ir residency update - msu radiology · 2017-01-12 · integrated ir residency programs • 62...
TRANSCRIPT
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IR Residency Update Chuck Ray, MD, PhD
University of Illinois COM
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Acknowledgement
Vicki Marx, M.D.
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IRs as clinicians. • Perform inpatient consultations • Operate outpatient clinics • Admit patients • Provide focused clinical care
with longitudinal follow-up
Interventional Radiologist
IRs as specialists. • Interventional oncology • Women’s health • Venous disease • Peripheral arterial disease • Pediatrics
Evolution of IR
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Imaging Procedures
Patient care
IR
2012 ABMS specialty status (IR)
Evolution of IR
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ABMS ACGME
IR be recognized as a unique specialty …
with a unique training program
Approved 2012 Approved 2014
Evolution of IR
IR IR/DR
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Clinical Care in IR
?
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Clinical Care in IR
Periprocedural care Specific activities - Before, during, and - Outpatient clinic after procedures - Inpatient service - Focused care related - Admitting service to procedure - MutiD conferences
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Clinical Care in IR
Smouse H. Seminars in IR 2006; 23; 305
Evaluation and Management (E&M) Coding
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Clinical Care in IR
Evaluation and Management (E&M) Coding
Khan N. JVIR 2005; 16: 1753
Kwan S. JVIR 2012; 23:887.
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Clinical Care in IR in the Age of Health Care Reform
How to provide clinical care: - Safely - Efficiently - With high quality
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Clinical Care in IR in the Age of Health Care Reform
How to provide clinical care: - Safely - Efficiently - With high quality
High Quality Low Cost
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Interventional Radiologist
• To facilitate optimal patient care in IR • To provide trainees with the tools they need to deliver this care - as imagers, proceduralists, and clinicians
Purpose
New training program
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• Greater focus on clinical care: outpatient clinics, inpatient consultation and admission, and critical care • More time to master the procedural and clinical domains of IR (1 additional year) • New opportunity for trainees to enter into IR from medical school
Key Elements
IR Residency
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• Maintain core competency in DR • Not extend length of training • Bring people in from medical school but also allow entry from DR • Do not leave any (many) programs behind
While at the Same Time …
IR Residency
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• DR programs, PDs: big/small - with or without IR fellowship
• Department chairs • IR programs: big/small
- with or without DR - ratio of DR residents to fellows
Recognize Many Stakeholders
IR Residency
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• All current IR training programs must convert to the new system • Within 5-7 years (2020)
Comply with ACGME Mandate
IR Residency
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• Fortuitous advent of the new ABR exam paradigm
- Frees up the 4th year for electives Nevertheless, designing a system that meets the stated objectives and that will work for (almost) everyone has been a challenge.
IR Residency
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RRC Tasks • Program Requirements • FAQs • Application Forms • Procedure Logs • Milestones
IR Residency
Site visits and review
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Integrated Program - Medical school match - Internal DR transfer
Independent Program - DR graduate - ESIR 2nd year entry
Clinical Internship
IR Residency
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ESIR
• DR programs wishing to provide residents with sufficient IR training to qualify for advanced entry into the 2nd year of an Independent IR residency must have prior approval from the RRC for their ESIR training program: −DR programs must specify the IR training that the ESIR
resident will receive in PGY2-5 (12 IR or IR-related rotations and 500 procedures)
−DR programs must have adequate IR facilities and personnel to provide IR training.
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SlLIDE FROM Midwest Chairs 2016
Current ACGME Accreditation Status Integrated IR Residency Programs
• 62 applications for Integrated IR programs have been submitted to ACGME
• The RRC approved 8 programs during the Nov 2015 meeting – These are eligible to participate in the next NRMP
Match cycle (Match Day in March 2016)
• More program approvals will take place at the RRC meetings in Jan and April 2016
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The approved integrated programs are: Brigham U Michigan U Pennsylvania U Kansas MGH Georgetown Washington U Vanderbilt
SLIDE FROM Midwest Chairs 2016
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SLIDE FROM Midwest Chairs 2016
Current ACGME Accreditation Status Integrated IR Residency Programs • ACGME will begin consideration of applications
for Independent residency sometime in 2016 – date TBA
• Departments with approved integrated programs will submit a shortened application. – Site visits will be limited to programs that have not
been site visited for an integrated program • To ensure no gap in graduation of trainees after
June 30, 2020, it is recommended that applications be submitted by July 1 2017.
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Current status of training programs Current training programs entering the match
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Current status of training programs Current training programs entering the match
• 61 accredited programs entering the 2017 match • ~120 positions • ~40 ESIR programs
– Most plan on taking internal PGY 3-4 residents
• Handful of Independent programs applied for accreditation. None certified. All will launch simultaneously on July 1, 2020
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Current status of training programs Current training programs entering the match – 2017 data • 558 applicants • 418 US medical grads • ~2/3 applying for both IR and DR
residency spots
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What are our own data?
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What are our own data?
0
1
2
3
4
5
6
7
8
9
10
Yes No Pending
10
4
2
Currently approved program?
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What are our own data?
0
1
2
3
4
5
6
7
8
9
10
Yes No
10
0
Participating in 2017 Match
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What are our own data?
0
1
2
3
4
5
6
7
8
9
#1 #2 #3
3
9
2
Positions per PGY5/6 year
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What are our own data?
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Converted DR spots Converted DR and fellowshipspots
New GME funding New Dept funding
5
4 4
1
How will spots be funded?
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What are our own data?
0
1
2
3
4
5
6
7
2018 2018-2019 2019 2019-2020 2020 Unknown
1 1
2
1
7
2
When will fellowships be phased out?
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What are our own data?
0
2
4
6
8
10
12
Yes No Probably Unsure
11
2 1 1
Will you apply for independent residency positions?
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What are our own data?
0
1
2
3
4
5
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7
8
9
10
Yes Pending approval No
10
5
1
ESIR?
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Interventional Radiologist
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Thanks for your attention! About the picture…ask David