HILTON PALACIO DEL RIO, SAN ANTONIO, TEXAS
APRIL 19-21, 2006
 
PRELIMINARY PROGRAM OUTLINE
“New Frontiers in Recruitment”

1. The new 2006-2007 Green Book will include programs in the following disciplines for the first time:
   • Neuromuscular Medicine (Neurology)
   • Sleep Medicine
2. At its February meeting the ACGME approved major revisions (effective dates in parentheses) to the program requirements for
   • Vascular surgery (July 1, 2006)
   • Transitional year (July 1, 2007)
   • Anesthesiology (July 1, 2008)
   • Pediatric subspecialties (January 1, 2007)
3. Also approved (effective July 1, 2007) were multispecialty program requirements for pain medicine, which replace the separate pain medicine subspecialty program requirements under anesthesiology, neurology, physical medicine and rehabilitation, and psychiatry.
4. Two new subspecialties were recognized (both effective February 14, 2006):
   • Adult cardiothoracic anesthesiology (subspecialty of anesthesiology)
   • Congenital cardiac surgery (subspecialty of thoracic surgery)

If you want to enroll to receive this newsletter, look at the bottom of it
to subscribe.

NOTE: This electronic communication is distributed to members of the graduate medical education community.

        E-mail: gme@ama-assn.org
        Web: http://enews.ama-assn.org/UM/T.asp?A40.574.3158.1.376507

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Dear colleague,

If recent trends continue, there should be over 25,000 applicants in this month's match. About 15,000 applicants are current seniors in US medical schools (soon to be US MDs). Most of the rest are IMGs (both US citizens and noncitizens) and a growing number of osteopathic school graduates (DOs).

Whatever the starting point, all paths leading to US physician licensure must pass through GME. When it's all tallied, about 26% of residents/fellows will be IMGs, and almost 6% will be DOs.

Perceiving a looming shortage of physicians (and encouraged by COGME, AAMC and AMA reports), US allopathic medical schools have started ramping up enrollments. But unless an expansion in GME is planned for now and funded soon, in just a few years the growing numbers of US MDs will only compete with IMGs and DOs for the same number of residency slots. The pool of applicants will be bigger, true, but the number coming through the GME pipeline and entering practice will be the same.

The AMA believes the current caps on federally funded residency slots should be removed and all payers (not just Medicare and Medicaid) should contribute to the costs of GME--but for now, that message hasn't resonated in Congress.

We welcome your thoughts on how to raise broader public awareness of these issues. E-mail us at gme@ama-assn.org .

        Paul H. Rockey, MD, MPH, Director
        AMA Division of Graduate Medical Education

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GME E-Letter March 2006

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Contents

1. This is only a test: Do you prefer a text or html e-letter?
2. Just say no?
3. Updated GME Directory available soon; order your copy now
4. ACGME approves updated program reqs, recognizes 2 new subspecialties
5. Media hone in on physician workforce concerns
6. Residents' GME now counts for 20 "AMA PRA Category 1 Credits"(TM)/year
7. Students: Don't get lost, follow the roadmap to residency
8. Provide feedback to ACGME on pediatric subspecialty requirements
9. VM: Following the dollar signs in health care
10. Med schools receive AMA grants to promote lifelong physician learning
11. On the calendar: ABSAME to focus on depression/anxiety
12. Take part in medical education history at AHME's 50th anniversary
13. Are increased liability costs a threat to clinical faculty?

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1. This is only a test: Do you prefer a text or html e-letter?

Click here to view a graphically enhanced version of the E-letter:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.2.376507

And let us know what you think. Do you prefer this (text) version, or the online (html) version? E-mail your feedback to gme@ama-assn.org . One randomly chosen person will receive a complimentary copy of the new 2006-07 Graduate Medical Education Directory.

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2. Just say no?

In the February issue, we referenced the JAMA article calling for academic medical centers to help eliminate current conflicts of interest between physicians and the pharmaceutical and medical device industry.

"Is it time for physicians to draw a brighter ethical line and totally refuse any gifts from industry?" we asked.

One alliterative response characterized the climate as having gone from "frighteningly freewheeling to prissily puritanical," with a "backlash brewing." Another said industry support plays a vital role in legitimate educational endeavors. A third questioned whether academic medical centers were truly the best, unbiased stewards of funds.

To read all responses, see:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.3.376507

In related news, some CME leaders worry that the proposed restrictions could cause CME funding to dry up, leading to fewer courses and higher costs for physicians:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.4.376507

Two correspondents to AMNews also weighed in on the issue:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.5.376507

At the AAMC, a new high-level task force will examine industry influence on medical education:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.6.376507

Finally, USA Today reported that "at least nine states are considering bills that would require drugmakers to publicly report how much they and their sales representatives give to doctors, hospitals and pharmacists each year. A few proposals go further: A bill under debate in Mass. would ban all gifts to medical professionals from the drug industry." See:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.7.376507

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3. Updated GME Directory available soon; order your copy now

The new 2006-2007 Green Book will include programs in the following disciplines for the first time:

• Neuromuscular Medicine (Neurology)
• Sleep Medicine

The total number of programs in the Green Book is now 8,390, up from 8,250 in the 2005-06 edition.

Order your copy now:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.8.376507

To receive an order form, send an e-mail to meded@ama-assn.org with the words "single copy" in the subject line, or call 800 621-8335 and request OP416706CRJ.

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4. ACGME approves updated program reqs, recognizes 2 new subspecialties

At its February meeting the ACGME approved major revisions (effective dates in parentheses) to the program requirements for

• Vascular surgery (July 1, 2006)
• Transitional year (July 1, 2007)
• Anesthesiology (July 1, 2008)
• Pediatric subspecialties (January 1, 2007)

Also approved (effective July 1, 2007) were multispecialty program requirements for pain medicine, which replace the separate pain medicine subspecialty program requirements under anesthesiology, neurology, physical medicine and rehabilitation, and psychiatry.

Two new subspecialties were recognized (both effective February 14, 2006):

• Adult cardiothoracic anesthesiology (subspecialty of anesthesiology)
• Congenital cardiac surgery (subspecialty of thoracic surgery)

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5. Media hone in on physician workforce concerns

The US can't rely on IMGs, an increase in DO graduates, or physician extenders to meet its physician workforce needs and improve access, writes AMA President J. Edward Hill, MD in American Medical News.

Medicine needs to recruit those who want to care for the underserved. "We need to graduate more medical students and create more GME positions to accommodate them" (especially minority physicians, who are more likely to work with these populations).

Another key strategy, Hill notes, is to "reemphasize the importance of primary care physicians, who play a particularly critical role in caring for underserved Americans." See:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.9.376507

Similarly, to avert a primary care physician shortage the American College of Physicians has called for drastic changes, including pay for currently uncompensated services and helping ease the time crunch on practitioners:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.10.376507

Meanwhile, the Michigan State Medical Society projects a shortage of 6,000 physicians by 2020:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.11.376507

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6. Residents' GME now counts for 20 "AMA PRA Category 1 Credits"(TM)/year

Under new guidelines for the AMA Physician's Recognition Award (PRA) and PRA credit system, residents/fellows may apply to receive 20 AMA PRA Category 1 Credits for each year of GME completed in ACGME-accredited programs.

This is a significant benefit to those resident physicians who are subject to mandatory CME requirements for state licensure. The service is $40 for nonmembers but is offered at no charge to AMA resident/fellow members. A 1-year AMA membership for residents/fellows is only $45.

For a copy of the new guidelines, see:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.13.376507

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7. Students: Don't get lost, follow the roadmap to residency

A new guide for applicants to US residency programs, "Roadmap to Residency: From Application to the Match and Beyond," describes the policies, procedures, and practices of residency application.

Produced by the AAMC, with input from the AMA and other organizations, the handbook includes a description of candidacy requirements, factors involved in specialty choice, and possible criteria for residency selection.

Also featured is information about matching processes, program visits, potential application outcomes, and the transition from medical school to residency. For a free online copy see:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.12.376507

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8. Provide feedback to ACGME on pediatric subspecialty requirements

The ACGME is currently requesting comments on the proposed revisions to the Program Requirements for the following pediatric subspecialties:

• Adolescent medicine
• Cardiology
• Critical care
• Hematology-oncology
• Neonatal/perinatal medicine
• Rheumatology

Deadline for feedback is April 3. See:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.14.376507

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9. VM: Following the dollar signs in health care

A patient asking his doctor to waive the copay. Patients with insurance and those without receiving a different standard of care. Students and residents learning about drug costs and detailing. The effect of medical debt on access to care and overall health, and the possible consequences of pay-for-performance.

All these topics and more are covered in the March issue of Virtual Mentor, the AMA's online ethics and professionalism journal, which shines a bright light on the high cost of medical care:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.15.376507

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10. Med schools receive AMA grants to promote lifelong physician learning

A new AMA grant program will help physicians continue to meet the needs of their patients -- from the first days of medical school to the last days of clinical practice.

The Medical Education Research Consortium Planning Grants will bring together the AMA and teams of educators from across the medical education continuum to evaluate how physicians acquire and maintain the skills essential to quality patient care.

A list of the 16 teams of medical school educators that recently received the AMA grants is available at:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.17.376507

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11. On the calendar: ABSAME to focus on depression/anxiety

Association for the Behavioral Sciences and Medical Education October 19-22, 2006, Annapolis, MD

Primary care physicians, residency faculty, residents, medical students, and other health professionals are invited to the ABSAME 2006 conference. Presentations will highlight depression and anxiety comorbidity as under-taught, under-diagnosed, and under-studied, particularly for vulnerable populations:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.16.376507

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12. Take part in medical education history at AHME's 50th anniversary

Join the Association for Hospital Medical Education (AHME) in celebrating its 50th Anniversary at the 2006 Spring Educational Institute, May 10-13, in Chicago.

Geared towards undergraduate, graduate, and continuing medical education professionals, the program features experts who will speak on trends, best practices, and the latest news on medical education topics, including:

• Accreditation
• GME financing
• Trends in healthcare affecting medical education
• The six general competencies
• Transitional Year Program issues
• Preparing for an ACGME Site Visit
• Issues relating to Designated Institutional Officials

For conference details and a brochure, see:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.18.376507

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13. Are increased liability costs a threat to clinical faculty?

Are volunteer faculty members seeing increased medical liability premiums because they teach medical students and resident physicians?

An AMA report from its Interim 2005 meeting did not have enough evidence of this as a major problem. The AMA, however, will continue to monitor the ongoing impact of medical liability premium increases on the availability of clinical faculty for undergraduate and graduate medical education. To read the report, see:

        http://enews.ama-assn.org/UM/T.asp?A40.574.3158.20.376507
        (MS Word, 51KB)

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About Us . . .

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The GME E-letter is produced by the Medical Education Group of the American Medical Association (AMA), publishers of the Graduate Medical Education Directory ("Green Book") and other medical education products.

For more info:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.21.376507

Our monthly e-mail communication covers information of interest to the graduate medical education community. Readers include program directors and staff at ACGMEaccredited and board-approved residency and fellowship programs, designated institution officials (DIOs), hospital administrators, professional associations, medical school deans, and governmental organizations.

Past issues of the E-letter are available on the Internet via the FREIDA Online Web site:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.1.376507

Also see the Guidebook for GME Program Directors:

http://enews.ama-assn.org/UM/T.asp?A40.574.3158.22.376507

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Give Us Your Ideas and Feedback

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What's happening in the world of GME? If you have any ideas for future e-letters, please contact us. Also, let us know what you think about this newsletter--and feel free to forward it to your colleagues.

Direct suggestions, comments, compliments, gripes, to

        Fred Donini-Lenhoff
        Medical Education Products
        American Medical Association
        515 N State St, Chicago, IL 60610
        (312) 464-4635
        (312) 464-5830 fax
        gme@ama-assn.org

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