The Professional Graduate Medical Education Training Program Administrator

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The Professional Graduate Medical Education
Training Program Administrator

• Ruth H. Nawotniak MS, C-TAGME
• UB SUNY Surgery Training Program Administrator
• TAGME New Specialty Development Committee
  Co-Chair

2
Traditional Role of the Coordinator

• Den mother (father)
• Cheerleader
• Liaison between residents and the program
  director
• Contact between faculty and program director

• Data entry person
• Information resource
• Social/event planner
• Scheduler
• Support staff

3

• In the traditional perception of
• the role, what is often not
• acknowledged is that the
• coordinator is counselor,
• advocate, resource and advisor
• to both.

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What did the ACGME outcome project do in regards
to managing training programs?
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• For the Program Director
• Changed expectations
• Increased
• the scope and depth of the function of the
  program director
• responsibility for the development of program and
  curriculum to meet accreditation standards,
  requiring substantial time, effort, and
  commitment
• expertise in medical education and adult learning
  processes and concepts

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• For the Program Coordinator
• Changed Expectations
• Increased the scope and depth of the function of
  the program coordinator
• Established the importance of the administrative
  management of the training program the
  coordinator
• Required
• a higher level of skills, ability and knowledge
  that elevated the position from
  clerical/secretarial to manager/administrator
• a closer working relationship with the PD

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Expanded Role of the Coordinator

• Liaison between residents and the program
  director
• Liaison between faculty and program director
  (Contact)
• Manager/Administrator (Staff Support)
• Data Analyst for Program Improvement(Data Entry)

• Information Resource for Requirements for all
  Regulatory Agencies
• Monitor Track Duty Hours/Competencies
  (Scheduler)
• Human Resources medical/legal issues
• Arbitrator

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• Tasks of a Manager/Administrator
• Manage and coordinate the crucial interview
  season pre-screen applicants we are often the
  face of the program
• Monitor and document evaluation processes
• Manage process for adverse evaluations and
  potential subsequent actions
• Understand accreditation, board, and institution
  requirements, including state and federal
  regulations
• Manage resident activities and schedules

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• Tasks of a Manager/Administrator
• Identify the competencies and understand their
  implementation and resident and program
  compliance
• Understand work hour regulations and monitor
  compliance
• Provide reports, summaries, and reviews of all
  training program activities
• Understand legal issues with regards to
  employment, visas, discipline, health care

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• Tasks of a Manager/Administrator
• Have knowledge of personnel and human resources
  issues
• Access the resources and Web sites involved in
  medical education
• Utilize networking and Internet opportunities
  efficiently and effectively
• Active involvement in site visit
• Provide solutions for data management issues
• Understand budgeting issues

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How Successful is the Individual Coordinator?

• How the program director views the position
• How much credibility s/he has with the residents

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The 6 competencies lead to a successful and
professional graduate medical education program
coordinator.
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1st Competency

• Training Program Management that is
  compassionate, appropriate, and effective for the
  treatment of accreditation issues and the
  promotion of the well-being of the training
  program.

• Patient Care that is compassionate, appropriate,
  and effective for the treatment of health
  problems and the promotion of health.1

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For the Professional Coordinator

• Competency 1 Resident, Program Director,
  Residency Program Care
• The Professional Coordinator needs to
• Effectively handle accreditation issues for the
  health of the program
• Appropriately care for all aspects of the
  residency program to keep it viable
• Be compassionate
• Be sensitive to and supportive of the needs of
  the Program Director

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2nd Competency

• Job Experience and Knowledge about established
  and evolving accreditation and board standards
  and processes and the application of this
  knowledge to the care of the training program.

• Medical Knowledge about established and evolving
  biomedical, clinical, and cognate (e.g.,
  epidemiological and social-behavioral) sciences
  and the application of this knowledge to patient
  care.2

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For the Professional Coordinator

• Competency 2 GME Knowledge
• The Professional Coordinator needs to know
• Common, Institutional and Clinical Specialty
  Program Requirements
• Evolving Board and accreditation processes and
  standards
• How to apply knowledge to care for the residency
  training program and keep it healthy

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3rd Competency

• Practice-Based Learning and Improvement that
  involves investigation and evaluation of their
  own patient care, appraisal and assimilation of
  scientific evidence, and improvements in patient
  care.3

• Practice-Based Learning and Improvement that
  involves networking and evaluation of the
  programs well being, appraisal and assimilation
  of the trends in graduate medical education and
  improvements in the care of the training program.

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For the Professional Coordinator

• Competency 3 Practice-Based Learning and
  Improvement
• The Professional Coordinator needs to
• Network about and evaluate the program
• Appraise the residency looking at trends in
  graduate medical education
• Improve the residency by applying information
  learned through networking and evaluation

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4th Competency

• Interpersonal Communication Skills that result
  in effective information exchange and teaming
  with the programs residents, attendings, and
  administrative staff as well as networking on a
  national basis with other graduate medical
  education programs and organizations, and the
  accreditation bodies.

• Interpersonal and Communication Skills that
  result in effective information exchange and
  teaming with patients, their families, and other
  health professionals.4

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For the Professional Coordinator

• Competency 4 Interpersonal and Communication
  Skills
• The Professional Coordinator must
• Communicate effectively with PD, residents,
  faculty, medical students, ACGME, the Board, GME
  office, and applicants
• Network with appropriate institutions and
  individuals for sharing information to enhance
  the residency
• Take a role as counselor, liaison, and advocate
  to heart, being able to listen, as well as being
  able to speak

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5th Competency

• Resource management, as manifested by actions
  that demonstrate an awareness of and
  responsiveness to the larger context and system
  of graduate medical education and the ability to
  effectively call on people or website resources
  to provide education and/or direction that is of
  optimal value.

• Systems-Based Practice, as manifested by actions
  that demonstrate an awareness of and
  responsiveness to the larger context and system
  of health care and the ability to effectively
  call on system resources to provide care that is
  of optimal value.5

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For the Professional Coordinator

• Competency 5 Resource Management
• The Professional Coordinator must
• Demonstrate an awareness of and an understanding
  of the larger context of graduate medical
  education
• Know not only where to go, but also be able to
  access websites and resources to find answers for
  the needs of the residency program
• Apply this knowledge for the improvement of the
  residency program

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6th Competency

• Professionalism, as manifested through a
  commitment to carrying out professional
  responsibilities, adherence to ethical
  principles, and sensitivity to a diverse patient
  population.6

• Professionalism, as manifested through a
  commitment to carrying out professional
  responsibilities, adherence to ethical principles
  and sensitivity to a diverse graduate medical
  education population.

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For the Professional Coordinator

• Competency 6 Professionalism
• The Professional Coordinator is
• Understanding and respectful of the confidential
  nature of our jobs
• Committed to doing the job in a responsible
  manner
• Committed to presenting a professional appearance

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Recognition and Acknowledgement

• Recognition of complexity of the position
• Recognition of the skills, knowledge and
  abilities need to perform the job
• Recognition of the managerial / administrative
  responsibilities
• Acknowledgement of a job well done

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Certification

• One form of recognition and acknowledgement
• By Coordinators
• For Coordinators
• Creation of the National Board of Certification
  for Training Administrators of Graduate Medical
  Education Programs - TAGME

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Terminology

• Why Certification?
• Certification VOLUNTARY, non-
• governmental, individuals are
• recognized for advanced knowledge
• and skill

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Process of Certification

• Application Criteria
• Successful completion of Assessments
• Monitored Assessment
• Core Components Focus
• Clinical Specialty Focus
• Work Effort Assessment
• Core Components Focus
• Clinical Specialty Focus

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Current Structure of TAGME

• Board of Directors - Permanent Members Approved
  to offer Certification (10)
• 2005 Pediatrics, Surgery
• 2006 Psychiatry
• 2007 Neurology, OB/GYN, Orthopedics, Physical
  Medicine Rehabilitation, Thoracic Surgery
• 2008 - Emergency Medicine, Family Medicine

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Current Structure of TAGME

• Subspecialties Approved to offer Certification
  (3)
• 2005 Pediatrics, Surgery
• 2006 Psychiatry
• 2007 Neurology, OB/GYN, Orthopedics, Physical
  Medicine Rehabilitation, Thoracic Surgery
• Vascular Surgery (Surgery)
• 2008 - Emergency Medicine, Family Medicine
• Child Adolescent Psychiatry (Psychiatry)
• Neonatal-Perinatal Medicine (Pediatrics)

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Current Structure of TAGME
Approved Task Forces Core Programs (9) 2007
Neurosurgery 2008 Diagnostic Radiology,
Internal Medicine, Med Peds, Otolaryngology,
Transitional Year 2009 Anesthesia,
Ophthalmology, Urology Task Forces in Formation
(1) 2009 Subspecialty of Child Neurology
(Neurology)
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Stages of Development
Initial Interest - Core Clinical Specialties
(3) Dermatology, Pathology, Plastic
Surgery Interested Subspecialties (3) Cardiology
(Internal Medicine) Pediatric Gastroenterology,
Pediatric Pulmonology (Pediatrics)
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Stages of Development
Interested Focus Groups/Organizations Osteopathic
Coordinators GME Office personnel Canadian
Coordinators
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Current Certified Coordinators
Surgery (05) 36 Vascular Surgery (07)
2 Pediatrics (05) 33 Neonatal-Perinatal (08)
6 Psychiatry (06) 23 Child Adolescent (08)
5 Thor Surg (07) 2 PMR (07) 11 Ortho
(07) 26 OB/GYN (07) 15 Family Med
(08) 15 Neurology (08) 6 EM (08) 8 (8
Candidates Spring 09) TOTAL 188
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Continuing Certification

• A 5 year period from the date of certification.
  
• Application includes continuation of initial
  criteria
• Attainment of CEUs
• If there is a national initiative in graduate
  medical education, a measurement tool will be
  designed and required to document understanding
  and expertise in this initiative for continuing
  certification

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The Future

• Expand the constituency of the National Board to
  include other medical education personnel
• ACGME Program Coordinators Division - current
• Osteopathic accredited in initial discussion
• GME Division in initial discussion
• Dental accredited ?
• Non-accredited ? SSO
• Program Directors ?

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The Future

• Establishment of the
• Journal for the Management of
• Physician-In-Training Programs

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What Certification Will NOT Do

• It will not get you a raise. Pay is determined,
  in part, by the structure of the employment
  agency and geographic area
• It is not intended to be a requirement for the
  job as experience on the job is a criteria for
  certification. Also, It is a VOLUNTARY process.

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What Certification WILL Do

• It will
• standardize the knowledge base
• acknowledge expertise and skills
• establish the coordinator position as a
  profession
• enhance the career
• facilitate career advancement and movement

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Application Deadlines

• www.tagme.org
• Spring Assessment Sept. 1 Nov. 30
• Sites Spring Conferences
• Geographically Located Open
  Assessment Sites in the future
• Fall Assessment March 1 May 30
• Sites Geographically Located Open Assessment
  Sites

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National Trends
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Bibliography

• 1,2,3,4,5,6 www.acgme.org
• Nawotniak R, Grey E. Program Coordinators
  Professional and Successful. Association of
  Residency Coordinators in Surgery Spring
  Conference, Tucson, AZ, 2006.
• www.tagme.org

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Thank You

• Ruth H. Nawotniak MS, C-TAGME
• General Surgery Training Program Administrator
• University at Buffalo SUNY
• Founder and First President - TAGME
• Co-Chair, New Specialty Development Committee -
  TAGME
• rhn_at_buffalo.edu