June 2020 GME Connection

It has been a very difficult time. A once-in-a-century pandemic has disrupted our health, our work, our livelihood and our social and familial bonds. This invisible enemy has shined a spotlight on the more insidious but equally deadly healthcare disparities that exist in our country; a disproportionate number of COVID-related deaths occur in patients of color.

While still battling the virus we have once again borne witness to the murder of Black people-- George Floyd in our own community, preceded in death by Breonna Taylor and Ahmaud Aubery. Inequities built upon institutional racism permit these injustices. It feels apocalyptic.

My job is to guide and support, but I feel inadequate. Tackling institutional racism is a huge job. While I recognize that the first step is to begin a dialogue with open and honest communication, I fear that in my ignorance I will make things worse while trying to help make them better. This is my albatros.

My work ahead is to deconstruct my own fear, to work from a place of self-forgiveness, empathy and sympathy, and to begin this necessary work to move the difficult conversations forward.

The Graduate Medical Education office is compiling a list of resources to share with the community-- especially the white community-- to educate us about how we got here, where we need to go, and how to initiate the conversation about how we are going to get there. I would highly recommend a text by the Arbinger Institute titled “The Anatomy of Peace”. It is co-written by an Israeli and a Palestinian. It is a story about empathy and about the dangers of attributing intent to other’s actions.

Institutional racism affects and harms everyone in society. It is obvious how our colleagues and patients of color are brutalized by it. Its negative impact on the white majority is more opaque. I am trying to approach my new work on racial disparities in Graduate Medical Education the way I would approach a medical error investigation.

Even actions that result in horrific harm are not always the result of malice by a single caregiver or team of caregivers. Most medical errors result from a conspiracy of individuals’ at-risk behavior perpetuated in a system that institutionally reinforces and sometimes rewards those same behaviors. Often times practitioners do not even recognize that workarounds they develop to improve efficiency place patient safety at risk until after harm is incurred and they examine their behavior with a new perspective.

We cannot fix what we cannot see. We must view our world through a different lens to be able to see with clarity the historic workarounds that were explicitly racist that institutionalized and exacerbated disparities and continue to undermine our community today.This is the work we must do together-- without judgment, but with empathy, compassion and courage.

Susan Culican, MD, PhD

Associate Dean for Graduate Medical Education

Designated Institutional Official

University of Minnesota Medical School

ACGME President and CEO Thomas J. Nasca, MD, MACP recorded a video message for all Residents and Fellows completing their program this spring—in the midst of a global pandemic, while caring for patients on the front lines during an extraordinary time.

In this video, Dr. Nasca recognizes Residents and Fellows for their altruism, expresses concern for their well-being, and encourages them to take the lessons learned about health disparities during the pandemic to improve care for all during the course of their careers.

Sponsoring Institutions and programs are encouraged to incorporate the video into their commencement activities and/or distribute it directly to their Residents and Fellows.

Learn More in the ACGME Newsroom

Access the Video on the ACGME’s Vimeo Channel

Stay informed with COVID-19 Updates and communications on the GME Covid-19 Extranet. Covering news and updates from President Joan Gabel, Dean Jakub Tolar, Dr. Susan Culican, resources and more.

Graduate Medical Education Central Orientation is right around the corner. We are excited to meet all the incoming trainees this year and appreciate all the hard work that our programs have done to get them here.

GME Orientation for New Residents/Fellows, Main Sessions

Wednesday, June 17, 2020 and Wednesday, July 1, 2020, 8:00 AM-12:35 pm PM, Zoom

Central Orientation Schedule June 17th and July 1st

8-8:05 am Welcome

8:05-9:05 am Diversity and Inclusion

9:05-9:50 am Implicit Bias & Mistreatment

9:50-10:05 am Break

10:05-10:35 am Pain Management

10:35-12:35 pm Patient Safety & Safety Always Training

12:35 pm Thank You & Adjourn

International Medical Graduate Welcome

Friday, June 19, 2020, 5:00 PM-6:30 PM, Zoom

Graduate Medical Education Orientation, Abbreviated Sessions for New Residents/Fellows

Wednesday, July 8, 2020 and Monday, August 3, 2020 8:00 to 9:00 AM, Zoom

Health and Wellness Orientation, trainees choose one session to attend:

1. July 10, 2020 3:00-4:30 pm, Zoom

2. July 22, 2020 10:00-11:30 am, Zoom

3. August 11, 2020 1:00-2:30 pm, Zoom

Congratulations to Thoracic Surgery, Vascular Surgery and Vascular Neurology for a successful Match Day on May 13, 2020. We look forward to welcoming new Fellows into the University of Minnesota GME community.

We are so excited to share with you that Bobbi Kruse, U of M Medical Center Family Medicine Program, received the 2020 Program Coordinator Excellence Award on June 9, 2020 at the UMN GME Coordinator meeting.

Bobbi has been a Program Coordinator for more than 11 years. Nomination letters for Bobbi highlighted her local and national contributions to GME. Examples include her position as Past President of the Association of Family Medicine Administration (AFMA) and work with the Coordinator Advisory Workgroup (CAWG).

Bobbi consistently advocates for Residents, looks for ways to recognize and congratulate hard work and cares about the well-being of her Residents. Bobbi is a creative problem solver with incredible organizational skills.

Bobbi, we thank you for your commitment to GME and look forward to having you share your knowledge and expertise with our community.

Please join us in congratulating Falon Montreuil Nominee, Dermatology Residency Program and Mitch Gmyrek Nominee, Cardiothoracic Fellowship and Colon & Rectal Fellowship Program.

They were nominated by their Program Directors, Managers and trainees for the Program Coordinator Excellence Award. Each are outstanding Coordinators, and care deeply about their program(s) and trainees. They positively impact our community and create space each and every day to achieve operational excellence. We are grateful to them. Thank you.

• September 25, 2020

• October 30, 2020

• November 20, 2020

• January 15, 2021

• February 19, 2021

• March 19, 2021

• April 16, 2021

• May 21, 2021

• June 18, 2021

• July 16, 2021

Resident Leadership Academy participants are selected annually by departmental leadership and attend monthly sessions from September through July.

The aims of the Resident Leadership Academy are to: 1) teach skills relevant to organizational leadership to a promising group of residents; 2) engage this group of residents in institutional goals and priorities, where they can play a significant contributing role; and 3) invest in the development of trainees who have the potential to be future leaders at this institution beyond their residency training.

Please, look out for nomination letters this month for Cohort 7.

All residency and fellowship programs must have a program manual that is updated annually and distributed to trainees each year, on or before the program’s academic year start date. This past winter, GME Administration partnered with members of the Coordinator Advisory Work Group (CAWG) and the Education Managers to improve the program manual process and to provide flexibility, where possible, in how the required information is captured and shared with your trainees.

Action Needed:
1. Update your program manual for the academic year 2020/2021 in consultation with your Program Director. Instructions, the checklist and template for receipt of manual are available here.

** Please note we are updating the program manual webpage with the updated instructions. Please use the instructions linked above, as the program manual webpage is outdated at this time.

2. Email your updated manual to GME for inclusion on the Program Policy Manuals webpage.

Deadline to email to GME: June 19. Email your updated manual to gme@umn.edu.

3. Distribute your updated manual to ALL trainees (new and continuing) and post to your program/department website.

Deadline to distribute to trainees: On or before their academic year 2020/2021 start date.

Collect their signed confirmation of receipt and store the signed receipt in their file.

Deadline to post to your website: July 1 or your academic year start date, whichever is earlier.

All GME policies have their own webpage; find a complete list on the GME Institution Policy Manual page. If you have links in your manuals that point to specific policies, update those links so they are directed to the policy’s page rather than the previous Google Docs version.

Programs will not receive a citation from ACGME for non-completion of surveys. However, for programs to receive results of their survey (to use in Program Evaluation Committees and Institutional Reviews) they must have a 70 percent survey completion rate as in prior years. It is the expectation of GME that programs must meet this minimum requirement given reduction, not increased, clinical volume at UMN. The deadline has been extended to June 26, 2020.

• Resident/Fellow: ACGME Resident/Fellow Survey 3rd window only (email link from DoNotReply@acgme.org)

• Faculty: ACGME Faculty Survey 3rd window only (email link from DoNotReply@acgme.org)
  

Programs must update Milestone Reporting for their trainees, and they must provide updated Citation Responses and responses to Areas for Improvement/Concerning Trends in their program’s ADS profile by June 26, 2020.

GME Administration will provide a description of global sponsoring institution COVID-19 initiatives and work that each program will enter into their program's ADS profile. Programs must also add their local level COVID-19 initiatives, work and impact to inform their RCs.

Virtual Recruitment & Interviewing Resources

This resource is a compilation of virtual recruiting and interviewing resources and tools shared across the GME community. All are encouraged to add additional resources as you learn of them. There is a column to add your name and/or email as you add content so that others in the community know who added the resource in case there are questions. Thank you all for contributing!

Also, GME created this resource containing standard recruitment prep document that contains information still relevant as we transition to this season of virtual recruitment: Recruitment Prep Highlights.

The University of Minnesota official completion certificate paper is not currently accessible, because the GME office is closed. We have created a template letter to be used in lieu of a certificate of completion until staff are allowed to return to campus and obtain the official certificate paper. View the template at this link: Completion Letter in Lieu of Certificate of Completion.

All trainees must hold an active residency (fellowship) permit or a physician license from the Minnesota Board of Medical Practice (MBMP). Trainees moving from a permit to a physician license, at any point in residency or fellowship training, are required to communicate this change to the residency or fellowship program administration.

Reference: GME - Licensure Policy. Programs are reminded to apply for permit extensions for

any trainees who will graduate later than originally planned. Also, please ensure that all of your incoming trainees have an active permit or license with dates that align with their RMS training record.

GME Administration and the program follow the steps outlined in the Permit/License Guide & Templates. This guide illustrates the process to obtain a permit, and what to do if a license is obtained by the trainee. View slides 12-14 for instructions on how to upload a license to RMS and configure the automated email expiration reminders.

Program Coordinators are encouraged to talk with their trainees about permits and licenses to solidify an understanding of the requirements and the process.

This is a reminder that all GME programs are required to complete the ACGME approved Verification of Training Form (using the Verification of Training Form Guide to assist them) when a resident/fellow completes or leaves their current training program, per the Verification of Training and Summary for Credentialing Policy.

This form must be completed by the Program Director, after a thorough review of the trainee file, within 8 weeks of completion or departure from the program. Each form must be uploaded to the trainee’s personnel record in RMS.

If a program needs to supply credentialing agencies with more information (such as case logs, procedure logs, attestation of competence, etc.), they should add an attachment to the documentation as support.

The GME office must be notified when a trainee’s program length is altered so that an amended agreement may be issued. Programs should notify the GME office by completing the Program Length Agreement Amendment Request Form online. View a sample program length agreement amendment.

An agreement amendment will be issued only when the program duration is altered for:

• Chief Additional Year

• Surgery Lab Year(s)

• Need for additional training (remediation, probation, need for additional case volumes, etc.

• Alternate nationally recognized program track (Example: Non-standard Pediatrics research pathways)

• Other
  
  

An agreement amendment is not required for:

• LOA’s (the program length agreements have language in them that cover LOA’s as the overall program duration is not altered.

• Early termination

• Remediation that does not extend training
  
  

The MMCGME Services team also receives a notification when an agreement amendment request form is completed so that they may update the trainee’s RMS training record.

Share ideas, best practices and resources on GME COVID-19 Connect, a discussion board for the GME community. Email new topics for threads to gme@umn.edu. Connect users can post comments and feedback. Subscribe for notifications to stay informed on new topics and responses.

• GME Orientation Sessions:

June 17 & July 1, 2020, 8:00 am-12:35 pm, Zoom

• International Medical Graduate Networking & Welcome:

June 19, 2020, 5:00 pm-6:30 pm, Zoom

• Resident Leadership Academy:

June 19, 2020, 9:30 am-4:30 pm, Zoom

• Abbreviated GME Orientation Sessions:

July 8 & August 3, 2020, 8:00 am-9:00 am, Zoom

• GME Health & Wellness Orientation Sessions:

July 10, 3:00-4:30 pm & July 22, 10:00-11:30 am & August 11, 1:00-2:30 pm, Zoom

• Resident Leadership Academy:

July 24, 2020, 9:30 am-4:30 pm, Zoom

The GME Partnership Award recognizes members of the community who go above and beyond to partner with the GME office on various initiatives and efforts in alignment with our established core values. We work alongside so many talented and caring individuals and this award allows us the opportunity to formally recognize some of those individuals.

Jodi Deschene

Partnering with our office on fit testing the incoming trainees. In the middle of a pandemic when HPOEM was closing clinics and furloughing staff, Jodi worked with the GME office to pull two nurses back from furlough and partner on a creative solution to mask fitting the 300+ incoming Residents/Fellows. Jodi is committed to partnering with the GME office to develop solutions and meet the needs of the GME community.

Ashley Romero

Working with our office on fit testing the incoming trainees. Ashley worked with the GME office to fine tune the details and ensure that each fit test appointment was a success. Ashley is committed to ensuring that all of the details are carefully planned and thoughtfully executed.

Welcome to the following Program Coordinators who recently assumed this role:

• Claire Graham, Neurological Surgery and Neuroanatomy Research

The GMEC serves several purposes including program oversight and is the primary mechanism for communication of ACGME requirements to programs and departments. Our GMEC voting membership includes program leaders, resident representatives, a department Chair, and representatives from affiliated training sites. All interested individuals are also welcome to attend meetings. Meeting agendas, materials, and detailed minutes are linked on the GMEC website.

The next GMEC Meeting will be held on Tuesday, June 23, 2020 from 3:30-5:00 PM via Zoom (see information concerning GMEC agenda item submission deadlines).

The GME Meetings and Events Google Calendar is viewable on the GME Meetings & Events Calendar webpage. It can also be selected in your list of Google calendars. The calendar is updated in real time and captures all important meetings in GME Administration.

Graduate Medical Education Administration

University of Minnesota Medical School

420 Delaware Street S.E., MMC 293

Suite 254 Mayo Memorial Building

Minneapolis, MN 55455

http://www.gme.umn.edu

The GME operations team uses a shared email address: gme@umn.edu. Email us there regarding any topic! For private/sensitive matters, continue to use personal email addresses (listed below).