April 2018 MPPDA Bulletin

Great to see so many familiar AND new faces in San Antonio!

Meeting Feedback and CME:

If you haven’t yet filled out your AAIM evaluation (and claimed your CME credits), check your 3/22 emails for something from surveys@IM.org. Friday, April 20th is the deadline to claim.

And MPPDA-specific feedback is needed, direct-to-us using this link: https://redcap.urmc.rochester.edu/redcap/surveys/?s=43M94DPW3X

It’s not too early to volunteer for the 2019 Planning Committee by reaching out to Mike Aylward (aylwa002@umn.edu)

If you want new pics or any updates on your program’s slide in the places&faces slideshow, forward to me: Suzanne.mclaughlin@lifespan.org.

Interested in nominating someone to an award, or a leadership role in MPPDA?

Moving forward, MPPDA will use the award and leadership timing of AAIM – so watch in April/May for requests for nominations for the MPPDA Leadership Award, the Brendan Kelly Award, the Tunnessen Award and…introducing a new award recognizing an Association of MedPeds Program Adminstrators (AMPPA) member for outstanding contributions to their own MedPeds program and MP nationally. Nominations for the Executive Committee, including President-elect and Member Representative, will open in September.

Here are some meeting updates, including summaries from the committees and affiliates:

Recruiting/Match results:

In 2018, seventy-seven Med-Peds programs participated in the Match. A total of 382 positions were offered. There were 374 US seniors (allopathic) and 580 applicants (total) for Med-Peds positions. The fill rate in the 2018 MATCH was 99% for Med-Peds, consistent with the 5-year average of 98%. Med-Peds remains highly competitive among comparable specialties in terms of applicant positions, but has seen less growth in overall number of positions offered.  From 2014 to 2018, MP saw a 2% increase in the number of offered positions, while related specialties experienced increases of 14% categorical IM, 10% primary care IM, 5% pediatrics and 15% family medicine.

Changes in Med-Peds programs nationally: Med-Peds has seen the addition of several new training programs in recent years, most recently the University of Texas, Southwestern, with four positions in the 2016 Match. Shifts in health system alignments contributed to the closing of the Med-Peds program at University of West Virginia’s Charleston Area Medical Center (2 positions), and will lead to an integration of the Rutgers (4 positions) and Newark Beth Israel Medical Center (2 positions) programs to be completed in 2021, and retaining the 4 positions of the Rutgers program. Mt. Sinai, New York, is developing a program and intends to pursue 4 positions in the 2019 Match. These current plans would place 386 positions in the 2019 Match.

ACGME Updates: AY 2017-18 has seen the roll-out of the first major revision of the Combined Medicine-Pediatrics Program Requirements. MPPDA membership and the Accreditation Committee worked on reviewing and recommending revisions, and the requirements were published in September, 2017, and will become effective July, 2018. Membership has been able to provide feedback on the Common Program Requirements this March, was able to weigh in directly last week on the question of combined versus categorical milestones, and anticipates offering input to the Milestone revisions upcoming.

ACGME Accreditation- Jane Trinh, MD

This committee works with the ACGME, RRC, ABP, ABIM, APPD and APDIM and our membership on issues relating to the process and requirements for accreditation. The most recent update:

The MPPDA accreditation committee worked with the MPPDA Executive Committee in aggregating responses from the MPPDA membership to submit to the ACGME for the revised MP Program Requirements, which go into effect July 2018. In addition, we led a workshop on ACGME Self-Study and 10 year accreditation site visit preparation at the annual MPPDA meeting, in conjunction with APDIM. We had robust participation from MP programs, as well as IM programs. We will be putting together a list of MP programs, contacts, and self-study dates to be available for programs to collaborate, and will collate resources for MP program on this process.

Transition Care – Alice Kuo, MD

This group promotes the care of patients transitioning from pediatrics to adults as an important quality issue. We have developed national goals and objectives, on-line resources with the American College of Physicians, and produced a reference book published by Springer through the Society for General Internal Medicine. This year we are conducting a residency learning collaborative using the Institute for Healthcare Improvement’s Breakthrough College Series methodology with 22 residency programs to implement residency curricula focused on teaching learners about how best to transition pediatric patients to the adult health care system. We expect to have tools available by the end of 2019, along with data demonstrating the value of incorporating transition-related curricula in primary care residency training.

Recruitment – Allen Friedland, MD and Ron Magliola, MD

This group works on issues related to student education and recruitment. The primary focus is to disseminate high quality information to medical students about primary care careers, specifically the Med-Peds pathway. The committee updated written and web-based recruitment materials including new executive summary sheets for students and academic advisors at both allopathic and osteopathic medical schools. The committee presented a workshop on cultivating Med-Peds awareness via student interest groups at the Association of Pediatric Program Directors conference. The committee also celebrated the 50th anniversary of Med-Peds by collaborating with other Med-Peds organizations to host the National Med-Peds Residents’ Association meeting and 50th Anniversary Gala in Chicago, Illinois. Early release MATCH 2018 data was reviewed, summarized and disseminated by the committee and some of those results are reported in the opening of this report.

Research – Anoop Agarawal, MD

This group works on research questions in areas that are important to med-peds as well as have translational benefit for categorical programs and/or family medicine. The group serves as a resource for people interested in developing projects, connecting potential researchers with mentors and collaborators, and facilitating the combining of projects where possible to avoid unnecessary duplication. The committee serves as a workgroup of physicians monitoring the literature and identifying important gaps in our current knowledge of med-peds, including spearheading projects to address these gaps. Perhaps most importantly, they are the group that surveys our membership annually to provide our organization with med-peds specific national data and trends including – demographics, program structure, program resources, faculty and program financial statistics, work-force data, resident interest career plans, and program challenges. The most recent updates:

Impact of Pediatric Hospitalist Fellowships on graduate career choices.

The MPPDA is interested in defining statistics about the professional careers of the graduates of combined Med-Peds training programs. With the recent accreditation of a pediatric hospital fellowship program, MPPDA is aiming to closely monitor the impact on career choices of those pursuing training as a med-peds hospitalist vs. medicine hospitalist vs. pediatric hospitalist. MPPDA will also be tracking the number of graduates electing to pursue the pediatric hospital fellowship.

Impact of X+Y scheduling on continuity clinic experiences

Changes and innovations in continuity clinic requirements such as X+Y and the recent RC guideline revisions have the potential to impact residency program compliance with ACGME requirements. MPPDA will be tracking the trends as it relates to the requirements and overall educational experience for our trainees.

Curriculum- Michael Aylward, MD (transitioning to Jaideep Talwalkar, MD)

This group serves to develop best practices in teaching curriculum for med-peds trainees to ensure excellent outcomes of our graduates in all the general competencies. Members are encouraged to have their curricula submitted to peer-reviewed clearinghouses such as AAMC’s MedEdPortal. Curricula that allow translation of med-peds emphasis to strengthen categorical programs is strongly encouraged (sports medicine for the internist, palliative care principles for the primary care provider, etc.). The most recent update:

This group serves to develop and share best practices in teaching curricula for med-peds trainees. Curricula that address the unique needs and challenges of combined training programs or allow translation of med-peds emphasis to strengthen categorical programs. Previously, this group collected curricula and assessment tools specific to med-peds and housed them on a large Google document that is linked to the MPPDA web site for all members to access, contribute to and view. In the past year, they used a scoring rubric for peer reviewing and annotating these tools, and highlighted highly-rated submissions in the MPPDA newsletter and at the annual meeting.

MPPDA affiliates:

The Association of Med-Peds Program Administrators (AMPPA) was formed to foster best practices and support for the program administrators in Med-Peds residencies across the country. The group meets at the annual MPPDA meeting with focused breakout sessions, and has regular call-in sessions and email exchanges to share information and provide support to members. AMPPA’s president is an ex-officio member of the MPPDA Executive Committee and participates in planning for the annual meeting. A recognition award for excellence in program administration is under development and an inaugural award will be made in 2019.

The National Med-Peds Residents’ Association is a key partner in supporting med-peds residents and recruiting medical students to the specialty. MPPDA members attend their national and regional meetings (upcoming regional meetings: Newark, April 14th; Albany, May 19th and LAC+USC, May 5th; 2018 National Meeting Orlando, FLA Nov 3rd). In a recently proposed activity that would benefit from the involvement of pediatric fellowship directors, and in conjunction with the Association of Specialty Professors, an AAIM group representing fellowship directors), MPPDA hopes to collaborate with NMPRA in the coming year on developing a set of “best practices for combined fellowship” that would build on the success of NMPRAs Guide to Combined Med-Peds Fellowships. Guidance would be of benefit to residents and adult and pediatric fellowship directors.