Spring 2016

News from the  TMA Resident and Fellow Section   


Join Your Colleagues in Dallas for TexMed 2016 

TexMed 2016, TMA’s annual meeting, is just around the corner. Join us from April 29–30 at the Hilton Anatole in Dallas, where we will explore Bridging the Gaps in health care. 

Physician leaders of different specialties from across the state come to TexMed to learn, network, and shape the future of Texas medicine. 

At TexMed you can choose from more than 80 hours of free CME programming. Topics include everything from value-based care and the future of medicine to quality initiatives and telemedicine.

Conference attendees also can help mold TMA policy and business decisions by heading to the House of Delegates and participating in reference committee meetings. All TMA members can testify at the reference committees on resolutions presented before the house. 

And the EXPO provides a great way to see the newest in medical devices, technology, and practice services. Sign up for a free, 15-minute Quick Consult at the TMA Member Services booth #263 and meet face-to-face with TMA staff experts to ask specific questions on various topics, or to address your general practice needs.

Register today, or check out the Advance Program for more information.  

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TMA-RFS to Elect Executive Council Members During TexMed 2016

The TMA Resident and Fellow Section (RFS) Executive Council elects officers annually to direct section activities. Elections for the 2016-17 term will be held during TexMed 2016 on April 29. To apply, submit a letter of intent and CV to your section coordinator.        

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Don’t Miss the RFS Meeting at TexMed 2016

Join us for the next Resident and Fellow Section (RFS) Business Meeting on Friday, April 29, at the Hilton Anatole in Dallas during TexMed 2016. Conference attendance is free for TMA members. 

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 Apply Now to Serve on TMA Boards, Councils, Committees

If you’d like to serve as a representative on a TMA board, council or committee, submit an application by April 15, 2016, to your section coordinator. Resident and fellow representatives serve one-year terms starting in June. Appointments are made during TexMed 2016

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 State Announces Final GME Expansion Grant Awards for 2016-17

The Texas Higher Education Coordinating Board (THECB) has finalized its awards for graduate medical education (GME) expansion grants. On Jan. 26, as reported in the February edition of It’s Academic, THECB announced provisional awards, which didn't change.  

Senate Bill 18 by Sen. Jane Nelson (R-Flower Mound) and Rep. John Zerwas, MD (R-Richmond), authorizes the grants. A total of $49.2 million will fund 683 residency positions at 65 programs. Of the 683 funded positions, 224 received grant funds for fiscal year (FY) 2016, and 459 received grant funds for FY 2017. Some positions received funding in both years.  

The board took the unusual step of announcing provisional grant awards in January in recognition of the Jan. 31 deadline for residency programs to submit 2016 match quotas to the National Resident Matching Program. This deadline was critical to allow for new residency positions in the match.  

Almost 100 residency programs submitted grant applications, and the total requested amount exceeded available funding by 50 percent.  

The agency used these priority levels in determining the grant awards:  

Residency positions initially funded through state grants in 2014-15
(Expected $65,000 per resident, per year)
FY 2016: 167
FY 2017: 273 

New primary care residency positions
(Expected $75,000 per resident, per year)
FY 2016: 44
FY 2017: 150 

$3.675 million for new residency positions in psychiatry
(Expected $75,000 per resident, per year)
FY 2016: 13
FY 2017: 36 

No funding was available for the last priority level encompassing new positions or new residency programs in specialties not included in the three top priority levels. Grant funds will be dispensed after verification that the residency positions have been filled. 

The University of Texas Health Science Center at Houston received the largest amount of grant funding at $6.46 million, followed by Doctor’s Hospital at Renaissance in Edinburg at $6.39 million, and Baylor College of Medicine at $6.2 million. Total awards for other educational institutions and hospitals ranged from $225,000 to $4.5 million, as shown in this table. 

March 4, 2016: It's Academic THECB 2016-17 GME Expansion Grant Awards

 Stay tuned for an additional opportunity to apply for state GME expansion grants in March, when THECB plans to issue the request for applications for the Planning and Partnership Grant Program. SB 18 broadened the previous Hospital Planning Grant Program. In addition to hospitals, medical schools and community-based ambulatory patient care centers, such as federally qualified health centers or teaching health centers (as defined by the federal government), are now eligible to apply. The grant must be used for planning a new GME program with first-year residency positions.

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 Texas Launches Loan Repayment Program for Mental Health Professionals

The Texas Higher Education Coordinating Board (THECB) launched the Loan Repayment Program for Mental Health Professionals to help expand the state’s mental health workforce and improve access to mental health services in Texas. 

The program, created by the passage of Senate Bill 239 by Sen. Charles Schwertner, MD (R-Georgetown), and Rep. John Zerwas, MD (R-Richmond), offers student loan repayment assistance for qualified psychiatrists, psychologists, licensed professional counselors, psychiatric mental health advanced practice nurses, and clinical social workers who agree to provide direct care to underserved Texans. 

THECB is now accepting online applications for the program. The application deadline is May 6. 

“Texas needs a mental health workforce capable of meeting the growing needs of our growing state,” Senator Schwertner said. “Without an adequate number of mental health professionals, we will continue to see those experiencing mental illness cycle through our jails and emergency rooms at great expense to the taxpayer.” 

More than $2 million will fund the program through the 2016-17 biennium — an amount expected to provide more than 100 new health professionals, including 25 physicians, two full years of loan repayment. 

This is the second state loan repayment program available to psychiatrists. The state’s Physician Education Loan Repayment Program has offered loan repayment to psychiatrists for decades. Both programs require practice in an underserved area and offer up to $160,000. 

“The Loan Repayment Program for Mental Health Professionals is a critical piece of the overall investment made by the legislature to help solve the state’s mental health crisis,” said Representative Zerwas. “We must continue to work at addressing all aspects of this difficult issue that touches so many Texas families.” 

The shortage of mental health professionals represents one of the state’s most serious health care challenges, according to Gov. Greg Abbott’s Healthy Texas plan. 

For more information on the program, email THECB or call (800) 242-3062.  

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 TMA Council on Medical Education Forms GME Funding Sources Workgroup

The 2015 Texas Legislature took the monumental step of establishing the state’s first-ever permanent fund for graduate medical education (GME). Recognizing the unique opportunity for long-term GME funding, the TMA Council on Medical Education late last month established a Workgroup on Sources of GME Funding. The workgroup plans to hold its first meeting in late February to begin identifying and evaluating various proposals for funding GME, including potential sources of funding for the permanent fund. 

Senate Bill 18 by Sen. Jane Nelson (R-Flower Mound) and sponsored by Rep. John Zerwas, MD (R-Richmond), identified the first potential funding source for the GME permanent fund. The bill directs the Texas Department of Insurance to conduct an assessment of any unneeded funds at the state’s Joint Underwriting Association. Any identified unneeded funds are to be transferred to the GME permanent fund. The fund can accept donations and grants. 

Watch for future updates on the workgroup’s activities in RFS Connection.  

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 THECB Tracking Texas Med School Graduates, Residents Completing Training

Texas will begin tracking Texas medical school graduates who remain in the state for residency training, as well as residents who complete training and become licensed in the state. Senate Bill 295 by Sen. Charles Schwertner, MD (R-Georgetown), requires the Texas Higher Education Coordinating Board (THECB) to track the initial medical training information for Texas medical school graduates and the initial practice choices of those completing residency programs in the state. Residents will be tracked two years following completion of residency to determine their practice specialty and practice location. The agency will identify whether and for how long physicians work in primary care in the state.

Following the 2016 National Resident Matching Program and American Osteopathic Association Match, the coordinating board plans to collect match results for fourth-year medical students in the state. They will partner with the Texas Medical Board to collect practice information for residents completing training who then go on to receive a Texas medical license. 

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Medical Education in Texas Undergoes Major Reformation

Texas is taking on the challenge to reform its medical education system and maintain enough physicians for a growing statewide population. The March issue of Texas Medicine magazine takes a look at why Texas has one of the lowest ratios of physicians to patients of any state in the country — ranking 43rd in the nation — and what strides the state is taking to improve that ratio. 

Texas Medicine’s special medical education symposium issue has articles and commentary written by physicians for physicians, examining medical education in the Lone Star State. The issue aims to educate physicians about the transformation of medical education and how Texas is moving forward with new reforms, preparation of medical students for future challenges, increased state funding for fellowship programs, and the expansion of graduate medical education positions for any medical graduate who chooses to remain in state for graduate training

“There has been great concern about the physician shortage nationwide and in Texas,” said Surendra K. Varma, MD, coeditor of Texas Medicine’s symposium issue, and vice chair of pediatrics at Texas Tech University Health Sciences Center (TTUHSC). “Texas’ residency positions trail the number of medical graduates Texas produces annually. The unmatched graduates look outside Texas for residency positions. There is general consensus that the majority of residents settle closer to their respective place of training. This could contribute to a physician shortage in Texas,” Dr. Varma said. 

“It’s in our best interest to find room for all of our high-quality graduates, or we risk losing them to other states,” said Christian Cable, MD, a member of the TMA Council on Medical Education and director of the hematology-oncology fellowship at Baylor Scott & White in Temple. 

The current state of education reform, in Texas and nationwide, goes back to 2010 and the Carnegie Foundation’s report, Educating Physicians: A Call for Reform of Medical School and Residency. Texas Medicine magazine examines how the report sparked a national movement in medical schools to implement competency-based education; greater integration of students into health care delivery; and professional identity formation, which establishes core values, moral principles, and self-awareness; and in some schools to consider three-year medical curricula. 

Christina M. Gutierrez; Susan M. Cox, MD, and John L. Dalrymple, MD, authors of the article “The Revolution in Medical Education,” describe Texas’ current medical education reformation paradigm as “creating entirely new models that incorporate unique curriculum elements with the latest knowledge in learning and assessment strategies and innovative teaching methods, as well as technology to better equip students for the medical practice of tomorrow.” 

The reformation also is helping Texas meet its future health care needs in rural areas by way of the Family Medicine Accelerated Track, a three-year curriculum that links medical students to family medicine residency programs at TTUHSC campuses in Lubbock, Amarillo, or the Permian Basin (Odessa and Midland). 

Nancy Dickey, MD, president emeritus of Texas A&M Health Science Center and professor of family and community medicine at Texas A&M College of Medicine who contributed the symposium issue article “Retaining Medical Graduates in Texas,” said, “Texas is committed to ‘growing its own’ physicians to meet the workforce needs of the state’s population. Ongoing attention to creating and protecting a satisfactory environment for the practice of medicine will not only help keep Texas graduates in the state but will also facilitate continued efforts at in-migration.” 

Visit the TMA website to read these articles and more: 

  1. Furthering Medical Education in Texas” by Surendra K. Varma, MD, and John Jennings, MD;
  2. Costs Associated With Residency Training” by Lois L. Bready, MD, and M. Philip Luber, MD;
  3. Experience-Based Lessons From Rural Texas Graduate Medical Education” by Lisa R. Nash, DO; Tricia C. Elliott, MD; and Jorge Duchicela, MD;
  4. The Next Accreditation System: Will Residents Be Better Prepared for Medical Practice?” by Lynne M. Kirk, MD;
  5. The Revolution in Medical Education” by Christina M. Gutierrez; Susan M. Cox, MD; and John L. Dalrymple, MD;
  6. The Family Medicine Accelerated Track at Texas Tech University Health Sciences Center” by Betsy Goebel Jones, EdD, and Steven L. Berk, MD; and
  7. Retaining Medical Graduates in Texas” by Nancy Dickey, MD. 

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Become More Business Savvy with Help from TMA

Visit TMA’s new Business of Medicine resource page for information and education on the fundamentals of the business side of medical practice, including contract negotiation, human resources management, financial policies, and more. Read more about life after residency in the April issue of Texas Medicine

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AAMC Report Highlights Top Practice Trends Among Recent Residents

A Feb. 10 AMA Wire article focuses on the three key post-residency trends from the Association of American Medical Colleges’ (AAMC’s) annual Report on Residents. They are: 

  1. Almost one-quarter of recent residents practiced in medically underserved areas.
  2. More than one-half — 52.9 percent — of recent residents now practice in the state where they did their residency training.
  3. A notable percentage of residents landed faculty appointments after training.   


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Study Says Longer Shifts by Surgeons-in-Training Don’t Harm Patients

A Feb. 2 Kaiser Health News story reports “patients suffered no extra harm when doctors training to be surgeons were allowed to work longer shifts,” according to a New England Journal of Medicine study. The study’s findings come at a time when the Accreditation Council for Graduate Medical Education (ACGME) is “reassessing requirements that prevent residents from working extremely long stretches or back-to-back shifts.” 

For more information, read the ACGME letter to the graduate medical education community. 

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 Stay Connected

Keep up with important news and connect with colleagues across the state through the RFS Facebook page

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