Escolar Documentos
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Handout
William W. Robertson, Jr., MD
The ACGME Site Visit-
Preparation and the Day
I. 9 “Red Flags”
• Lack of Program Leadership
• Lack of Infrastructure for Teaching and Evaluation
• Lack of Appropriate Volume and Variety of Patients
• Problems Resident (Fellow) Recruitment and/or Retention
• Lack of Dedicated Teachers (Number, Turn-over)
• Lack of Meaningful Didactics (Rounds, Conferences and Lectures)
• Lack of Financial and Human Resources
• Priority of Service over Education
• Lack of Preparation for the Accreditation Process
II. Preparation
A. Program Citations 2007-2009
1. Educational Program-61%
a. Patient care (procedural experience deficiencies - spine, foot,
pediatric, etc.)
b. Competencies
c. Duty hours (1 day in 7 free, 80 hours per week, etc.)
2. Program Personnel and Resources-16%
a. Qualifications of faculty
(with required expertise)
b. Responsibilities of Program Director (ensure residents use Case
Log System)
3. Institutional Support-11%
a. Facilities (educational space including library)
b. Sponsoring institution deficiencies (time, funding, facilities)
4. Evaluation-10%
a. Resident evaluation (Summative evaluations not provided)
b. Program evaluation (confidentiality, must be done annually)
c. Board score performance
B. Specific Comments
1. Patient Care Citations
• Pre-operative care
• Post-operative care
• Pediatric orthopaedic patients
• Orthopaedic trauma
• Non-operative care
2. Procedural Experience Citations
<1000 procedures by graduating residents
>3000 procedures by graduating residents
Uneven experience among residents
Too few CPT Codes in, for example: arthroscopy, microsurgery,
foot & ankle, pediatrics, trauma
3. The Case Log System
621 Residents Finishing in 2008
– Mean # CPT Codes Reported: 1,910
– Adults: 1616
– Children: 294
– Trauma: 489
4. Program Director and Case Logs
• RRC recommends review at least every 2 months
• At least with 6-month summative evaluation of resident &
document
• Compare members of same PGY “Class”
5. Scholarly Activity
• Resident publications and/or presentations
• Faculty publications
• Number of faculty involved in scholarship
• Mentoring of residents in scholarship
• Instruction in research methods
6. PIFs for Fellowships
• Common PIF format April 2009
• “Previous Citations” and “Changes” Sections
(automatically completed)
III. Surviving the Site Visit