Subspecialty Clinical Training & Certification Initiative

Association of Pediatric Program Directors March 29, 2012

Rob Spicer • Cardiology Fellowship P.D. Cincinnati, 2002-2012 • Chief of Cardiology, Children’s Omaha, 3/1/12 • SPCTPD Board Member 2006-2011 • CoPS Cardiology Representative 2007-current • CoPS Executive Committee Member 2010-current

A.P.P.D. 2012

MISSION

The Council of Pediatric Subspecialties

advances child health through

communication and collaboration within its

network of pediatric subspecialties and

liaison organizations.

VISION

All pediatric subspecialties working

together for optimal child health.

VALUES

As an organization, we embrace:

•Collaboration

•Responsiveness

•Diversity

•Transparency

Strategic plan 2011-15

www.pedsubs.org

Subspecialty Clinical Training and Certification History

• July 2010; Invitational conference sponsored by the ABP Foundation(80 attendees,

14 specialties, ABP, ACGME, and others • May 2011; CoPS to assist ABP with Initiative • Chicago, July 2011; Spicer to lead CoPS

involvement with L. Van Marter, M. Punaro, & CoPS Ex. Com.

A.P.P.D. 2012

SCTC Initiative

• Announcement by ABP of SCTC initiative on 7/1/11

• Task Force conference calls monthly since 9/16/11

• ABP presentations to AAP, ABP sub-boards, AMSPDC

A.P.P.D. 2012

Timeline for the Subspecialty Clinical Training and Certification Initiative

Date Meeting Date Meeting

Oct-Dec 2011 ABP Subboards June 1-4, 2012

ABP Long Range Planning Committee & BOD

Oct 10, 2011 CoPS, Chicago Sept 21-23, 2012 ABP Subboard Chairs & BOD

Oct 14, 2011 AAP BOD, Boston Oct 3-5, 2012 APPD Fall Meeting

Oct 23-26, 2011 RC for Pediatrics, Chicago Oct 14-17, 2012 RC for Pediatrics

Nov 12, 2011 COPE Oct 19, 2012 AAP BOD

Jan 30, 2012 FOPO Fall 2012 CoPS

Feb-Apr 2012 ABP Subboards Fall 2012 Task Force Meeting

Feb 25-26, 2012 ABP BOD Jan 2013 FOPO

Mar 2-5, 2012 AMSPDC (CoPS leadership to attend)

Feb 2013 ABP BOD

Mar 29 – Apr 2, 2012 APPD (CoPS leadership to take lead role in organizing workshop)

Mar 2013 RC for Pediatrics

Apr 15-18, 2012 RC for Pediatrics Apr 2013 APPD

Apr 27 – May 1, 2012 PAS, CoPS, AAP Exec Committee May 4-7, 2013 PAS / CoPS

May 2012 Subspecialties Committee & Task Force Joint Meeting

May 2013 Task Force & Subspecialty Committee Joint Meeting

June 2013 ABP BOD

A.P.P.D. 2012

Timeline of SCTC Initiative

Spring 2012 Meeting with Stakeholders FOPO, AMSPDC, AAP, APPD, ACGME, PAS

May 2012 Task Force meets to review survey results and feedback from stakeholders

Fall 2012 Task Force begins to formulate specific recommendations

Spring/Summer 2013 Finalize recommendations

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SCTC Initiative

Charge to the Task Force: The Task Force will: a) examine the current model of pediatric subspecialty fellowship training and certification with emphasis on competency-based clinical training b) recommend changes in the current requirements if warranted.

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SCTC Initiative CHEAR

• ABP has contacted Child Health Evaluation and

Research Unit @ U of M • Gary Freed, MD, MPH is “collecting information

regarding perceptions of optimal fellowship training in 14 subspecialties.”

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SCTC Initiative Today

A.P.P.D. 2012

• Determine the ideal communication vehicles for optimal dialogue

• Begin evaluation and discussion of The Initiative • Gain support throughout the subspecialty

community to insure grassroots involvement

SCTC Initiative Building the Network

• Communications

• Creating an effective 2-way informational network

• Who?-What?-How? lists

• CoPS web site/ABP web site

• Social Networking

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SCTC Initiative

Issues Under Consideration

• What is good about the current requirements for fellowship training and what should be preserved?

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SCTC Initiative

Issues Under Consideration

• How closely should training align with the diversity of

professional practice in a subspecialty? • Should the requirements be flexible? • If more flexibility is desirable, what specifically is meant

by this notion?

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SCTC Initiative

Issues Under Consideration

• How should each discipline determine its core

competencies (clinical, procedural, scholarly)?

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SCTC Initiative Issues Under Consideration Alignment with Professional Practice

• Is the expectation for a scholarly experience with a Scholarship Oversight Committee (SOC) important to retain?

• Does a trainee need to create new knowledge to understand the principles of evaluating new knowledge?

• Could there be a purely clinical track?

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SCTC Initiative Issues Under Consideration

Flexibility & Career Orientation

• Should training in different subspecialties vary in length with a shorter minimum requirement (e.g., two years?)

• Should tracking in fellowship be explored (e.g., extended research training, clinical educator tracks, advanced clinical tracks, etc)?

• Should non-core clinical time be more flexible? For example: incorporating advanced clinical training or third-tier competencies

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SCTC Initiative Issues Under Consideration

Core Competencies

• Are entrustable professional activities (EPAs) a better

way to understand and evaluate competence in subspecialty training?

• Is a Clinical Oversight Committee (CLOC) a desirable addition to the requirements for subspecialty training?

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SCTC Initiative Issues Under Consideration

Certification Issues:

• What is the purpose of certification? • Should the ABP require specific documentation of

clinical competence in subspecialties performing high-risk procedures (as with surgical boards?)

• Should the length of training and requirement for scholarship be based on the nature of discipline?

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SCTC Initiative Issues Under Consideration Certification Issues:

• Should third-tier competencies incorporated into core training be recognized with a credential or a certificate that reflects differences in training?

• How would “niching” in advanced clinical training in subspecialties change the cognitive examination and the certificate awarded?

• Are there subspecialties in which maintenance of certification in general pediatrics is essential?

A.P.P.D. 2012

Thanks