CALIFORNIA BOARD OF PODIATRIC MEDICINE BOARD MEETING … · 07/06/2019 · Maria Cadenas, MBA : RECOMMENDATION : Receive and file the status update report on Licensing Unit activity

STATE OF CALIFORNIA ,,.

BOARDOF ~

PODIATRIC 'ff MEDICINE l

BUSINESS, CONSUMER SERVICES ANO HOUSING AGENCY • GAVIN NEWSOM, GOVERNOR

DEPARTMENT OF CONSUMER AFFAIRS • CALIFORNIA BOARD OF PODIATRIC MEDICINE 2005 Evergreen St. , Suite 1300, Sacramento, CA 95815 P (916) 263-2647 I F (916) 263-2651 I www.bpm.ca.gov

CALIFORNIA BOARD OF PODIATRIC MEDICINE BOARD MEETING

June 7, 2019

SUBJECT: LICENSING PROGRAM REPORT V A1-2 ACTION: RECEIVE LICENSING PROGRAM REPORT

Committee Members: Judith Manzi, DPM, Chair

Maria Cadenas, MBA

RECOMMENDATION

Receive and file the status update report on Licensing Unit activity.

ISSUE

This status report highlights key statistics of BPM’s Licensing Unit and other licensing activity of note since last reported at the March 1, 2019 meeting of the Board.

DISCUSSION

The following data below lists current and up to date information for all licensing statistics, including new licenses and renewals.

1. Licensing Statistics

The following Licensing Report reflects a current capture of licensing statistics including new licenses and renewals during FY 18/19 Quarter 3 running from January 1, 2019, through March 31, 2019.

Licensing Statistics – New Licenses Issued, Year Over Year Comparison

This report provides a comparison of BPM licenses that have been issued during the three previous fiscal years for: 15/16, 16/17, 17/18 and those issued to date for FY 18/19. In FY 15/16, 80 permanent licenses were issued; FY 16/17, 75 permanent licenses; FY 17/18, 100 permanent licenses; FY 18/19, 61 permanent licenses to date. For a grand total of 316 newly licensed DPMs in the last four fiscal years. A comparison of gender, age and incoming to outgoing DPMs is provided for review. The categories for the outgoing licensee population include: retired, inactive, disabled and *canceled licenses.

*License cancels after 3 years of non-renewal.

A breakdown of licensing data includes the number of initial applications received that are currently pending. Of the 32 pending applications, four candidates recently completed their package.

Currently in fiscal year 18/19, BPM had 17 of its applicants come from out of state, 20 were third year residents from California and 24 were third year residents from an out of state program. (Attachment A)

Licensing Statistics - Renewal Data and Renewal Data Breakdown

This report provides an overview of license renewal data for FY 18/19 for which full reporting data is available and running from January – March 2019. In the month of January, 94 license renewals were mailed with 88 licenses renewed by the end of the month. During the month of February, 96 renewals were mailed with a total of 92 licenses renewed, and March had 88 license renewals mailed with 79 licenses renewed by the end of the month. For licentiates that did not comply with renewal requirements, Delinquent Renewal Notices were mailed to all pending renewals 30 days after license expiration.

License renewal data is broken down to include those that have filed for a Retired, Military, Disabled or Inactive modifier. Also included is the number of licensees in Delinquent status in addition to those whose status has changed from Active to Canceled, Revoked, Surrendered or Reinstated. (Attachment B)

Licensing Statistics – Residents

This report reflects the resident licensee base to date. The resident academic year started on July 1, 2018 and will end on June 30, 2019. BPM currently has 39 first year residents; 39 second year residents; and 43 third year residents, bringing our resident license total count to 123. Resident data includes the number of third year residents that currently hold or are applying for a permanent license. (Attachment C)

2. BPM Calendar (June – August 2019)

Provided for committee planning purposes and review is a 3-month timeline to enhance committee awareness for pertinent dates and approaching deadlines. (Attachment D)

NEXT STEPS

Staff will continue to maintain the Licensing Program by remaining current with processing applications, performing operations without backlog, and responding to specific inquiries from consumers, licensees and stakeholders on a daily basis.

2

ATTACHMENTS

A. Licensing Statistics - New Licenses Issued (YearNear Comparison) B. Licensing Statistics - Renewal Data Quarter 3 (January - March 2019) C. Licensing Statistics - Residents D. 8PM Calendar (June - August 2019)

Prepared by: Andreia Damian, Licensing Unit Coordinator

Andreia Damian

L~

Brian Naslund Executive Officer

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*******

STATE OF CALIFORNIA -~

BOARDOF ~

PODIATRIC ~ MEDICINE\

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BPM Calendar

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

2019

State Holidays

DCA Information

June July August

Legislative

Committee

Enforcement

Committee

Public Education

Committee

Licensing

Committee BPM Staff CA Legislature Committee Chairs

Jun 4

Sep 2019 license

renewals mailed out

Jun 7

BPM Board Meeting

Aug 12

Legislature reconvenes

from Summer Recess (J.R.

51

Jun 15

Budget Bill must be passed by midnight

(Art. IV, Sec. 12(c)(3)).

July 10

Last day for policy

committees to hear and

report fiscal bills to fiscal

committees (J.R. 61(a)(10)).

Jun 21

Consultant Training

Jun 3

Committee meetings may

resume (J.R. 61(a)(9)).

Jun 19-22

Western Foot and Ankle

Conference

July 12

Last day for policy committees to

meet and report bills (J.R. 61(a)(11)).

Summer Recess begins upon

adjournment, provided Budget Bill has

been passed (J.R. 51(a)(3)).

Aug 5

Nov 2019

Renewals mailed

out

July 3

October 2019

license renewals

mailed out

July 4

Independence

Day

Aug 30

Last day for fiscal

committees to meet and

report bills (J.R. 61(a)(12)).

Aug 21

BPM Committee

Meetings

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ATTACHMENT D

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STATE OF CALIFORNIA ,,.

BOARDOF ~

PODIATRIC 'ff MEDICINE l

BUSINESS, CONSUMER SERVICES ANO HOUSING AGENCY • GAVIN NEWSOM, GOVERNOR

DEPARTMENT OF CONSUMER AFFAIRS • CALIFORNIA BOARD OF PODIATRIC MEDICINE 2005 Evergreen St. , Suite 1300, Sacramento, CA 95815 P (916) 263-2647 I F (916) 263-2651 I www.bpm.ca.gov

CALIFORNIA BOARD OF PODIATRIC MEDICINE BOARD MEETING

June 7, 2019

SUBJECT: DISCUSSION AND POSSIBLE ACTION OF RECOMMENDATION FOR APPROVAL OF CALIFORNIA PODIATRIC RESIDENCY PROGRAMS FOR ACADEMIC YEAR 2019-2020 V A3

ACTION: REVIEW AND APPROVE QUALIFYING RESIDENCY PROGRAMS

RECOMMENDATION

Review and approve qualifying California residency programs.

ISSUE

19 separate California Post-graduate clinical training programs seek approval of applications of residency programs offered for the 2019-2020 academic year.

DISCUSSION

Section 2475.2 of the California Business and Professions Code (the “Code”) defines podiatric residencies as post-graduate clinical training programs that are supervised and last one or more years in duration. These clinical training programs offer graduates of colleges or schools of podiatric medicine the opportunity and expectation to function as members of the health care team and gain hands-on medical and surgical training and experience in patient management in addition to structured learning in the diagnosis, treatment and care of podiatric pathology.

As part of the Board of Podiatric Medicine’s (“BPM”) licensing initiative that is unique to California, the Board requires a Podiatric Resident’s License for all post-graduate clinical training participants and requires successful completion of at least two years of podiatric medical and surgical residency before a certificate to practice podiatric medicine may be issued.

As part of the effort to ensure the quality of post-graduate clinical training in California, BPM is legislatively required to approve podiatric residencies in the state under section 2475.3 of the Code for applicants or those individuals that have been issued a resident license to practice podiatric medicine.

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Accordingly, consistent with stated requirements contained in section 1399.667 of the Podiatric Medicine Regulations, the Board may approve a podiatric residency provided that the program:

1) reasonably conforms with the Accreditation Council for Graduate Medical Education’s Institutional Requirements of the Essentials of Accredited Residencies in Graduate Medical Education: Institutional and Program Requirements;

2) is approved by the Council on Podiatric Medical Education;

3) has a designated Director of Medical Education;

4) provides emergency medical training through emergency room rotations;

5) measures and evaluates the progress of participants;

6) measures and evaluates program effectiveness; and

7) has a minimum 75% resident pass rate on Part III of the National Board of Podiatric Medical Exam (the “Nat’l Boards”) within the last five-year period.

Residency programs falling below the required minimum 75% passage rate on Part III of the Nat’l Boards may nevertheless be granted program approval if it is determined after inspection by the Board’s site visit team or a review of reports submitted by the program that the program demonstrates reasonable conformance with all applicable requirements. Accordingly, the BPM Licensing Committee may in its discretion recommend approval of the applications for a vote by the full Board

The applicable BPM statutes and regulations are attached for Board reference in addition to submitted applications for Board review.

FINANCIAL IMPACT

Approval of this item will not have a financial impact on BPM’s FY 19/20 Budget.

POLICY IMPLICATIONS

Board action is consistent with BPM’s mandate for approval of post-graduate medical education for ensuring the quality of post-graduate clinical training in California as provided in:

1) Section 2475.3 of the California Business and Professions Code; and 2) Section 1399.667 of the Podiatric Medicine Regulations.

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NEXT STEPS

With Committee approval, staff will forward program applications with corresponding recommendations to the full Board for consideration at the June 7, 2019 meeting.

ATTACHMENTS

A. Section 2475.3 of the California Business and Professions Code B. Section 1399.667 of the Podiatric Medicine Regulations. C. Applications for Approval of Residency Programs in California

1. Cedars-Sinai Medical Center - Los Angeles, CA

2. Chino Valley Medical Center - Chino, CA

3. Department of Veterans Affairs Greater Los Angeles - Los Angeles, CA

4. Department of Veterans Affairs San Francisco- San Francisco, CA

5. Department of Veterans Affairs Palo Alto - Palo Alto, CA

6. Department of Veterans Affairs Jerry L. Pettis- Loma Linda, CA

7. Fountain Valley Regional Hospital - Fountain Valley, CA

8. Kaiser Permanente - Oakland and San Francisco, CA

9. Kaiser Permanente - Sacramento, CA

10. Kaiser Permanente - Santa Clara, CA

11. Kaiser Permanente - Vallejo, CA

12. Lakewood Regional Medical Center - Lakewood, CA

13. Long Beach Memorial Medical Center - Long Beach, CA

14. Dignity Health - St. Mary's Medical Center- San Francisco, CA

15. Scripps Mercy Hospital - San Diego, CA

16. Scripps Memorial Hospital - Encinitas, CA

17. Silver Lake Medical Center - Los Angeles, CA

18. West Covina Medical Center - West Covina, CA

19. White Memorial Medical Center - Los Angeles, CA

Prepared by: Andreia Damian, Licensing Unit Coordinator

Andreia Damian

~ tor _

Brian K. Naslund Executive Officer

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State of California

BUSINESS AND PROFESSIONS CODE

Section 2475.3

2475.3. (a) The board shall approve podiatric residency programs, as defined in Section 2475.2, in the field ofpodiatric medicine, for persons who are applicants for or have been issued a certificate to practice podiatric medicine pursuant to this article.

(b) The board may only approve a podiatric residency that it determines meets all of the following requirements:

(1) Reasonably conforms with the Accreditation Council for Graduate Medical Education's Institutional Requirements of the Essentials of Accredited Residencies in Graduate Medical Education: Institutional and Program Requirements.

(2) Is approved by the Council on Podiatric Medical Education. (3) Complies with the requirements of this state.

(Amended by Stats, 2003, Ch. 586, Sec. l. Effective January 1, 2004.)

ATTACHMENT A

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ATTACHMENT B

DIVISION 13.9 BOARD OF PODIATRIC MEDICINE OF THE MEDICAL BOARD OF CALIFORNIA

1399.667. Postgraduate Medical Education.

Podiatric medical residencies approved by the board in accordance with Section 2484 of the code

shall be those that meet the minimum requirements set by the Council on Podiatric Medical

Education, have designated a Director of Medical Education, provide emergency medical

training through emergency room rotations, measure and evaluate the progress of participants

and program effectiveness, have at least a seventy-five per cent pass rate for residents taking the

Part III exam of the National Board of Podiatric Medical Examiners within the most recent five-

year period, and, in the board's determination, reasonably conform with the Accreditation

Council for Graduate Medical Education's Institutional Requirements of the Essentials of

Accredited Residencies in Graduate Medical Education: Institutional and Program Requirements,

as revised effective September 1998, which are incorporated by reference in their entirety.

Reasonable conformance means that, in applying such requirements, the podiatric medical

equivalent should be substituted for references made to general medicine, as appropriate. For

example, in regard to resident eligibility and selection, references to "graduates of medical

schools accredited by the Liaison Committee on Medical Education" should be interpreted as

graduates of podiatric medical schools accredited by the Council on Podiatric Medical Education

and approved by the California Board of Podiatric Medicine.

If a residency program falls below the specified seventy-five per cent pass rate, the board may

grant the program approval if it determines after review of reports submitted by the program or

the board's own site visit team that the program is in reasonable conformance with all applicable

requirements.

NOTE: Authority cited: Sections 2015, 2018 and 2470, Business and Professions Code.

Reference cited: Sections 2475, 2475.3 and 2484, Business and Professions Code.

HISTORY:

1. Renumbering of Section 1366.8 to Section 1399.667 filed 12-7-79; effective thirtieth day

thereafter (Register 79, No. 49).

2. Amendment filed 8-4-83; effective thirtieth day thereafter (Register 83, No. 32).

3. Change without regulatory effect (Register 87, No. 15).

4. Amendment of section and NOTE filed 12-11-95; operative 1-10-96 (Register 95, No.

50).

5. Amendment of first paragraph, new subsection (b) and amendment of Note filed

8-21-98; operative 9-20-98 (Register 98, No. 34).

6. Amendment of first paragraph filed 11-7-2000; operative 12-7-2000 (Register 2000, No.

45).

7. Amendment of section heading and section filed 11-12-2003; operative 12-12-2003

(Register 2003, No. 46).

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Application for Approval Residency Programs in California

Academic Year 2019-2020

•

Edmund G. Brown Jr, (iovemol'

Please complete the application and return to our office no later than May 1, 2019. If your Institution offers more than one type of pediatric residency program, please use a separate ap~ication for each program. The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by BPM may subject the institution to a Citation and Fine.

. ... ··;

Sponsorina Facilitv: Cedars-Sinai Medical Center

Address: 8700 Beverlv Blvd. Los Anaeles, CA 90048

Phone: (310) 423-5000 I Email: [email protected]

Residency Program Type: PMSR- Pediatric Medicine and Sur□erv Residencv

X PMSR I RRA- Pediatric Medicine and Suraerv Residencv / Reconstructive Reartoot /An~e

Does the Sponsorlna Facllltv: Yes No

/al Meet Iha oeneral inslituUonall reouirements of the ACGME? X /bl Have a Director of Medical Education? X

(c\ Provide residents emeroencv medical trainino throuoh ER rotations? X /di Measure & evaluate orooress of residents? X le\ Measure & evaluate prooram effectiveness? X

Annroved bv the Council on Podlatric Medical Education? X

Date of Last CPME site visit: April 29, 2019 . ·.,.-. ··-· .. , ... ,, .... ... ·,·· , -,·.·- •v, .• • ',":,·

Sia natures: / / Proaram Director: ,#,,/~,_.-~' Printed Name: ~lh O~vid Massa and, DPM

Da.t~ April 19, 201 9 PhoQe: (310) 657-2828 I Email: [email protected] ,;•,•., .. ·-,

Director of Medical Education: VIA n./\.( ~ \IIJ;:-d / '--- -· Printed Name: Mark S. Noah, MD

Date: Aoril 19, 2019.----.._ Phone: (~O) 423-4226 I Email: [email protected] .. , .-.·,-,.•;-.,,. .,. - - · •.. -,_ .

Facilitv / Hosoital Administrator: M ~ 1[.,,/('X'l, u. Printed Name: Betsy McGaughey,CI:: D, MS'-" u ¥

Date: April 19, 2019 Phone:(310) 423-5711 I Email; betsy.mcgaughey@cshs,org

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815--3831 j P (916) 2.63~2647 [ F (916) 263-2651 www.bpnua.gov

ATTACHMENT C

23

STAfE OF CALIFORN IA 9 BOARDOF ~

Edmund G. Brown Jr. Governor

PODIATRIC 'f MEDICINE'

Application for Approval

Residency Programs in California Academic Year 2019-2020

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of pediatric residency program, please use a separate application for each program. The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by 8PM may subject the institution to a Citation and Fine.

SponsorinCI Facilitv: Chino Vallev Medical Center

Address: 5451 Walnut Avenue, Chino, CA 91710

Phone: 909-464-8600 I Email: iarrod0517®nmail.com

PMSR - Podiatric Medicine and Surqerv Residency , Residency Program Type:

IV PMSR / RRA- Pediatric Medicine and Surqerv Residency I Reconstructive Rearfoot /Ankle

Does the SponsorinCI Facilitv: Yes No

Jal Meet the aeneral (institutional) reauirements of the ACGME? ✓ (bl Have a Director of Medical Education? ✓ (c) Provide residents emergency medical training through ER rotations? ✓ (d) Measure & evaluate progress of residents? ✓ (e) Measure & evaluate program effectiveness? ✓

Aooroved by the Council on Pediatric Medical Education? ✓ Date of Last CPME site visit: November 10, 2017

Signatures:

Proaram Director: ( ) .,,. '!. A ~d s~.,,. -: ~ I z;;/J}n, Printed Name: ta'arrod Shapiro, c:5PM

Date: 4/3/19 I Phone: 909-706-3892 I Email:[email protected]

Director of Medical Education: ~ / 2,.-' Printed Name: ~-u!IIJJ{ l,\f«nA-- v"'() y'-\~IV'\...

Date: u I toll~ /I I Phan;· 'l o l 'ff -!:J"'Z,fj" \ lG,e, I Email: i·bh,ch;,,ie_,p\'i~ ,✓ ,

Facility I Hospital Administrator: '\ii~/' ,//~---- ·,

Tim Moran, CEO , - ,..,,

Printed Name:

Date: 4/10/19 I Phone: I Email:

2005 Evergreen Street, Suite 1300 I Sacramento, CA 9S815-3831 I P (916) 263-2647 I F (916) 263-2651 www.bprn.ca.gov

Pm

~'

ATTACHMENT C

24

STATE OF CALIFORNIA • BOARDOF ·~ • Edmund G. Brown Jr.

PODIATRIC' MEDICINE'-,



Governor

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of podialric residency program, please use a separate appficatloo for each program, The Board wHI not issue a Resldenrs License to any resident participating in an institutloo's residency program until the resldency program application has been submitted and approved by the Board and the resident has met all necessary requirements, Unlicensed residents participating in programs that are not approved by BPM may subject the institution to a Citatloo and Ane.

,. ·····--··-"------- ...... - -····. -- .. . ----------"' ..... ··--······--. . ____ ,. •••-""• •••• OOM,O•• -·· ----' .... --- ,. _____ --~ .. --··-•·- .... ,., _________ ....

Soonsorlna Facllitv: :Dv~ ~ 1-,os IJ,._,, ..... ,; -Address: \lilol Wi.\sh..:rc- ~1-,A_ ~. .,r: .. • ~1'\al, 1-A...,'"½ """ ~3

Phone: •"" ~bi' i6"4'1 Email: t>~. Ao>-"-"'.> VA, &ov Pl>iSR - Podiatric Medicine and Suroerv Res/dencv Residency Program Type:

V PMSR / RRA- Podlalric Medicine and Sum""' Residencv / Reconstructive Rearfoot /Ankle Does the Snnnsorlna Facilitv: y~ No

la) Meet the aeneral (institutional) reaulrements of the ACGME? cpr.-.e.. ✓/ lh\ Have a Director of Medical Education? ✓ ./' (cl Provide residents ernergencv medical trainlno throuoh ER rotatloos? ✓-(rl\ ' ✓ Measure & evaluate l'Mllress of residents? (el Measure & evaluate effectiveness? ✓/

Annroved by the Council on Podlatrlc Medical Educatlon? ✓ Date of Last CPME site visit ol.011-f -- --- --····- ,,,,____ -- .. -· -- .. .,_ ... __ ., .. -- ···-·· .. . - ··---······- .. --··--···"~---- . -----•··--···· ------ ··--••><-, .. ···---·· ----· .. - , .... Sia natures: L/./ ........---Prnnram Director: CA - - 1 .1, L\uiu!. qc

Printed Name: -Date: 4 fol 1"\ ' ~Phone: ,1,<Q 1'-'it 2.s,-0 I Email: t>Avu,,A~ Z) •---• .. --------- .. .... ·- ·-· - -···-····-·· .. ·-·-····-··-- - .. -·--·--·- ·······----- .. ---«·- ,.,, . -------- ,,,. ... -·--Director of Medical Educatlon(.l ~ - \ I • ,~ ,. ,,;

Printed Name: A,JK, ✓ 1+ ·,1.~ "..11 .. _\_ - ':b.,n')-., ·- ~ ,I I

Date: -+ l,rvl 19 / I j, P"4e~ IC>'!, QI 'bl ~ { I Emaii:a.~,., r,aA',. J .•. 1 ----------· •--·-···· -···•. ·--···· -- ...... ·-·-·· .... ---· .. ---- -· •.. --· .• -·-·~ ··--•-·· ----· .,.- ... ·- .. , .. ,-----•- ., Facilitv / Hosoltal Admlnlstrat/ ~ "· . ., rk -Printed Name: Date: I Phone: I Email:

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 I F (916) 263-2651 www.bpm.ca,gov

1,

d

ATTACHMENT C

25

2019-05-01 16:47 Lexmar 510 555 1212 >>

STATE OF CAllFORNIA ~

Poo,i~;.~ f' MEDICINE\

Application for Approval Residency Programs In California

Academic Year 2019·2020

& Edmu11dG,BrownJr. w GOV@rnot

Please complete the application and return to our office no later than May 1, 2019. If your insUtuUon offers more than one type of podiatrio residency program, please use a separate application for each program. Th• Ooarrl will not issue a Re~denrs Llcenso lo any resldool participaling in an lnslilution's residency program until the residency program ap~icalion has been submitted and approved by the Board and the resident has niot all necessary requirements. Unlicensed residents parUcipallng in programs tnat are not approved by 8PM may subject lhe institution to a Citation and Fine.

",., .. ~- . ,• ., .... , .•. , ...... SoonsorlnaFacllllv: OYA - s"'V\ fro- A,•\<:.Lo Address: '\\S"O C\e\M{v'l.\ ';:,-\,,-ee;\:, '?CA·· Fr<AII\C1.c:c.o (A 'I'll:!.\ Phone:'-\ \5'- 22.\ • '-\ll1 O <')(~ 2.'~S-( ,· I Email: 0..f 1M o-vi . ¼'1 .,..,,,_1,~ ·, ct v, "'iv,, , ,, -· I Rosldency Program Type: •

L--------'--'-'P-"M"'SR"'"'/ R"-R"'-A-Podialric Medicine and Suroiw Resldencv / Reconslruotive Rearfoot /Ankle - ~ ~

{J PMSR • Pediatric Medicine and ~,_,,,uro,ee=.vR::::e::,sd,,,ee,n""'.L-----------<

Does the s·•nsorinn Facilitv:

la\ Meet the general (instilutional)rnquirements of Iha .~.:.:Cc::G::.::M:::.E?'---------+---'✓'---4----J fb\ Have a Direclor or Medical Education? ✓ fol Provid~residents emet}lency medio<i training through ER rota/ions? ✓ 1"' Measure & evaluate nronress ofresidenls? ✓ l-...1!!L.!!!2!!-~!!1!'!======.!._ ------.. ·------1-----11---__J le\ Measure & ovaluale ,~_000_, "'ram=e"'ffe=ct'-'lve"'n"'es~s?'--------------+--'V __ +----I

~proved by the Council on Podlatrl~:;.M::::•d::::ic;:•:..:I Ec,:d.:,:Uc;:a,,,tlo,,,n"-? _________ __Jc_,/:____, __ --1 DateofLastCPM~sitevisit: 3)10) ;:l.O/b

·~l~~:t~;.:: . ····•·· J .• j; ; .. .. . ······•······· .. , .. ,,. ____ ·_--_·_···_··_··_·-_ .. _·_···_· ._ ... _ .. _ .. ll@g.@!11 Director: · ·• /ln Tl/iJ& /J.Ii.fo.1// --

PrlntedNamo: An'A"-V\ \L:,'4'-?o,;·itl"' , or1\I\

P 1/1

Date: 'JI 11·1 I'\ ·1 Phone:l\lf· '2.1-\ -'-lg\ o z.,1,~I Email:c,J~'-'.'·"-)<t,\/.Q ?•A~.' V<\• ~w ~lr~~t;, oi~~d;~; t~~:;i~;: ~n i.- ~~ ·:: ' TJ}· . .. ,_ · . ··· · · ·· · · ...... , ..

~~te: .. 11~~ \,',\ .... •r .. ...... l~h~n~:'+l~ ~li-~IO)(;'/tJi}Email:.':-~ ~(/a)Li<,BN Facitilv / Hw ital Admlnistralol: /.I , • - · U · • , · • PriniedName: '73o~·- ,.., f::rt"lta"'1 Date: '(/ 307 I q I Phone: 4/1' - '15r. • 'o'i I I Email:bo.,.,,,. - 1 · , . J

ions ~vergreen Street, Suite 1300 I Sar.ramento, CA 9S815-3831 f P (916) 263-2647 I F (916) 263-1651 www,bs,ni.ca,11,ov

ATTACHMENT C

26

Type text here

STATE OF CALIFORNIA •

BOARDOF ~

PODIATRIC ' MEDICINE'



Ed mund G. Brown Jr. Governor

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of podiatric residency program, please use a separate application for each program. The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by BPM may subject the institution to a Citation and Fine.

VA Palo Alto Healthcare S stem Address: 3801 Miranda Avenue Palo Alto, CA 94304 Phone: 650-493-5000 ext 67524 Email: [email protected]

PMSR - Podiatric Medicine and Sur e Residenc Residency Program Type: r-1-----------~~--~---------------, PMSR / RRA- Podiatric Medicine and Sur e Residenc / Reconstructive Rearfoot /Ankle

Does the S onsorin Facilit : Yes No

X

X

c Provide residents emer enc medical trainin throu h ER rotations? X

Measure & evaluate ro ress of residents? X

e Measure & evaluate ro ram effectiveness? X

A roved b the Council on Podiatric Medical Education? X

Date of Last CPME site visit: 10/7/2016

Si natures:

Pro ram Director: C Printed Name: Chatra Klaisri

Date: '--\ e,/ \9 Email: chatra.k\[email protected]

Date: Email: r~~ '1 .Pc,()

F acilit / Hos ital Administrator:

Date: Phone: (pS O ~q ?> · 5M!O

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 I F (916) 263-2651 www.bpm.ca.gov

ATTACHMENT C

27

STATE OF C/11.IFORNIA 4.J& E!OARD OF .-7

PODIATRIC ~ MEDICINE t



• Edmund G, Brown Jr, Go11emor

Please complete the application and return to our office no later than May 1, 2019. If your Institution otters more than one type of podiatric residency program, please use a separate application for each program. The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by BPM may subject the Institution to a Citation and Fine.

Phone: /12&? £6

Email: {? rJ c,, " · f½ ~I/,

Residency Program Type: PMSR - Pediatric Medicine and Sur e Residenc

MSR I RRA- Podlatric Medicine and Sur er Resldenc I Reconstructtve Rearfoct /Ankle Yes No

c Provide residents emer enc medical trainin

Measure & evaluate ro ress of residents?

e Measure & evaluate r ram effectiveness?

Date: ~ 2)0("j Phone CJO"'J-5t':3- 005 Email: J<A-P.P,NtYc£·f,S. rJoN VA, GoV

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 I F (916) 263-2651 www.bpm.ca,gov

ATTACHMENT C

28

, ' '"'"'' '~ BOAROOF ~

PODIATRICI MEDICINE'



• -~--.,"- Edmund G Brown Jr Governor


Phone:\\'\ l\ '"'\ l \JI:::)

Residency Program Type: Residenc / Reconstructive Rearfoot /Ankle

Yes No

✓

V throu h ER rotations?

V v

A

Date of Last CPME site visit:

Si natures:

Date: Email :

2005 Evergreen Street, Suite 1300 I Sacramento. CA %815-3831 IP (916) 263-2647 I F (916) 263-2651 www bpm.ca.gov

ATTACHMENT C

29

,i t.",I ) .. '' f,'1

£lQ,\fll)i)f

PODIATRIC ~f MELJICINE '



Please complete the application and return to our office no later than May 1, 2019.

,,

If your institulion offers more than one type of pediatric residency program, please use a separate application for each program, The Board will not issue a Resident's License to any resident participating In an Institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by 8PM may subject the institution to a Citation and Fine,

/L,u s e.r t??-'~ O'Yl ~,+.J- tJ o..Wa f-'=="-"--!."'----'-"""'"·~~ g /,, J oa.kL«.J c,4 1'-lt:t 1

Phone: 'Sfo -?so> -t,lio5· Email: c,i,..r:s~. f/1, k-•\:5§~1"-'-'"'--'l-------1

R 'd P T PMSR - Pediatric Medicine and Sur er Residenc es1 ency rogram ype: -.. .. ____ _ _ . . . PM$g I RRA - Podiatric Medicine and ~UJ§le.ry Residenc / Reconstructive Rearfool /Ankle

Yes No

✓

Provide residents emergency medical training llJ.r.Q.ll0=h-=E"'R""roc.:la"'lio:e.nc:.s?,__ _____ __,f--"'-~+----Measure & evaluate r ress of residents?

Date of last CPME site visit: Ma. rdJ.,. &-0 I "I

.,,'.'.', t:p,,

ATTACHMENT C

30

BOARD OF

PODIATRIC\ MEDICINE



Edmund G. Brown Jr Governor


Phone: ~11 '-& 11'-f - '-f { 5

Residency Program Type: PMSR / RRA - Podiatric Medicine and Sur e Residenc / Reconstructive Rearfoot /Ankle

Does the S onsorin Facilit : Yes No

a Meet the eneral institutional re uirements of the ACGME?

Have a Director of Medical Education? X c Provide residents emer enc medical trainin throu h ER rotations? ;(


e Measure & evaluate ro ram effectiveness? ;<

A roved b the Council on Podiatric Medical Education?

Date of Last CPME site visit: cJ.,o / ::J--Si natures:

Pro ram Director:

Email: $tl ,1tl:. , Shtuov1 J ft.-p. fY:}l

2005 Evergreen Street, Suite 1300 I Sacramen to, CA 95815-3831 J P (916) 263-2647 J F (916) 263-2651 www.bp111 .ca.gov

ATTACHMENT C

31

2019-04-22 14:32 educational services 4088513839 >> P 1/2

'

srATE OF CALIFORNIA ~· BOARDOF ;fijjijl' • Edmund G. Brown Jr,

PODIATRIC~ MEDICINE'



Governo,

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than 011e type of podlatrlo residency program, please use a separate application for each program, The Board will not issue a Resident's License lo any resident particlpat'lng in an institution's residency program unfll the rasldency program application has beim submitted and approved by the Board and the resident has met all necessary requirements, Unlicensed residents participating In programs that are not approved by BPM may subject the lnstllutlon to a Citation and Fine,

Resldenc / Reconstructive Rearfoot/Ankle Yes No

Printed Name: GH12.lS B()

Date: l1 Z-0 I IJ Phone:-'lCfo , 61;7I • 4 I 1.D

200s Evergreen Street, Suite 1300 I Sacramento, CA 95B15-3831 I P 1916) 263-2647 I F 1916) 263,2651 www.bpm.ca.gov

ATTACHMENT C

32

~}Tl'ill Of CAUFOFHUA ,..-~~

BOARD OF -,w";lV

PODIATRIC i~ MEDICINE'

~ Edmund G. Brown Jr. w Govemor



Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of podiatric residency program, please use a separate application for each program, The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements, Unlicensed residents participating in programs that are not approved by BPM may subject the institution to a Citation and Fine,

Saonsorina Facillhl: Kaiser Permanente Medical Center Vallejo

Address: 975 Sereno Drive

Phone: 707-651-5033 I Email: Rey,[email protected]

Residency Program Type: PMSR - Podialric Medicine and Suroerv Residencv

X PMSR / RRA- Podiatric Medicine and Suraerv Residencv / Reconstructive Rearloot /Ankle

Does the s~nsorina Facilihl: Yes No

/al Meet the aeneral linstitutionall r00uirements of the ACGME? X

/bl Have a Director of Medical Education? X

/ct Provide residents emeraen"' medical trainina throuah ER rotations? X

ldl Measure & evaluate nrooress of residents? X

/el Measure & evaluate nmnram effectiveness? X

Annroved bv the Council on Podlatric Medical Education? X

Date of Last CPME site visit: I~ 20 /)3

Slanatures: / t • ~ /

Prnnram Director:'- .J'. \!\ 1'....,,

Printed Name: Gray William~ DPM

Date: 4/3/2019 I Phone: 707-651-;3338 I Email:[email protected]

Director of Medical Education: 1G, n., - d 1,-../. AJ. m /) Printed Name: Kathryn Holder, MD

Date 'i / q f :Z6 I '7 I Phone: 7 o, -bi:;-1 - 'i b0h l Email: kathryn.k.holder@k; , org

Facilitv / Hosni1al Administrator: / -• -. ' Printed Name: Norair Jemjemian

Date: '1 /'\.,.'-( /wtCf I Phone: I Email: norair.jemjemianrc .

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 I F (916) 263-2651 www,bpm.ca.gov

kp.org

ATTACHMENT C

33

STAU OF CALIFORNIA

BOARD OP

PODIATRIC MEDICINE



•

EdmundG.BrownJr, Governor

Please complete the application and return to our office no later than May 1, 2019. If your institutioo offers more than one type of podiatric residency program, please use a separate appllcatloo for each program. The Board will not Issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. UnMcensed residents participating in programs that are nbt approved by 8PM may subject the institution to a Citation and Fine.

Date:

/ Recoostructive Rearfool /Ankle Yes No

✓

--r: £1t.b/-µe.d.i I l'Mn--2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P {916) 263-2647 ) F {916) 263-2651

www.bpm.ca.gov

ATTACHMENT C

34

STATE QF Ct\l!FORN!A # po01irr:1cf' MEDICINE\.



•

EdmundG,BrownJr, Governor

Please complete the application and return to our office no later than May 1, 2019. If your Institution offers more than one type of podlatrlc residency program, please use a separate appncatlon for each program. The Boal'd win not 1$$11e. ·a Residerit's ~nse to any resident participating In an insUwtion's residency prqgram unBI the residency prog'rilln . $ppl/caflon has been sul1milted ~nd apprQved by the Board and the resident has met all necessaiy requirements. l:lnficensed residents pa(li<lipailng In plograms that are not approved by liPM may ®bject th61nstttotioh to a Cltatlon and Fine.

Rearfool/Ankle Yes No

A .>< Date of Last CPME site visit:

2005 Esergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 I F (916) 263-2651 www.bpm.ca,gov

ATTACHMENT C

35

.... - - ..... ~: :, - .r,,,>1'' -

BOARDOF -:-< PODIATRIC j MEDICINE '



Edmund G. 8row11 Jr . Govc)rnor


PMSR / RRA - Pediatric Medicine and Sur e Residenc I Reconstructive Rearfoot /Ankle Yes No

A roved b the Council on Podiatric Medical Education?

Si natures:

Pro ram Director:

Printed Name: L Date: 5 '2- i ~ Email: I V'l\.o l / @ Co/'f\lc.sJ. e.+

Email: r1

Printed Name:

Date:


ATTACHMENT C

36

STATE OF CALIFORNIA ,?

PODIAT;IC f MEDICINE'



~ Edmund G. Brown Jr. • Governor

RECEIVED APR OS 2019

MEDICAL EDUCATION SCRIPPS MERCY HOSPITAL

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of podialrlc residency program, please use a separate application for each program, The Board ~II not Issue a Resident's License to any resident participating in an Institution's residency program until the residency program applcation has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents partlclpattng in programs that are not approved by BPM may subject the institution to a Citation and Fine,

- 7;)~~ Email·


ATTACHMENT C

37

'.TAf '; ' ~.. . • ,A BOARD OF ...,

PODIATRIC i ~ MEDICINE'



Edm, rnrJ G. Brown J, . Governor

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of podiatric residency program, please use a separate application for each prog ram. The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by BPM may subject the institution to a Citation and Fine.

Residency Program Type: t--t-;------- --- ~~--~ ------- - - - - --,

Date:

/ Reconstructive Rearfoot /Ankle Yes No

a Meet the eneral institutional re uirements of the ACGME?

Have a Director of Medical Education?

c Provide residents emer enc medical trainin throu h ER rotations?


2005 Evergreen St, eet, Suite 1300 I s~cramento, CA 95315-3331 I P (916) 263-2647 I F (916) 263-2651

www .bpm.ca .gov

ATTACHMENT C

38

Apr 1119,01 :28p Alan Snyder, D.P.M. 3236669784 p.1

BOARD OF

PODiATRIC -~ MEDICINE'

Application for Approval Residency Programs in california


l ..irnnd C,. ~"'"'··,.-:;i ::;·, ,:_,:,,,:era=,;r

Please complete the application and return to our office no later than May 1, 2019. If }'-Our iristitution offers more than one type of podialric resiclercy µ-ogram, please use a separate ~plicoooo for each program. The Board will not issue a Resident's License to any resident parti~ng in an institution's residency program ll'ltil the resideooy program ~lication has been Slbrrilted and app,wed by the Board and the resident has met an necessary re(llirements. Unicensed residents partici~ng in programs that ...., not a~ by 8PM may st.t,jecl the institution to a Citatioo and Fine.

c~.

I Recaistructive Rearfoot /Ankle Yes No

irements of the ACGME?

h ER ro1alions?

Date of Last CPME site visit:

Si res:

Pr

Phone '32.3

Date:

ATTACHMENT C

39

ST/He OF CALIFORNIA &-~\/? BOARD OF ~,d

PODIATRIC~ MEDICINE~



• Edmund G. Brown Jr, Governor

Please complete the application and return to our office no later than May 1, 2019. If your Institution offers more than one type of podiatrlc residency program, please use a separate application for each program, The Board will not issue a Resident's License to any resident participating in an Institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements, Unlicensed residents participating in programs that are not approved by 8PM may subject the Institution to a Citation and Fine,

Have a Director of Medical Education?

c Provide residents emer enc medical trainin

v ✓

A roved b the Council on Podlatrlc Medical Education?

Date: Phone /;'Ji,. 50.;)..-iC,', 0 Email:

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 I F (916) 263-2651 www.bpm,ca.gov

ATTACHMENT C

40



• Edmund G. Brown Jr, Governor

Please complete the application and return to our office no later than May 1, 2019. If your institution offers more than one type of pediatric residency program, please use a separate application for each program. The Board will not issue a Resident's License to any resident participating in an institution's residency program until the residency program application has been submitted and approved by the Board and the resident has met all necessary requirements. Unlicensed residents participating in programs that are not approved by BPM may subject the institution to a Citation and Fine.

Residency Program Type: Hf--'--'='------'-===========--------------1 / Reconstructive Rearfoot /Ankle

Yes No

X

Date of Last CPME site visit: I <'I I 'O

Date:

2005 Evergreen Street, Suite 1300 I Sacramento, CA 95815-3831 I P (916) 263-2647 [ F (916) 263-2651 www.bpm,ca.gov

ATTACHMENT C

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Documents

CALIFORNIA BOARD OF PODIATRIC MEDICINE BOARD MEETING … · 07/06/2019 · Maria Cadenas, MBA : RECOMMENDATION : Receive and file the status update report on Licensing Unit activity