Family Practice Residency Annual Orientation Gail Feinberg DO

Family Practice Residency Annual Orientation Gail Feinberg, DO, FACOFP, M. Ed Director of Medical Education 2014

Objectives • Review program and updates • Brief review of program training manual • Brief description of expectations • • • Didactics Clinic hours Call • Other information regarding the residency

Residency Manual • Has now been e-mailed. Should have provided a signed copy of receipt form • OLBH employee handbook • Given at OLBH New Employee Orientation • July 14, 8 am-4 pm, Bellefonte Center 5 th Floor boardroom for Dr. Smith

Manual Highlights • Program Director Description – superseded by agreement between OLBH/Feinberg and Howard Research Moonlighting • • • Prescription writing • Even with full license and DEA only preceptor/attending can write for narcotic rx in clinic • Requirements for Promotion/Graduation

Professionalism • Cell phone • Dress Code • Attendance • Addressing Preceptors • Parking

Other • Wiki • www. olbh. pbworks. com • • • Quarterly evaluation (by PD/DME) Clinical Preceptor Evaluation of service by resident Time sheet Logs • ACOFP paperwork (done by DME) • SOLE survey (for MSOPTI)

Other • OMM eval expectations for hospitalized patient • • • OMM glossary OMT coding Written in admission note • Research information • Resident Job Description • Standards of Practice for Resident

Didactics • Journal Club • • IM • • • FIRST Thursday of the month • MUST have them to DME office 1 week before • • Residents responsible for selection of articles Refer to Wiki (and/or printed list in resident lounge) for who is on what month and the topic • Will pull Saturday call if not turned in on time No peds or OB articles. Can only use NEJM once during the year FP • • THIRD Thursday of the month Students responsible for selection of articles

Didactics • • Attendance expectation • What does 80% mean? Chief to collect sign in Unexcused attendance • paper on topic discussed More than 2 unexcused • Will meet before Medical Education Committee formal discussion

Didactics • • Tumor Board • • Mandatory Thursdays, noon Will be on weekly schedule when planned Watch for e-mail on Thurs if cancelled MSOPTI lectures • • • Mandatory Although given live Tues noon and Thurs 8 am, we watch them taped Once a quarter live OMT (dinner provided)

Didactics • • Resident Teaching • • Run all Yale one month Resident will lecture on “bread and butter” ambulatory care topic • Give topic to Chief Resident and/or DME for posting on Wiki • …to avoid duplication Resident Grand Rounds • • • Resident lead – in front of room Presentation of case admitted the night before or interesting case on “days” Find teaching elements Not power point format Attending physicians are in room as proctors/hecklers

Didactics • • Other Live Lectures • • • Mandatory attendance Based on resident requests/wish list • Also include Pulm/Sleep medicine, pharma sponsored speakers, ER lectures, FP lectures, Peds lectures OK for residents to recruit live lectures Practice Management Series • • Mandatory 20 total hours during 3 year residency

Didactics • Other • M&M • Will be given by resident the month AFTER either ICU or Inpatient Medicine Days • Residents – it’s ok to recruit speakers for live lectures • • Just not 1 st or 3 rd Thursday morning. Monthly calendar availability

Curriculum 1 2 3 4 5 6 7 8 9 10 11 12 I IM IM nights ER OB SURG PEDS NEURO CARDIO ICU DERM ELECT II ER IM PEDS GYN NICU OPHTH BEHAV RHEUM RADIO GI IM Nights ELECT III PEDS GYN NEPH ID ENDO PODIATRY ALLERGY IM ORTHO ELECT ** ELECT

Elective rotations • 5 electives • • • OGME 1 – 1 OGME 2 – 1 OGME 3 - 3 • If felt more time needed on a specific rotation (eg IM Days), medical education committee may “assign” one of the electives as another month (hence the **)

Other rotations required by ACOFP • Behavioral Health • Community Medicine • • • Hope’s Place Free clinic Occupational Medicine

Other rotations required by ACOFP • Sports Medicine • • Impact Program School pre-participation physicals • Geriatrics • • Longitudinal in years 2 and 3 Resident is first call

Resident Teaching Expectations • • Medicine/ICU Bread and Butter Grand Rounds WVSOM education days • Presentation counts as “Statewide” presentation for Residency Project • • Table trainers for OMT Assist with clinical skills labs (August/September)

WVSOM education days • Third Friday of each month • At OLBH/SMMC alternately • 3 -4 x/yr “COILS” – OMM presentation • Will be at SMMC but residents invited and encouraged to be table trainers • Skills labs – can come to teach/update yourselves • If stay entire day – will be asked to review student lecture presentations

Other Mandatory Activities • WVSOM midwinter Resident seminar • Hinting at changing that to spring or summer for better weather • WVSOM simulated patients • • Once during residency in Lewisburg or Charleston Residency to pay for mileage/gas whichever is less • KOMA Resident Saturday • DME will give notice if NOT mandatory at least 1 month prior to conference • Residency will pay for registration. CME for hotel if stay more than 1 day.

Other Mandatory Activities • Annual Orientation • Residency Graduation • Nursing Home rounds • ACLS/BLS • Morning Didactics if rotation is not linked to another hospital

MSOPTI lectures • Telehealth/Youtube • One Thursday/mo 8 -9 am* • One Tuesday/mo noon* • * will be shown recorded at 7 -8 am • One OMM session with lab each quarter Thurs 68 pm • Mandatory • Expected to watch webinar if not present at time of presentation if not excused.

MSOPTI • Library facilities • Through WVSOM • Procedures Consult • Chief Resident’s council • Mid Winter Seminar • Research assistance

Core competencies • Medical Knowledge • OMM • Patient Care • Professionalism • Interpersonal/communication • Practice based learning/improvement • Systems based practice

OSCE (but it’s not) • NOT a PE exam • Clinical skills • Also can look at professionalism, cultural issues, etc. • Part of core competency evaluation • Mandatory in either 1 st or 2 nd year (repeat in rd 3 if poor performance)

Requirements for promotion • PGY 1 to PGY 2 • Must have Kentucky license • Can remain on rotations but will still be considered PGY 1 • Once have IP license will get pay increase to PGY 2

Requirements for promotion • PGY 2 to PGY 3 • Passage of COMLEX 3 • MUST show proof to DME – copy for your residency file • Will be removed from rotations at conclusion of PGY 2 rotations (per AOA requirement) • Leave without pay • Request that you take COMLEX 3 before 6 month mark of 2 nd year

Requirements for promotion • SOLE survey • Attendance at ACOFP • Once in either 2 nd or 3 rd year • Something in writing for residency file • Research project • ALL hospital and office work completed

Requirements for promotion/graduation • ? Numbers of ambulatory patients seen • May need to take another elective to meet requirements • Receipt of “diploma” does not guarantee completion of program • Still have to file forms with ACOFP • ACOFP has to provide final verification to program

Continuity Clinic • OLBH Primary Care FLATWOODS • • 2420 Argillite Road (606) 836 -3900 or 836 -1900 • Dr. A. Lobach • Dr. Kevin Howard • Lisa Pennington, PA-C

Clinic Hours • Flatwoods primary site • Dr. Kevin Howard supervising physician • ½ day a week PGY 1 • 3 separate ½ day sessions PGY 2/3 • AM hours start 8: 00 am - Noon • PM hours start 1: 30 -5: 30 pm

Chart Documentation • Every Hospital Admission • OMT eval expected and MUST be in your H&P • FULL H&P • Preventive measures in ROS • epss/USPSTF • Every Office Chart • Must be co-signed by preceptor • Document health maintenance • Assessment in chart must match diagnosis on billing sheet exactly

Chart Documentation • MUST let Medicare know that this is a residency clinic • Billing and coding separate lecture…however… • GE modifier – you saw the patient on your own (will NOT apply for the first 6 months of PGY 1) • GC modifier – the preceptor saw the patient after you did and performed their own exam • • First 6 months of PGY 1 year ANY 99204 or 99214 or greater visit

Other Information • Geriatrics • Continuity starts midway through PGY 2 • Derek Jones, DO • Patient panel of 7 -8 residents of Trinity Station • Electives • Sooner select the better • Request 2 months in advance or may end up on vacation

Other Information • Vacation • • Ignore paycheck information re vacation and sick time • • • Use it/loose it 15 days per year plus any days program assigns for conference (e. g. , KOMA, WVSOM Doctor Days) Space it out – can’t use all at end of academic year NO vacation last 2 weeks of June No more than 5 days consecutively Not while on Medicine rotations MUST request 3 months in advance

Other Information • CME $$ • Use it/loose it • Licensing • Will pay for KY licensing • • • WV license fees would come out of your CME allowance Watch timing for filing information 1 st year under watch of OLBH

Program does NOT cover • Licensing other than KY • ACOFP conference • Board fee (for board certification) • Salary over 12/36 months of mandatory rotations

Important Numbers • Door codes • Mail Room • Call room 24282 0710 • Key to Education Classroom • Located at switchboard #61

• Feinberg • • Important Numbers • • Cell (606) 922 -8598 ERC office (606) 833 -3171 • SMMC office (304) 399 -7592 • Kevin_howard@bshsi. org • Fax (606) 833 -2280 • gail_feinberg@bshsi. org • Fax (304) 399 -7593 • gfeinberg@osteo. wvsom. edu Flatwoods (606) 836 -3900 Howard