MPPDA 2014Presidential Address

Russ Kolarik, MDMPPDA National Meeting

April 10, 2014

• MPPDA.org

• 2014 Match Results

• 2012 ABIM and ABP Results

• Accreditation for Pediatric Hospital Medicine

• The first year of the NAS

2013-14 Year in Review

MPPDA.org

• First year of new web resource for our organization.

• Will briefly review site at the end of the day today. Please review it today and subscribe.

• Designed as a comprehensive information hub for everything you should need to access quickly as a Med-Peds PD.

MPPDA.org

• All feedback about the site, however small is highly welcomed!

• info@mppda.org goes directly to me. Please email me.

• Please take a moment to send your name, institution and academic rank to me at info@mppda.org

2014 Med-Peds Match Results

2014 2013 2012

Total # of Programs 79 77 77

Total Positions Offered  374 366 366

Total Positions Filled  362 363 344

Fill Rate 96.8% 99.2% 95.0%

% of Positions filled by US Graduates (MD)

75.9% 85.2% 76.2%

2014 Med-Peds Match Results

2014 Med-Peds Internal Medicine Pediatrics Family

MedicineTotal # of Programs 79 408 194 480

Total Positions Offered

374 6,524 2,640 3,109

Total Positions Filled

362 6,465 2627 2,977

Total # of Unfilled Positions

12 59 13 132

Total Unfilled Programs 7 21 4 64

2014 Med-Peds Match Results

2014 Med-Peds Internal Medicine Pediatrics Family

MedicineTotal # of Applicants 582 11,236 3,993 5,999

Total # of US Graduates Applying

334 3,762 2,065 1,664

Fill Rate 96.8% 99.1% 99.5% 95.8%Positions filled by US Graduates

75.9% 48.5% 68.9% 45%

2014 ERAS Data

• Applicants that applied to at least 1 Med-Peds program:

• US Allopathic applicants was 439 down from 468 total in 2013.

• US Osteopathic applicants 65 (14.8%) up from 48 in 2013 (10% of total).

Conclusions and Next Steps

• The total number of candidates applying to Med-Peds decreased from 603 in 2013 to 582 in 2014, but is still higher than the 560 in 2012.

• Local recruiting efforts are needed to promote our specialty.

• Get involved with NMPRA and creating Med-Peds Student Interest Groups

2012 ABIM Results

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2005 2006 2007 2008 2009 2010 2011 2012

InternalMedicineIM-Peds

2012 ABP Results

Conclusions and Next Steps

• We have some breathing room, but still need to pursue board preparation aggressively with our at-risk residents.

• Maintaining equivalence with categorical programs is VITAL for our specialty.

• To compare favorably at this rate, only 40 MP residents nationwide can fail the ABP, and 56 the ABIM.

Board Preparation for at risk residents

• At risk residents include those with USMLE I less than 220, or ITE in final year of training of less than 65%

• 14 respondents to survey for up to four at-risk residents per program.

• Roughly 50% of respondents reported mandating resident-specific study programs for at-risk residents that involve additional board study and questions.

Board Preparation for at risk residents

• About 50% of respondents also said that they would recommend that they would recommend deferring the ABIM for at risk residents so they could focus on passing the ABP.

• About 30% did not counsel either way because the decision is up to the resident.

• 20% counseled them to take both exams.

From the PD Survey

• 43% of programs use the USMLE scores to determine residents at risk for failing the board certification exams, 79% use the ITE’s, and 43% use other or personal reasons.

• 72% who were identified at risk passed the ABIM, and 71% passed the ABP.

Next Steps

• We should know who our high risk residents are.

• We should take a personal interest in our at-risk passing their boards, starting as early in training as possible. Reach out to other programs and the MPPDA for assistance.

Accreditation for Pediatric Hospital Medicine

• JCPHM: Joint Council for Pediatric Hospital Medicine has initiated the application process for acreditation.

• Applying for an accredited two-year pediatric hospitalist fellowship that if approved would start in about 6 years time.

Intended impact

• Standardize care for pediatric inpatient clinical diagnoses.

• Focus on specialized clinical services and procedures for hospitalized children.

• Emphasis on healthcare systems, quality leadership and advocacy

Intended Impact

• Develop leaders in pediatric hospital medicine at academic medical centers and community hospital medical directors.

• Not intended to restrict ability of general pediatricians or Med-Peds physicians to practice hospital medicine in academic or community settings.

Potential unintended effects

• Board certification may ultimately become standard for medical staff offices hiring new hospitalists or leaders.

• Concern about grandfathering criteria for current Med-Peds hospitalist who see proportionately fewer pediatric patients.

Potential unintended effects

• Could potentially limit scope of employment opportunities for general pediatrics or Med-Peds graduates wishing to pursue jobs as hospitalists.

• Effectively increases training time to 6 years for Med-Peds graduates wishing to work primarily as hospitalists. Medical students are already inquiring about this as a significant concern.

Current proposal

• I am working to make criteria for grandparenting to sit for boards as encompassing as possible for current Med-Peds hospitalists.

• I have also proposed a one-year pediatric fellowship option for Med-Peds trainees that may or may not be combined with adult hospital or transitional care activities.

Follow-up

• Will share data with JCPHM leadership.

• Need for Med-Peds representation on Committees and at society meetings.

• Jen O’Toole is conducting a hospitalist workforce survey inquiring about recent graduates. PLEASE complete this survey.

Next Accreditation System

• First year of using the Milestones, implementing Clinical Competency Committees, and CLER visits.

• First reporting of Internal Medicine and Pediatric Milestones to the ACGME in May/June.

• Need to share experiences – website and listserve.

Next Accreditation System

• Need for ongoing Med-Peds representation with national organizations and feedback regarding milestone evaluation process.

• Need to share assessment and evaluation tools to help track milestones and other outcomes of training.

• Just one last thing….– I invite each of you, think of just ONE thing

you can do when you go back home after this meeting is over that will help the specialty of Med-Peds.

– Take a moment, write down one thing that you are going to do and the date you plan to do it. When you are successful, let the rest of us know.