It's Academic

January 2017 


  Texas Programs Highlighted in GME Innovations Report

A Nov. 30, 2016, AMA Wire article highlights findings from the Innovations in Graduate Medical Education report from the Josiah Macy Jr. Foundation. The report recognizes several Texas graduate medical education (GME) programs for their collaborative practices and innovative training. The report’s six themes, which “help define new directions” for GME, are:   

  1. Residents can be empowered to improve the quality and value of care.
  2. GME must be outward-looking.
  3. GME is expanding, creating new partnerships, and developing training opportunities in different settings.
  4. Training will become more individualized.
  5. Focus on the importance of teamwork training and interprofessional collaboration.
  6. The funding of GME must be more diversified.    

The final theme on diversified GME funding cites Texas as an example of a state with funding initiatives that “address the physician shortage and … increase the number of doctors in rural or underserved areas.”   

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 FIRST Trial: Residents More Satisfied With Patient Safety, Care Continuity

A Nov. 28 HealthLeaders Media article reports general surgery residents are more satisfied with patient safety and continuity of care with flexible duty hours. The findings are based on an analysis of the Flexibility In duty hour Requirements for Surgical Trainees Trial (FIRST Trial), published on the Journal of the American College of Surgeons website. This analysis focused on the impact of duty hour restrictions on residents by year of training.  

“Eighty-six percent of the FIRST Trial participants preferred flexible duty (work) hour policies over standard duty hours, or had no preference,” the article states. Residents in all years of training preferred the flexible work hours. This adds to earlier FIRST Trial research findings published by the New England Journal of Medicine in February that found no increased risk of death or serious complications for patients of surgical residents with flexible duty hours.  

However, the more recent research also found that “residents in programs with flexible duty hours were more likely to report that duty hour policies had a negative effect in areas such as their rest and leisure time.” 

The Accreditation Council for Graduate Medical Education (ACGME) accepted public comments on proposed changes to accreditation standards, including resident work hour restrictions for U.S. residency and fellowship programs, over a 45-day public comment period that ended Dec. 19. Implementation of the proposed changes is targeted for the 2017-18 academic year.  

ACGME reports “the revised requirements do preserve core elements from the 2003 and 2011 ACGME Requirements, including a weekly limit of 80 hours, averaged over a four-week period, a 24-hour limit on continuous assigned clinical and educational work, the requirement that residents receive one day in seven free of all duties, and that in-house call be scheduled no more frequently than every third night.” The “existing requirement limiting PGY-1 residents to 16 hours of consecutive time on-task” has been removed in the proposed changes. 

The FIRST Trial’s objective is to assess whether current resident duty hours are detrimental to patient care and resident training. A cluster-randomized trial design was used across 154 hospitals, including several in Texas, to determine if more flexible work hour limits make a difference in postoperative outcomes.  

The American Board of Surgery, the American College of Surgeons, and ACGME financed the trial. ACGME issued waivers of relevant standards for participating programs in the trial and provided seed funding from its reserves.  

Findings from a similar research project on duty hours for internal medicine residents is expected in 2017. The Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education, or iCOMPARE, is led by investigators from the University of Pennsylvania, Johns Hopkins University, and Brigham and Women's Hospital/Harvard Medical School. 

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2017 TMA Winter Conference: Physician Leaders Unite

Reconnect with colleagues while earning continuing medical education credit at the 2017 TMA Winter Conference at the Hyatt Regency Austin downtown, Jan. 27–28. Whether facing local or national health care challenges, physicians unite under the TMA umbrella to improve the health of all Texans. Join the conversation and your colleagues for collaboration and education.

Attend the General Session on Saturday from 8:30 am to noon to hear how health insurers are adapting to the changing health care landscape and how it will affect you. You'll also learn how physicians are responding to physician-led accountable care organizations, receive a legislative update, and hear the story of a Dallas trauma surgeon who responded to the Dallas police department shootings. Check out the conference agenda for more details. 

All Saturday meetings will take place at the Hyatt Regency Austin. The group rate is $199 plus tax. TMA expects rooms to sell out, so make your reservation online today, or call (888) 421-1442.

Meetings will take place on Friday, Jan. 27, at both the Hyatt Regency and the TMA building. A shuttle will be provided. The first shuttle will leave the Hyatt at 7 am, and the last shuttle will leave the TMA building at 8:30 pm. 

You can register for the conference online, or you can register on site Friday at the TMA building from 7 am to 7 pm or at the Hyatt from 7:30 am to 7:30 pm. Registration is available at the Hyatt on Saturday from 6 am to 12:30 pm.

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Survey Finds Low Physician Morale Affects Future Workforce

The Physicians Foundation’s 2016 Survey of America’s Physicians: Practice Patterns & Perspectives found 46 percent of the nation’s physicians plan to accelerate their retirement, cut back on patients, or seek nonclinical roles. That’s compared with 54 percent of Texas physicians who say they plan to accelerate their retirement. Of 17,236 survey responses, 2,044 were from Texas physicians. 

Additionally, the survey finds 21 percent of Texas physician respondents plan to cut back on their hours over the next one to three years. Sixty-one percent of Texas physicians surveyed say their morale is somewhat or very negative — the highest rate in the nation — and 51.5 percent say they either often or always feel burned out. 

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Submit NRMP Board of Directors Nominations by Feb. 1

The National Resident Matching Program (NRMP) is seeking nominations for these positions on its board of directors:  

  • A director,
  • Three resident physician/fellow directors (one must be an international medical graduate), and
  • A student director.  

NRMP is governed by a board of directors that includes representatives from national medical and medical education organizations, medical students, resident physicians, and graduate medical education program directors. 

The term of service for the director is four years, with a maximum of two terms. The term of service for resident physician/fellow and student directors is two years, with the option for an additional one-year term if the person maintains resident or student status for the entirety of the second term. The board meets three times a year, usually in January, May, and October. Additional day-long meetings and telephone conference calls may be required for board committee work. Learn more and submit a nomination by Feb. 1. 

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AMA Education Consortium Releases Health Systems Science Textbook

Developed by the American Medical Association’s Accelerating Change in Medical Education Consortium, Health Systems Science is available for preorder. The textbook provides a fundamental understanding of how health care is delivered, how health care professionals work together to deliver that care, and how the health system can improve patient care and health care delivery. 

With comprehensive, practical guidance, this textbook offers:   

  • Relevant content applicable to medical and health professions students training to work in today’s evolving health care system;
  • Chapters written by experts in core areas of health systems science; and
  • A Student Consult e-book version included with purchase that enables access via a variety of devices to the complete text, images, and references.  

The book is $54.99 for AMA members and $59.99 for nonmembers. Preorder Health Systems Science through the AMA store or by calling (800) 621-8335. 

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This Month in Texas Medicine

The January issue of Texas Medicine features a 2017 legislative session preview, which delves into TMA’s plan to build on significant successes medicine achieved over the past two legislative sessions, including reforming the state’s Medicaid program and expanding graduate medical education opportunities. In the issue you’ll also find coverage of TMA’s scope of practice court victory against the Texas Board of Chiropractic Examiners, an explanation of the final rule to implement the Medicare Access and CHIP Reauthorization Act, and what’s involved in achieving patient-centered medical home status.

You can subscribe to RSS feeds for TMA Practice E-Tips, TMA news releases, Blogged Arteries, and Texas Medicine. More

It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page and Advocacy page on the TMA website.

Please share with your colleagues who are not TMA members and ask them to join.

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