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Jeff (Jeff)
Board Administrator
Username: Jeff

Post Number: 21
Registered: 06-2005
Posted on Tuesday, July 26, 2005 - 06:11 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

This folder can contain information specific to Transitional Year residency programs and can be used by program directors, faculty, residency coordinators, or others to post questions and answers. This area, like all areas of the AHME Message Board, is open to everyone, AHME members and non-members alike. Please post any suggestions you may have for this section here and I will try to address them.
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Hassan
Unregistered guest
Posted on Sunday, October 16, 2005 - 12:11 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hello!

I am kind of stuck with my last applications, so it would be very helpful if somebody could send me a sample of a transitional year personal statemente.

My email is: juptodate@yahoo.com

Thank you very much for your help!
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Shirleyk (Shirleyk)
New member
Username: Shirleyk

Post Number: 1
Registered: 09-2007
Posted on Tuesday, January 15, 2008 - 11:21 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hello,
What qualifies as a legimate TY elective. Can an away elective be at a hospital that has rotating students only--no residents?
Thanks
Shirley
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Sbloom (Sbloom)
New member
Username: Sbloom

Post Number: 35
Registered: 07-2005
Posted on Tuesday, January 22, 2008 - 04:44 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hi Shirley:
TY Electives don't have to be in a hospital that has residents as long as they meet the following critera (taken from the transitional program requirements):

(3) Outside rotations not part of ACGME-accredited programs must be designated as electives. The program director must provide a complete description of the experience to include curriculum objectives, resident responsibilities, and the faculty assigned for supervision;

Sheryl
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Hogge (Hogge)
New member
Username: Hogge

Post Number: 1
Registered: 05-2010
Posted on Tuesday, September 11, 2012 - 01:43 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Our TY residents are being asked to report to their categorical programs as early as mid-June nowadays. Our standard has been to require the TYs to stay until the end of our academic year which is June 26th.

How many TY programs allow their TYs to leave one week prior to the end of the academic year?
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Pshmcty (Pshmcty)
New member
Username: Pshmcty

Post Number: 3
Registered: 05-2012
Posted on Tuesday, September 11, 2012 - 01:47 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Due to services that need coverage some cannot leave until the last day of their contract. Those on services that CAN be excused have to use vacation for the last week.
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Nalberto (Nalberto)
New member
Username: Nalberto

Post Number: 1
Registered: 04-2013
Posted on Monday, April 01, 2013 - 01:55 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Would appreciate very much if the council would be able and willing to offer our program advice as to how we can address and improve our program with respect to the citation that our program recieved at our last site visit and listed below.

Would also like to know as to what other TY Programs are doing to remain in compliance with the Practice-based Learning and Improvement Competency

Citation :
Practice-based Learning and Improvement Competencies [Program Requirement, IV.A.5.c).(1) through 3)] Residents are expected to develop skills and habits to be able to identify strengths, deficiencies, and limits in one’s knowledge and expertise; set learning and improvement goals; and, identify and perform appropriate learning activities.
The information provided did not demonstrate compliance with the requirement that the program provides opportunities for residents to develop the requisite competency in practicebased learning and improvement. The learning activity described the PIF includes presentation of a journal club or case conference.. It is unclear how this learning activity would require the resident to self-assess, develop learning goals, and to develop and implement a plan to address those learning goals (Program Information Form, p. 42).
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Nalberto (Nalberto)
New member
Username: Nalberto

Post Number: 2
Registered: 04-2013
Posted on Monday, April 01, 2013 - 01:57 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Would appreciate very much if the council would be able and willing to offer our program advice as to how we can address and improve our program with respect to the citation that our program recieved at our last site visit and listed below.

Would also like to know as to what other TY Programs are doing to remain in compliance with the Practice-based Learning and Improvement Competency

Citation :
Practice-based Learning and Improvement Competencies [Program Requirement, IV.A.5.c).(1) through 3)] Residents are expected to develop skills and habits to be able to identify strengths, deficiencies, and limits in one’s knowledge and expertise; set learning and improvement goals; and, identify and perform appropriate learning activities.
The information provided did not demonstrate compliance with the requirement that the program provides opportunities for residents to develop the requisite competency in practicebased learning and improvement. The learning activity described the PIF includes presentation of a journal club or case conference.. It is unclear how this learning activity would require the resident to self-assess, develop learning goals, and to develop and implement a plan to address those learning goals (Program Information Form, p. 42).
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Craigsr (Craigsr)
New member
Username: Craigsr

Post Number: 11
Registered: 05-2007
Posted on Monday, April 01, 2013 - 02:31 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We have developed a resident self-assessment process that each TY resident completes prior to his/her quarterly evaluation meeting with the Program Director. This includes having the resident complete a check list evaluating his/her skills in each of the 6 general competency areas. From this review the resident then develops a learning plan that identifies at least 3 areas that the resident wishes to work on and improve on during the next quarter. This plan gets reviewed and a new self-assesment and a new resident-generated learning plan is created at the time of the next quarterly meeting. The Program Director includes a brief summary of this process in the quarterly evaluation summary generated for each resident.

This seemed to be well-received by the site visitor at the time of our last site visit last year.

We are working on a new self-assessment process involving the proposed TY Milestones that we plan to share at the CTYPD meeting in Las Vegas in May 2013.

Steve Craig
Iowa Methodist Medical Center TY Residency
Des Moines, Iowa
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Marko (Marko)
New member
Username: Marko

Post Number: 4
Registered: 05-2006
Posted on Monday, April 01, 2013 - 04:55 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

RE: journal club, case Conf, and PBLI

All of the RRC's are now increasingly looking for not only process but also outcomes measurements related to those processes (presumably to judge their effectiveness).

For any activities which are listed under PBLI there must be assessment measures attached. To stay specific to your post--if you review articles in journal club how do you assess whether what was presented had had impact ? Example--if you review an article on the management of diabetics by following A1C trends , do you do chart reviews after the presentation to assess whether they are doing it or do you assign them the duty of charting and reporting back to you their own compliance with this clinical best practice ? In the example of the case conference it would be appropriate to simply have the resident list what changes in management of the disease process in question he/she will make based on the research and prep for the conference (...and add it to the residents's file under PBLI). Revisiting the issue later as a chart review and documenting it closes the learning activity-->behavior /habit change--> demonstrable outcome loop.

Marko Jachtorowycz,MD
Transitional Year Program Director
Presence Saint Francis Hospital
Evanston,Illinois
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Marko (Marko)
New member
Username: Marko

Post Number: 5
Registered: 05-2006
Posted on Monday, April 01, 2013 - 05:08 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

RE: General compliance w PBLI-2 practices

1-Our program utilizes structured curricula (GME on line curriculum formerly and now the AMA's Prep for Practice) which are targeted toward specific competencies (incl PBLI). These have built-in post tests. These passed muster on our last survey.

2-we are examining use of standardized quality measures [as in those required by CMS/Medicare or SCIP (surgical care improvement pgm)] as a measurable PBLI outcomes. Hospitals are all gathering this data (...and hiring people to do it) for reporting and reimbursement reasons. Thus the data is easily obtained from the quality improvement folks--requiring a minimum amount of effort for a
PD to acquire it . Following and trending this easily extractable data per resident would have the added benefit of involving residents in Quality improvement activities (CLER visit...) Examples are: pneumonia vaccination, ACE or ARB (or contraindication documented) at discharge for cardiac patients, smoking cessation, antibiotic choice, etc.
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Nalberto (Nalberto)
New member
Username: Nalberto

Post Number: 3
Registered: 04-2013
Posted on Tuesday, April 16, 2013 - 04:00 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

how much time off are transitional year residents allowed to take ( vacation/study time/sick time ) in the academic year before the program considers extending their training period....
and what implications does this have for their subsequent speciality training....
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Marko (Marko)
New member
Username: Marko

Post Number: 7
Registered: 05-2006
Posted on Wednesday, April 17, 2013 - 03:11 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The answer rests in multiple places--

1-TY Program Requirements: Any resident completing a Transitional Year must have 24 weeks of fundamental clinical skills (FCS), 1 month of emergency medicine (May be included in FCS if criteria are met), 140 hours of ambulatory experience, and a minimum of two electives--all those have be met regardless of time off, illness, vacation.

2-Your program contract and individual institutional policies (check your institution's contract).

What we do--One year, minus allowed vacation, PTO, etc. as stipulated in the resident contract will yield about 3 weeks (15 PTO days) in most places. Some allow additional PTO days (3-5) which can add up to another week. The number of extra days beyond this is at the discretion of the program director consistent with the institution and its established policy (-ies).

3-Certifying board:

Check the requirements of the ultimate certifying board (of the specialty in which the individual resident is planning to enter). Some Boards are very specific in terms of how many weeks of what they require in the PG-1 year while others are less specific. If an absence from training would compromise fulfillment of any requirement stipulated therein, the program director bears the responsibility of prolonging training to ensure that those requirement are met.

Examples:

Ophthalmology : http://abop.org/board-certification/requirements/

Neurology (page 15 of this pdf); http://www.abpn.com/downloads/ifas/2013_IFA_Cert_N-ChiN_AFTER_111512.pdf

Etc.

4- Verifying competency: It is ultimately the responsibility of the program director to make certain that a resident has reached the level of clinical competency expected for a PG-1 before being credited for the year of training. The PD has latitude regarding time off but is also charged with the responsibility of the final say on competence and fitness.

Please note that other specialty RRCs may be more prescriptive and may offer more precise answers.
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Craigsr (Craigsr)
New member
Username: Craigsr

Post Number: 12
Registered: 05-2007
Posted on Thursday, April 18, 2013 - 11:23 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I agree with Marko that we consider these resident requests on a case-by-case basis. I would add that when thse requests occur, if it is clear that the requested leave of absence is going to exceed alloted vacation + up to 1 week of personal time, we contact the resident's categorical program and explain that there may be a delay in the start date for categorical training. The categorical program can work with the involved resident and us to determine how much time will be missed and what affect this will have on TY training and the start of categorical training and the subsequent completion of categorical residency training.
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Marko (Marko)
New member
Username: Marko

Post Number: 9
Registered: 05-2006
Posted on Monday, May 20, 2013 - 11:05 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The ACGME's TYRC has posted the training milestones for Transitional Year Residents. They can be viewed at:

http://www.acgme-nas.org/assets/pdf/Milestones/TransitionalYearMilestones.pdf
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Marko (Marko)
New member
Username: Marko

Post Number: 10
Registered: 05-2006
Posted on Monday, May 20, 2013 - 11:07 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The ACGME's TYRC has posted the training milestones for Transitional Year Residents. They can be viewed at:

http://www.acgme-nas.org/assets/pdf/Milestones/TransitionalYearMilestones.pdf

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