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Audrea79 (Audrea79)
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Username: Audrea79

Post Number: 6
Registered: 07-2019
Posted on Monday, April 04, 2022 - 03:53 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hi,

What is your process for determining how early you allow your TY residents to leave in the last block for their new program? Our current process is that we encourage them to save some PTO days to use while they transition but I'm noticing this year that some programs are wanting the residents on-site the second week of June of which the residents are still on rotation. Please share your process.
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Cphillips (Cphillips)
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Username: Cphillips

Post Number: 1
Registered: 05-2021
Posted on Tuesday, April 05, 2022 - 12:28 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hi! We recommend our TY's end their year on a research elective month, so that months schedule is more flexible.
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Mccajb (Mccajb)
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Username: Mccajb

Post Number: 5
Registered: 05-2016
Posted on Tuesday, April 05, 2022 - 05:15 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hello,
Thank you for this question.I want to address the issue of advanced PGY-2 programs starting earlier and earlier as well as our process at UPMC Medical Education TY program.
As a TY program director (PD) I have had this issue happen increasingly over the years. In my humble opinion, the biggest PD concern here is assuming the resident wants to leave early versus the resident is being told to leave and can’t/won’t say “no” to the advanced program. There are many “solutions”, and I believe it is my PRIMARY responsibility to be resident and education-focused in my approach for my learners. I will always defend their contracted time with us, if that is their wish. I believe it’s unfair for advanced programs to require TYs to be there before their PGY-1 contracts end. I recognize this question is about “how" to get them to that next program, but I am playing the devil’s advocate and asking “Why is this OUR problem?”.

How we do this at UPMC;
Most importantly, we start PGY-1 mid-June (i.e. June 16th, 2022) and end a week before July 1 (6/23/2023). The system has an earlier June orientation and a July orientation, depending on the program start dates. So it is flexible. Most PGY-1’s start in mid/late June.
Due to the early start, TY residents have a week to transition from PGY-1 to PGY-2 both geographically and emotionally. (I think THIS is what helps all the way around)
In the event a PGY-2 program asks for the TY before their TY training is over, I alert the advanced program that the resident is in our program and contracted until a certain date. They can come afterwards.We also attempt to ameliorate any needs the resident has with this transition. In this way, the education of the TY resident is not interrupted by an early PGY-2 start
The TY resident CAN AND SHOULD use their PTO or vacation when they need it - in September, January, April whenever and NOT forced to at the end of the year. TY programs have to make all kinds of changes and concessions to allow residents to have an elective as their last rotation and have "time off at the end". We are “Robbing Peter to pay Paul”. Having an elective last is not always possible for many TY programs. ALL residents' well-being is tied to their ability to have time off when needed. ACGME Section VI.C. Well Being matters.
However, if the TY resident desires to use PTO/vacation to move and prep before the advanced program starts, we put them in a non-required elective and they complete their TY training, as many others have mentioned.
In summary - there are obviously many ways to manage this request. I believe it is my job, as program director, to determine the resident’s desire to comply with this PGY-2 request to leave their TY program early. I then advocate for our TY residents while challenging the PGY-2 start date “creep” that keeps getting earlier and earlier. My 2 cents.

Sincerely,
Julie

Julie B. McCausland, MD, MS, FACEP
Associate Professor of Emergency Medicine and Medicine || Transitional Year Program Director, UPMC Medical Education|| Co-Chair, Professional Development Subcommittee of the GMEC
EM office 412 647-3078 || TY office 412 692-4945 || Cell 412 298-9095

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