaluation system. Evaluations both of and by fellows are essential parts of maintaining our status as an accredited fellowship program and producing superior fellow-physicians. While traditional paper-based systems allow for simple data tracking, they do not provide an easy means for improving the quality of the program. The information obtained from the analysis of evaluation data is instrumental in objectively assessing the quality of all aspects of the fellowship program and for identifying and continuously monitoring areas for improvement. RMS is a completely web-based computer system that allows us all to enter evaluations, receive rapid feedback, view reports, and compare teaching performance with other programs. The system 1/30/2015 23 | P a g e
  24. 24. is highly secure and flexible. Faculty and trainees are expected to complete evaluations on a monthly basis. The web address for RMS is https://www.new-innov.com. If you experience any problems with logging into, please contact the Program Coordinator at 612-626-5548. COMPLETING EVALUATIONS IN RMS • Log into RMS • Enter your User ID & password – Click “login” • Click “continue” • Under the notifications box you will see the number of evaluations you have pending completion. Click the text that reads “complete them”. • Click the “evaluate” link next to the evaluation you wish to complete; this will bring you to the evaluation. • NOTE: If you have not worked with the faculty - place a check mark in the box and click “submit selected evaluation as NET”. 1. Login to RMS. From the Main Menu, select Evaluations or click the link in your Notifications box on your Welcome Page. 2. Select the evaluations you wish to complete from the list. For evaluations where you did not spend enough time with the person to warrant an evaluation, place a check mark in the box and click NET. 3. To view your evaluations select Evaluations from the main menu and click View Completed Evaluations. MONITORING OF RESIDENT WELL-BEING Both the Program Director and faculty are sensitive to the need for timely provision of confidential counseling and psychological support services to the fellows. Fellows feeling fatigued or stressed are encouraged to discuss their concerns with the Program Director, or to contact the (RAP) Resident Assistance Program at 651-430-3383 or 1-800-632-7643, especially if unable to provide safe patient care. ACLS/BLS/PALS CERTIFICATION REQUIREMENTS • BLS – All residents must remain current on their Basic Life Support Training. • ACLS – It is recommended that residents maintain Advanced Life Support Training Travel The Department may cover up to three days of expenses for fellows presenting at national meetings. Individuals traveling on University business are covered under the Worldwide Travel Accident Policy, providing they have obtained permission to travel before travel begins. Requests to travel are made via the University’s Travel Authorization form. This form can be obtained from the Travel Services website. BEFORE THE TRIP: 1. Submit complete conference registration form to Program Coordinator along with department approval documentation for processing. 2. Submit proposed flight plan Program Coordinator for processing. 1/30/2015 24 | P a g e
  25. 25. 3. Fellow is responsible for making travel arrangements. AFTER THE TRIP: 1. Receipts are required for reimbursements of $25 and above (accept for Per Diem meals). 2. Gather all receipts and submit to Program Coordinator for processing reimbursement. Program Coordinator will contact fellow when the University Employee Reimbursement Form is ready for their signature. LIBRARIES INSTITUTIONAL LIBRARIES University of Minnesota Biomedical Library (Diehl Hall) Hours of operation: Monday through Friday: 7:00 AM – 12:00 AM Saturday: 8:00 AM – 8:00 PM Sunday: 12:00 PM – 12:00 AM DEPARTMENTAL LIBRARIES University of Minnesota Medical Center, Fairview Radiology Department Eugene Gedgaudas Learning Center, Mayo – Room B-218 Hours of operation: Accessible via combination lock 24 hours per day, 7 days per week In addition to the departmental library, there are subspecialty reference books and online access in each reading room. YOU WILL NOT BE ABLE TO PARTICIPATE IF YOU FAIL TO SUBMIT YOUR DOCUMENTATION • Application Form • Confidentiality Agreement • Immune Status Form • Immunization Documentation – must be current (obtain from Boynton Clinic) • Positive mantoux - (obtain from Boynton Clinic) • Background check – will be submitted by the program coordinator Teaching Medical Students Fellows are an essential part of the teaching of medical students. It is critical that any fellow who supervises or teaches medical students must be familiar with the educational objectives of the course or clerkship and be prepared for their roles in teaching and evaluation. Therefore, we’ve included in this manual the URL to the objectives for the Clerkship(s) specific to our Department as well as the overall Educational Program Objectives. Educational Program Objectives University of Minnesota Medical School Graduates of the University of Minnesota Medical School should be able to: OBJECTIVE OUTCOME MEASURES ACGME ESSENTIAL COMPETENCY 1. Demonstrate mastery of key concepts and principles in the basic sciences and clinical disciplines that are the basis of current and future medical practice. • USMLE Steps 1 and 2 • Year 1 and 2 course performance, based on standardized examinations • Clinical rotation performance • Feedback from residency directors Medical Knowledge 2. Demonstrate mastery of key concepts and principles of other sciences and humanities • USMLE Steps 1 and 2 • Course performance (esp. in Physician Medical Knowledge 1/30/2015 25 | P a g e
  26. 26. that apply to current and future medical practice, including epidemiology, biostatistics, healthcare delivery and finance, ethics, human behavior, nutrition, preventive medicine, and the cultural contexts of medical care. and Society, Nutrition, and Human Behavior at TC campus; Medical Sociology, Medical Epidemiology and biometrics, Family Medicine I, Medical Ethics, Human Behavioral Development and Problems, and Psycho-Social-Spiritual Aspects of Life-Threatening Illness at DU campus) • Clinical rotation performance • Feedback from residency directors 3. Competently gather and present in oral and written form relevant patient information through the performance of a complete history and physical examination. • Yr 2 OSCE • Physician and Patient (PAP) course performance at TC campus, assessed by tutors using global rating forms and observed practical exams • Course performance at DU campus in Applied Anatomy, Clinical Rounds & Clerkship (CR & C), Clinical Pathology Conference, and Integrated Clinical Medicine • Clinical rotation performance Patient Care; Interpersonal and Communication Skills 4. Competently establish a doctor-patient relationship that facilitates patients’ abilities to effectively contribute to the decision making and management of their own health maintenance and disease treatment. • Yr 2 OSCE and Primary Care Clerkship (PCC) OSCE • PAP course performance at TC campus, assessed by tutors using global rating forms and observed practical exams • Preceptorship and CR & C course performance at DU campus • Clinical rotation performance Patient Care; Interpersonal and Communication Skills 5. Competently diagnose and manage common medical problems in patients. • PCC OSCE • Clinical rotation performance Medical Knowledge; Patient Care 6. Assist in the diagnosis and management of uncommon medical problems; and, through knowing the limits of her/his own knowledge, adequately determine the need for referral. • Clinical rotation performance • Documented achievement of procedural skills in the Competencies Required for Graduation Medical Knowledge; Patient Care; Practice-Based Learning and Improvement 7. Begin to individualize care through integration of knowledge from the basic sciences, clinical disciplines, evidence-based medicine, and population-based medicine with specific information about the patient and patient’s life situation. • Clinical rotation performance • Feedback from residency directors Patient Care; Medical Knowledge; Interpersonal and Communication Skills; Professionalism 8. Demonstrate competence practicing in ambulatory and hospital settings, effectively working with other health professionals in a team approach toward integrative care. • Yr 2 and PCC OSCE • PAP course performance at TC campus, assessed by tutors using global rating forms and observed practical exams • Physician and Society (PAS) course performance at TC campus • Preceptorship, CR & C, and Introduction to Rural Primary Care Medicine course performance at DU campus • Clinical rotation performance Practice-Based Learning and Improvement; Systems-Based Practice 9. Demonstrate basic understanding of health • PAS course performance at TC campus Practice-Based Learning 1/30/2015 26 | P a g e
  27. 27. systems and how physicians can work effectively in health care organizations, including: • Use of electronic communication and database management for patient care. • Quality assessment and improvement. • Cost-effectiveness of health interventions. • Assessment of patient satisfaction. • Identification and alleviation of medical errors. • Medical Sociology and CR & C course performance at DU campus • Clinical rotation performance, especially the PCC • Feedback from residency directors • Feedback from local health plans and Improvement; Systems-Based Practice 10. Competently evaluate and manage medical information. • Critical reading exercises in PAS and other courses at TC campus • Clinical Pathology Conference performance and exercises in Problem Based Learning Cases at DU campus • Year 2 Health disparities project • PCC EBM project Patient Care; Medical Knowledge; Practice- Based Learning and Improvement; Systems- Based Practice 11. Uphold and demonstrate in action/practice basic precepts of the medical profession: altruism, respect, compassion, honesty, integrity and confidentiality. • PAS course performance at TC campus • Preceptorship and Cr & C course performance at DU campus • Clinical rotation performance • Participation in honor code and student peer assessment program • Participation in anatomy memorial • Participation in volunteer service activities Professionalism 12. Exhibit the beginning of a pattern of continuous learning and self-care through self- directed learning and systematic reflection on their experiences. • PBL cases at DU campus • Yr 2 Health disparities project • Clinical rotation performance • Participation in research Professionalism 13. Demonstrate a basic understanding of the healthcare needs of society and a commitment to contribute to society both in the medical field and in the broader contexts of society needs. • Course performance in all years • Introduction to Rural Primary Care Medicine course project at DU campus • Involvement of students in international study • Enrollment in RPAP, RCAM, and UCAM • Yr 2 Health disparities project • Feedback from residency directors • Participation in volunteer service activities Patient Care; Medical Knowledge; Practice- Based Learning and Improvement; Professionalism; Systems- Based Practice These objectives are written to reflect the qualities and competencies expected of our graduates. Each objective specifies the expected competency level to be attained by our students, the outcome measures used to evaluate attainment of the objective, and the essential qualities and competencies of a physician (as defined by the six ACGME Essential Competencies) addressed by the objective. The Accreditation Council for Graduate Medical Education (ACGME) has formulated essential competencies felt to be necessary for physicians practicing in the current health care climate. They are:  Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health  Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care 1/30/2015 27 | P a g e
  28. 28.  Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care  Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals  Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population  Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide optimal patient care The objectives for the undergraduate curriculum can be grouped as follows: Objectives 1-3: Knowledge and skills addressed principally in the first two (preclinical) curricular years; Objectives 4-9: Knowledge and skills addressed principally in the second two (clinical) curricular years; Objectives 10-13: Knowledge, attitudes, and skills addressed throughout the curriculum. The objectives, which relate to the ACGME essential competencies, are designed to be modified for use also by the graduate (GME) programs at the University of Minnesota Medical School. Fellowship programs can modify the competency level stated in the objectives and the outcome measures to reflect their own programs, while maintaining the overall integration of basic learning objectives across undergraduate and graduate medical education. One of the primary outcome measures for the objectives is clinical rotation performance. To expand on this; clinical rotation performance is assessed by attending physicians and residents using a Web- based global rating form, evaluating the following knowledge, competencies, skills, and attitudes:  Medical knowledge and the ability to apply knowledge in clinical situations  Competency in patient care including communication and relationships with patients/families  Skills in data gathering from the history, physical examination, clinical and academic sources, and diagnostic tests  Assessment and prioritization of problems  Management of problems, including knowledge of patient data and progress  Appropriate decision making  Communication in written and oral reports  Professionalism, including: patient care and management in teams (work habits), independent learning, personal characteristics, and commitment to medicine  Specific procedural skills (see report outlining Competencies Required for Graduation) Ratified by Education Council 2/18/03 SECTION VI. ADMINISTRATION (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: University of Minnesota Physicians, GME Administration Contact List, GME Administration by Job Duty; GME Organization Chart) UMMC PROGRAM ADMINISTRATION DIRECTOR & CHAIRMAN: CHARLES DIETZ, JR. M.D. Office: B234 Mayo Bldg Phone: 612.626.3345 Fax: 612.626.3366 Pager: 612.899.7591 Mail Code: MMC292 Email: dietz004@umn.edu 1/30/2015 28 | P a g e
  29. 29. PROGRAM DIRECTOR, F. GLEN SEIDEL, M.D. Office: B292 Mayo Bldg Phone: 612.626.4511 Fax: 612.626.5580 Pager: 612.899.9237 Mail Code: MMC292 Email: fgseidel@umn.edu PROGRAM COORDINATOR, TRISHA PEDERSON Office: B292 Mayo Bldg Phone: 612.626.5548 Fax: 612.625.5580 Pager: N/A Mail Code: MMC292 Email: pede0220@umn.ed u ALRT GRADUATE MEDICAL EDUCATION MANAGER: SALLY SAWYER Office: 763 Mayo Bldg Phone: 612.625.3518 Fax: 612.626.2696 Pager: N/A Mail Code: MMC609 Email: sallyann@umn.edu HCMC PROGRAM ADMINISTRATION ASSOCIATE DIRECTOR: ANOTHONY SEVERT, M.D. Office: 2E-20 HCMC Phone: 612.873.2036 Fax: 612.904.4567 Pager: 612.530.8654 Mail Code: MMC822 Email: sever025@umn.edu PROGRAM COORDINATOR: PAMELA THOMPSON Office: P4-221 HCMC Phone: 612.873.2036 Fax: 612.904.4567 Pager: N/A Mail Code: P4 Email: pamela.thompson@hcmed.or g PROGRAM COORDINATOR, SHARI JOHNSTON Office: P4-221 HCMC Phone: 612.873.2718 Fax: 612.904.4567 Pager: N/A Mail Code: P4 Email: hiltje.loyd@hcmed.org VAMC PROGRAM ADMINISTRATION ASSOCIATE DIRECTOR: HOWARD ANSEL, M.D. Office: 1Q-109 Phone: 612.725.2038 Fax: 612.727.5635 Pager: 612.660.7016 Mail Code: 114 Email: howard.ansel@med.va.gov PROGRAM COORDINATOR: CAROL STEVENS Office: Phone: 612.467.2929 Fax: 612.467.5635 Pager: N/A Mail Code: 114 Email: carol.stevens@hcmed.org PARK NICOLLET PROGRAM ADMINISTRATION DIRECTOR: TBA Office: Phone: 612. Fax: 612. Pager: 612. Mail Code: Email: PROGRAM COORDINATOR: BARB RICKE Office: Phone: 952.993.6106 Fax: 952.993.0212 Pager: N/A Mail Code: Email: barb.ricke@parknicollet.com 1/30/2015 29 | P a g e
  30. 30. REGIONS PROGRAM ADMINISTRATION DIRECTOR: JOSEPH TASHJIAN, M.D. Email Preferred: jtashjian@stpaulrad.com ER ROTATION COORDINATOR: DAVID LEE, M.D. Email Preferred: como57@comcast.net PROGRAM COORDINATOR: DEB COLLIER Office: 125 Phone: 651.254.3456 Email: Deb.k.collier@healthpartner.com SITE CENTRAL CONTACT INFORMATION UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW 420 DELAWARE STREET SE MINNEAPOLIS, MN 55455 PHONE 612.273.6004 FAX: 612.626.3366 HENNEPIN COUNTY MEDICAL CENTER 701 PARK AVE SOUTH MINNEAPOLIS, MN 55415 PHONE 612.873.2036 FAX: 612.94.4258 VETERANS ADMINISTRATION MEDICAL CENTER ONE VETERANS DRIVE MINNEAPOLIS, MN 55417 PHONE 612.725.2038 FAX: 612.727.5635 REGIONS HOSPITAL 640 JACKSON STREET ST. PAUL, MN 55101 PHONE 651.221.3793 FAX: 651.221.2849 PARK NICOLLET MEDICAL 3800 PARK NICOLLET BLVD. ST. LOUIS PARK, MN 55416 PHONE 952.993.6106 FAX: 952.993.0212 1/30/2015 30 | P a g e
  31. 31. Addendum I: Goals, Objectives, and Expectations of Fellows University of Minnesota Children’s Hospital-Fairview Department of Radiology Division of Pediatrics June 2009 Schedule of Pediatric Radiology Conferences Conference Frequency Responsible Individual or Service/Department Neonatal Working Rounds Daily Pediatric Radiology Faculty, Fellow, and Resident 1/30/2015 31 | P a g e
  32. 32. ICU & In-Patient Rounds Daily Pediatric Radiology Faculty, Fellow, and Resident MSK/Ortho Tumor Board Weekly Dr. Hoggard Pediatric Cardiac Conference Weekly Dr. Hoggard Pediatric Grand Rounds Weekly Pediatric Radiology Faculty and Fellow Pediatric Morbid. & Mortality Weekly Dr. Holm Tumor Board Weekly Dr. Holm GI & Surgical Conference Bi-Weekly Pediatric Radiology Faculty, Fellow, and Resident Neuroradiology Conference Bi-Weekly Pediatric Radiology Faculty, Fellow, and Resident Radiology Res. Conference Bi-Weekly Pediatric Radiology Faculty and Fellow Pediatric Res. Conference Monthly Dr. Seidel Radiology Grand Rounds Monthly Pediatric Radiology Faculty, Fellow Rad.-Urol.-Nephrol. Rounds Monthly Dr. Seidel Journal Club Monthly Pediatric Radiology Faculty, Fellow, and Resident Pediatric Radiology Rotation Schedule The fellowship generally consists of twelve months; spending at least one month on each of the following: ultrasound, Body CT/MRI, Fluoroscopy, Plain Films, Nuclear Medicine including PET/CT, NeuroRadiology, and Interventional Radiology. The remaining time will be tailored to the fellow’s interests and/or weaknesses. At least one additional month of plain films and NeuroRadiology will be expected, leaving two months for electives and one month for vacation. The fellow will have one half day a week for academic time. The rotation schedule is as follows: Ultrasound 4 weeks X-Ray/Palin Films 4 weeks N.I.C.U. 4 weeks CT/MRI/Cardiac 8 weeks Fluoroscopy 4 weeks Nuclear Medicine 4 weeks Neuroradiology 8 weeks Interventional 4 weeks Electives 8 weeks Vacation 4 weeks Pediatric Radiology Fellowship Didactic Conference Schedule Date Rotation Lecture Week 1 Ultrasound Testicles and ovaries Week 2 Ultrasound Abdominal “Masses” Week 3 Ultrasound Pylorus & Bowel Week 4 Ultrasound Transplants Week 1 X-Ray/Plain Films Chest & Airway Week 2 X-Ray/Plain Films Musculoskeletal: Fractures 1/30/2015 32 | P a g e
  33. 33. Week 3 X-Ray/Plain Films Abdominal Week 4 X-Ray/Plain Films MSK Tumors Week 1 N.I.C.U. Chest Week 2 N.I.C.U. GI/GU Week 3 N.I.C.U. Neonatal Head US Week 4 N.I.C.U. Dysplasias & Metabolic Diseases Week 1 CT/MRI/Cardio CT: Chest Week 2 CT/MRI/Cardio CT Body I Week 3 CT/MRI/Cardio CT Body II Week 4 CT/MRI/Cardio CT Angiogram Protocol Week 5 CT/MRI/Cardio Vascular Malformations Week 6 CT/MRI/Cardio Musculoskeletal MRI Week 7 CT/MRI/Cardio Segmental Anatomy of the Heart Week 8 CT/MRI/Cardio Radiation Dose Reduction Week 1 Fluoroscopy Radiation Dosage and Technique Week 2 Fluoroscopy Enemas and Intussusception Reduction Week 3 Fluoroscopy VCUG Week 4 Fluoroscopy Upper GI Week 1 Nuclear Medicine Bone scan Week 2 Nuclear Medicine Thyroid Scintigraphy Week 3 Nuclear Medicine GI/GU Week 4 Nuclear Medicine Tumor Imaging and PET CT Week 1 Neuroradiology Neck Week 2 Neuroradiology Orbits Week 3 Neuroradiology Spine Week 4 Neuroradiology Trauma Week 5 Neuroradiology Infection Week 6 Neuroradiology Sinuses & Middle Ear Week 7 Neuroradiology Neoplasm& Metabolic Disease Week 8 Neuroradiology Congenital Anomalies Week 1 Interventional Biopsy Week 2 Interventional Drainage Week 3 Interventional Vascular Access Week 4 Interventional GI Access & Tube Management Week 1 Miscellaneous Fetal MRI I Week 2 Miscellaneous Fetal MRI II Week 3 Miscellaneous Cardiac CT and MRI I Week 4 Miscellaneous Cardiac CT and MRI II Week 5 Miscellaneous MR Urography Week 6 Miscellaneous MR Enterography Week 7 Miscellaneous Imaging Findings after BMT Week 8 Miscellaneous Pediatric Feet Week 9 Miscellaneous Pediatric Hips Week 10 Miscellaneous Pediatric Elbow READING ROOM/GENERAL RADIOGRAPHY I. GOALS Fellows and Residents will acquire the knowledge, skills, and professionalism necessary for providing quality, appropriate imaging of the pediatric and adolescent patients who present with a need for emergent imaging. They will be able to communicate results to the referring physician. 1/30/2015 33 | P a g e
  34. 34. II. OBJECTIVES Fellows and Residents rotate on-call throughout the year and their knowledge base and skills vary according to their experience. The objective of the rotations is to provide important clinical imaging care of infants, children and adolescents who need emergent imaging and to provide results of the imaging in a timely manor. Fellows and Residents will be able to: 1. Be able to interpret imaging procedures on patients including but not limited to recognizing life threatening airway conditions such as croup, recognizing signs of child abuse, trauma patients with injuries, description of fractures and dislocations, and common emergent conditions of the chest and abdomen. 2. Be knowledgeable about the clinical protocols for imaging children in ultrasound, radiography, nuclear medicine CT, and MR. 3. Be able to effectively multitask and problem solve with clinicians concerning management decisions and imaging. 4. Be a valuable consultant and efficiently add on cases to aid treatment or diagnosis. 5. Communicate the results to the appropriate individuals. 6. Know lines of supervision for on-call issues and use good judgment on when to ask for help. 7. Be an active participant in managing trauma cases concerning imaging recommendations and prioritizing cases appropriately. 8. Understand the unique clinical situations and significance of diseases of the newborn, infant, child, and adolescent as it applies to emergency imaging. 9. Understand the appropriate us of imaging in the evaluation of childhood and adolescent diseases who present with acute and sometime chronic conditions. 10. Be able to us on-line resources including www.fairview.org and the Radiology homepage for specific issues that relate to departmental function and or safety issues. III. LEARNING EXPECTATIONS A. MEDICAL KNOWLEDGE 1. Learn the systems and procedures that support emergency radiology at University of Minnesota Medical Center-Fairview 2. Learn the support systems in the department when there are questions including but not limited to the web base, exam preps, protocol books, and others. 3. Learn the common and unusual patterns of injury as well as normal variants of skeletal radiology 4. Learn findings of child abuse and reporting mechanisms 5. Know protocols for emergency imaging 6. ACLS/BCLS certification 7. Knowledge of contrast reactions and their treatment 8. Learn approach and differential of neonatal emergencies 9. Learn approach, and differential of neurological emergencies 10. Have knowledge and skills concerning placement of G tubes, or NJ tubes as requested. 11. With chest/abdominal imaging, be able to identify the position of various catheters, tubes, lines and inserted monitors such as ph probes. 12. Understand appropriateness of imaging the child with abdominal pain 13. Understand low dose techniques or strategies which may be useful in children 14. Understand when emergency MRI studies are useful in patient management B. PATIENT CARE 1. Consider requests for add on exams, and work effectively with the health care team to advance and prioritize the diagnostic workup of children who present with acute problems 1/30/2015 34 | P a g e
  35. 35. 2. Provide safe environment by following standard procedures according to the Procedures and Policy Statements 3. Always wash your hands or use the gels before or after touching a patient. 4. Avoid using unapproved abbreviations (such as cc, etc.) 5. Use “stop” techniques when and where appropriate 6. Dictate in a timely manor. All images must be seen by faculty as well as the dictated report. 7. Recheck the correct sidedness of the patient. 8. Where appropriate learn significant past history from the chart, the parent or directly from the family. 9. Obtain informed consent from patients when indicated 10. Assist in difficult fluoroscopic procedures 11. Perform basic fluoroscopy/IVU with minimal assistance 12. Procedural competency: each of these studies should be done with a faculty member and documented. a. Intussusceptions (3 cases) b. Testicular or ovarian torsion c. Place NJ tube d. Placement of G tube or G tube exchange e. Neonatal obstruction with contrast study f. UGI to rule out malrotation g. Pyloric stenosis US h. Imaging following liver transplant i. CT trauma cases (3) C. COMMUNICATION 1. Must work to insure an accurate dictated report in a timely manor 2. For urgent or emergent studies, direct phone to physician or service caring for the patient, with documentation in the report. 3. If there is a change in interpretation after reviewing with staff, notify ordering physician of the change and document the notification in the report. 4. Must work with the health care team including the technologists, secretarial support for add on cases, necessary information and preparation for emergency cases. 5. Know supervisory lines of responsibilities every time one is on call 6. Must recognize and call others for support when the fellow is not well, excessively tired and not able to function or needs help in dealing with difficult or unusual case material. 7. Must prioritize the needs of trauma cases or emergency studies 8. Must be able to delegate to the residents, faculty, or ancillary help so the effective and appropriate studies can be done. 9. Consultation with ER, or primary service 10. Function as primary consultant to ER/Referring physician concerning emergency imaging 11. Patient communication skills at attending level 12. Thorough knowledge of case presentation including procedure and outcome 13. Presentation of trauma and emergency imaging at case conference. D. PROFESSIONALISM 1. Helpful, appropriate Interaction with attending, ER and resident staff 2. Understands concept of patient confidentiality 3. Demonstrates ethical behavior 4. Demonstrates sensitivity to diversity of patient background 5. Know “professionalism” as it is described in handbook 6. Always introduce yourself to parent, patient or health care team when doing procedures on patient 7. Always inquire about the special needs of the patient 8. Always respect the ethnic, economic, religious diversity of the families we serve 1/30/2015 35 | P a g e
  36. 36. 9. Familiarity with HIPPA requirements 10.Avoid negative comments concerning other health care provider E. SYSTEMS BASED PRACTICE 1. Understands how radiology fits into the system of caring for the patient, making the correct diagnosis and helping to improve outcomes. 2. Understand appropriateness of imaging guidelines from standard protocols such as ACR or from the department 3. Understand best practices and exhibit and promote positive attitudes and behaviors which enhance care 4. Always try to create a safe environment and endorse the JCAHO, institution guidelines for a safe environment 5. Works to improve systems not only within radiology but with the referring physicals or patients. F. PRACTICE BASED LEARNING 1. Reports errors or “Near miss” occasions so as to prevent harm. 2. Improvement in patient care through cognitive knowledge, observational skills, procedural skills and feedback. 3. Applies principles of evidence based medicine. 4. Critically uses on line resources for information. 5. Participates in QC & QA. 6. Effectively promotes learning with students, residents, and other healthcare professionals. 7. Directs learning of other residents students and healthcare professionals IV. EXPECTATIONS OF PERFORMANCE 1. The expectation is that the fellow will arrive on time or at least contact the faculty member if there is a delay. 2. Connect with the other fellow or faculty member for ongoing studies, and know the importance of “hand-off” cases 3. Quickly update ones knowledge concerning ongoing studies, urgent cases, and the need to plan to meet the needs of the emergency cases. 4. Work with the resident/faculty to insure coverage. Verbalize any issues 5. At night, dictate the cases with the faculty member, communicate any changes in interpretation. 6. Delegate some interesting cases to the resident. Work with him as he learns V. EVALUATION 1. There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section or designee. 3. 360ْ Fellow Evaluations FLUOROSCOPY I. GOALS Fellows and residents will acquire the knowledge, skills, and attitude necessary for providing quality fluoroscopic imaging of pediatric and adolescent patients. A. MEDICAL KNOWLEDGE 1. Learn the systems and procedures that support emergency fluoroscopy at 1/30/2015 36 | P a g e
  37. 37. University of Minnesota Medical Center-Fairview 2. Learn the support systems in the department when there are questions including but not limited to the web base “whose on call”, normal findings, fluoroscopy protocol books, and others. 3. Learn the common and unusual patterns of fluoroscopic abnormality as well as normal variant fluoroscopic findings of the GI and GU tract 4. Learn findings of child abuse and reporting mechanisms 5. Know protocols for fluoroscopic imaging exams 6. ACLS/BCLS certification 7. Knowledge of contrast reactions and their treatment 8. Learn approach and differential of neonatal bowel emergencies 9. Learn approach, and differential of bowel obstruction in children 10. Have knowledge and skills concerning placement or replacement of G, GJ, or NJ/OJ tubes. 11. Be able to identify the position of various catheters, tubes, inserted monitors such as ph probes and modify enteric tubes or pH probes appropriately. 12. Understand appropriateness of imaging the child with abdominal pain 13. Understand low dose fluoroscopic techniques or strategies in children Understand appropriate contrast material selection in upper & lower GI studies B. PATIENT CARE 1. Consider requests for add on exams, and work effectively with the health care team to advance and prioritize the diagnostic workup of children who present with acute problems 2. Provide safe environment by following standard procedures according to the Procedures and Policy Statements 3. When appropriate, utilize child life specialists to manage patients and families needing this assistance to facilitate exam safely and with patient’s best interest in mind. 4. Always wash your hands or use the gels before or after touching a patient. 5. Avoid using unapproved abbreviations (such as cc, etc.) 6. Use “stop” techniques when and where appropriate 7. Dictate in a timely manor. All images must be seen by faculty as well as the dictated report. 8. Recheck the correct sidedness of the patient. 9. Where appropriate learn significant past history from the chart, the parent or directly from the family. 10. Obtain informed consent from patients when indicated 11. Seek assistance if required in difficult fluoroscopic procedures 12. Perform basic fluoroscopy/IVU independently. 13. Obtain H & P when needed for procedures 14. Knowledge of ACLS/BCLS 15. Knowledge of contrast reaction and treatment 16. Procedural competency: each of these studies should be done with a faculty member and documented. a. Intussusceptions (3 cases) b. Placement of NJ tube c. GJ tube exchange d. Neonatal obstruction with contrast studies e. UGI to rule out malrotation f. VCUG g. IVP h. Distal colostogram in patient with anorectal malformation C. COMMUNICATION 1. Must work to insure an accurate dictated report in a timely manor 2. For urgent or emergent studies, direct phone to physician or service caring for the patient, with documentation in the report. 1/30/2015 37 | P a g e
  38. 38. 3. Fellows and Residents must acknowledge using the terminology: Significant change in interpretation…..if there is a change, and also document who was notified and when there was notification of the change. 4. Must work with the health care team including the technologists and secretarial support for add on cases, obtaining necessary information and preparation for emergency cases. 5. Must know how to use the available resources on the web, procedure preps, etc to facilitate cases. 6. Must recognize and call others for support when requiring help in dealing with difficult or unusual case material. 7. Must prioritize the needs of trauma cases or emergency studies 8. Must be able to delegate to the residents, faculty, or technologists for help so that effective and appropriate studies can be done. 9. Consultation with ER, or primary service 10. Function as primary consultant to ER/referring physician concerning emergency imaging 11. Patient communication skills at attending level 12. Thorough knowledge of case presentation including procedure and outcome. 13. Presentation of fluoroscopic imaging at Monday conference. D. PROFESSIONALISM 1. Helpful, appropriate Interaction with attending, ER and resident staff. 2. Understand concept of patient confidentiality. 3. Demonstrates ethical behavior. 4. Demonstrate sensitivity to diversity of patient background. 5. Know “professionalism “as it is described in handbook; 6. Always introduce yourself to parent, patient or health care team when doing procedures on patient. 7. Always inquire about the special needs of the patient 8. Always respect the ethnic, economic, and religious diversity of the families we serve. 9. Familiarity with HIPPA requirements. 10. Avoid negative comments concerning other health care providers. E. SYSTEMS BASED PRACTICE 1. Understanding how radiology fits into the system of caring for the patient, making the correct diagnosis and helping to improve outcomes. 2. Understand appropriateness of imaging guidelines from standard protocols such as ACR or from the department 3. Understand best practices and exhibit and promote positive attitudes and behaviors which enhance care 4. Always try to create a safe environment and endorse the JCAHO, institution guidelines for a safe environment 5. Report errors or “Near miss” occasions so as to prevent harm 6. Work to improve systems not only within radiology but with the referring physicals or patients. F. PRACTICE BASED LEARNING 1. Improvement in patient care through cognitive knowledge, observational skills, procedural skills and feedback 2. Applies principles of evidence based medicine 3. Critically uses on line resources for information 4. Participates in QC & QA 5. Effectively promotes learning with students, residents, and other healthcare professionals 6. Directs learning of other fellows, residents, students and healthcare professionals 1/30/2015 38 | P a g e
  39. 39. II. EXPECTATIONS OF PERFORMANCE 1. The expectation is that the fellow will arrive on time or at least contact the faculty member if there is a delay. 2. The fellow will review lines of responsibility from website. 3. Connect with the other fellow or faculty member for ongoing studies, and know the importance of “hand-off” cases 4. Quickly update ones knowledge concerning ongoing studies, urgent cases, and the need to plan to meet the needs of the emergency cases. 5. Work with the resident/faculty to insure coverage. Verbalize any issues. 6. At night, dictate the cases with the faculty member, communicate any changes in interpretation. 7. Delegate some interesting cases to the resident. Work with him/her as he/she learns. III. EVALUATION 1. There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section Or designee. 3. 360ْ Fellow Evaluations ULTRASOUND I. GOALS Fellows and Residents will acquire the knowledge, skills and attitude necessary for providing quality ultrasound imaging of pediatric and adolescent patients. A. PATIENT CARE 1. Be actively involved in patient care that is provided during ultrasound rotation 1/30/2015 39 | P a g e

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